A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

The ambulatory care clerkship at the College of Human Medicine of Michigan State University has an extensive database of clerkship experiences including a catalog of students' clinical experiences, assessment of students' performances by the faculty, and students' evaluation of various aspects of the clerkship. (MLW)

The cycles of growth of the nursing profession depict subordination of nursing to hospital administration and medicine. Nursing is ready to move into an integrative, collaborative stage of development that places nurses directly responsible to patients, and this would facilitate nursing's response to clients' health concerns wherever they occur.…

A survey of 246 primary care and 90 academic physicians found that for the former, length of training, direct patient contact, and threats of malpractice suits were significant influences in career choice. For the latter, long-term research participation, intellectual stimulation, specialty content, and mentor or role model were more significant…

Generalist physicians of the future will need new knowledge and skills for continuous improvement of health care. Successful examples can be found in the work of generalist physicians who combine knowledge for improvement with discipline-specific knowledge to improve patient and community health. Curricula can be developed to teach students and…

This pilot study provides information on the effort required to conduct a telephone survey on access to care of persons with angina. Allowing for noncontact calls, refusal to participate, and ineligibility, the response rate for whites was 23.4% (2,724 of 11,559), and that of African Americans was 24.3% (2,003 of 8,242). (SLD)

From 1984-87, 12 pediatrics residents from the Yale University School of Medicine participated in a 3-year program emphasizing well-child care, developmental/behavioral pediatrics, chronic illness, and adolescent medicine. Participants performed better than others on interview skills and management of behavioral problems, but not in other areas.…

Despite the effectiveness of vaccinations in preventing disease, preschool children, particularly in the inner cities, are not being adequately immunized. Inadequate clinic staff and hours, inconvenient locations, prohibitive policies, and missed opportunities within the health care system may contribute to this problem. Suggests policy changes…

A method for training physicians in a simple, efficient, and effective smoking cessation counseling strategy consisted of lunchtime seminar, follow-up reinforcement session, and prompt sheet for use during counseling. The counseling strategy emphasizes individual motivation, assessing and addressing obstacles to quitting, drug therapy, contracting…

Background: Concerns have been raised about the quality of medical care available for people with intellectual disabilities in community-based services. The aims of this study were to evaluate a model of medical care developed during a programme of deinstitutionalization, based on a specialist physician supporting general practitioners (GPs).…

This article describes innovative service delivery models and clinical strategies that support the social-emotional development of young children and their families in the pediatric primary care setting. By understanding the trends affecting well-child care, early childhood providers will be better equipped to partner with their pediatric…

This directory identifies 254 Community and Migrant Health Centers (C/MHC) and Health Care for the Homeless (HCH) programs in 10 regions of the United States that, in response to local requests and with mostly local resources, developed either school-based or school-linked health programs. Each listing provides information under the following…

The availability of primary health care services is an growing concern of New York's rural citizens. Many rural country doctors are approaching retirement age, while most graduating physicians choose high tech specialties rather than primary care. In November 1989, a statewide conference examined the role of New York State medical schools in…

Conducting research in the field of public health care policy requires the use of many different materials in the library. This guide provides a bibliography of useful tools as well as a basic strategy to follow when researching a topic. The following tools are included in the guide: indexes and abstracts; books; statistics; government documents;…

This paper describes a small set of successful school-based clinics (SBCs) that provide primary health care services for the underserved and identifies factors contributing to their success. Six sites were selected on the basis of three general criteria: (1) direct involvement between the SBC and a federally-funded community health center (CHC);…