The Future of Primary Care

The Future of Primary Care reports on the principles of organization and delivery of primary care to address the needs of our future population. The Future of Primary Care’s stellar panel of health care experts includes Barbara Starfield, Dana Gelb Safran, Bernard Lo, and Gordon Moore. They explore topics such as

· Current dilemmas and threats to primary care from both the clinician’s and patient’s point of view

· The impact of the self-care and alternative care movements

· The importance of improved information technologies

· Individual elements of primary care and the relative value of each element

· Primary care’s contribution to the overall health of our population

· Assessing alternative sites and circumstances where primary care may be provided

· The specialist and nurse as primary care providers

· The role of primary care in chronic illness management, care for the elderly, long term and home care

· Exploring recommendations for the future

Preface ix

The Authors xiii

Part One: Primary Care at a Crossroads 1

1 Primary Care in Crisis: Current Pressures and Threats to Primary Care as We Know It 3
Gordon T.Moore

2 Primary Care Performance: Views from the Patient 17
Dana Gelb Safran

3 The Internet, Complementary and Alternative Medicine, and Self-Care 40
Bernard Lo

Part Two: The Components of Primary Care: Processes and Providers 59

4 Deconstructing Primary Care 61
Barbara Starfield

5 Nontraditional Approaches to Primary Care Delivery 89
Helen Burstin, Carolyn Clancy

6 The Specialist as Primary Care Provider 109
Harry R. Kimball

7 Advanced Practice Nurses: The Preferred Primary Care Providers for the Twenty-First Century 120
Mary O’Neil Mundinger

Part Three: Reconstructing Primary Care for Patients and Populations 141

8 Is Primary Care Worthy of Physicians? An Ecological Perspective 143
Larry A. Green

9 Primary Care in a New Era: Disillusion and Dissolution? 161
Lewis Sandy, Steven Schroeder

10 Chronic Illness Management in Primary Care 180
Arlyss Anderson Rothman, Edward H.Wagner

11 Reconstructing Primary Care of the Elderly 203
Eric B. Larson

12 Palliative Care and Primary Care: Opportunities for Cooperation and Improvement 223
Christine Cassel, Beth Demel

13 Alcohol, Drug, and Mental Disorders, Psychosocial Problems, and Behavioral Interventions in Primary Care 243
Harold A. Pincus

14 Primary Care for Children and Adolescents 276
Michael Weitzman, Jonathan D. Klein, Tina L. Cheng

Part Four: Recommendations for the Future 299

15 Primary Care: The Next Renaissance 301
Jonathan Showstack, Nicole Lurie, Eric B. Larson, Arlyss Anderson Rothman, Susan B. Hassmiller

Name Index 313

Subject Index 320

"Overall the book is an excellent reference for those interested in primary care practice." (The Journal of Pharmacy Technology; 1/1/2005) Jonathan Showstack is professor of medicine and health policy in the Division of General Internal Medicine, Department of Medicine, and the Institute for Health Policy Studies, School of Medicine, University of California, San Francisco.

Arlyss Anderson Rothman is assistant professor in the School of Nursing, Department of Family Health Care Nursing, and researcher in the Institute for Health Policy Studies at the University of California, San Francisco.

Susan B. Hassmiller is a senior program officer at the Robert Wood Johnson Foundation.

The Future of Primary Care explores the organization and delivery of primary care to address the needs of our future population. Expert contributors include Barbara Starfield, Dana Gelb Safran, Bernard Lo, and Gordon Moore. They explore topics such as

• Current dilemmas and threats to primary care from both the clinician’s and patient’s point of view
• The impact of the self-care and alternative care movements
• The importance of improved information technologies
• Individual elements of primary care and the relative value of each element
• Primary care’s contribution to the overall health of our population
• Assessing alternative sites and circumstances where primary care may be provided
• The specialist and nurse as primary care providers
• The role of primary care in chronic illness management, care for the elderly, long-term and home care
• Exploring recommendations for the future

The Future of Primary Care offers a self-critical and constructive analysis of primary care that is perfect for scholars, faculty, and students who are interested in public health services and policy.