The development of competitive markets for health services and the shift to the provisions of services through large-scale organizations are having a profound effect on academic health sciences centers. The teaching programs based at the University of Minnesota Hospital and Clinic are threatened as health maintenance organizations restrict…

A geriatric health maintenance program, started as a community medicine elective and now an innovative model in humanistic health care, is described. Junior and senior medical students act as live-in facilitators of comprehensive health care for the elderly tenants in publicly subsidized housing units. (Author/MLW)

Major considerations that bear upon the capacity, dimension and distribution of institutions for the education of medical manpower and improvement of our nation's health services. (Editor/IR)

In 1981 the Robert Wood Johnson Foundation provided funds to 20 teaching hospitals to support health services to high-risk adolescents (young people living in communities with high rates of pregnancy, drug abuse, alcohol abuse, accidents, homicide, suicide, and depression). The experiences of these institutions are described. (Author/MLW)

Proper programs must be created to train physicians specifically educated to provide comprehensive medical care. (IR)

Defines a health system model and proposes a set of hypotheses relating the health system to health outcome. (Editor)

Joseph Dorsey describes the development of the Harvard Medical School service program now serving 40,000 members in two health centers. Planning considerations for developing the primary care residency are included. Arnold Relman discusses the role of internal medicine and pediatrics in training primary care physicians noting subspecialization…

Medical residency programs that offer student support groups and have taken other steps in support of residents' adjustment are reviewed. Options for program development that are flexible and convenient and offer psychological and social support are suggested for programs not already offering them. (MSE)

Two surveys show that the use of prepaid health care plans for educational purposes is rising. A review of published studies that have examined the costs of such training is included. (Author/MLW)

Prepared for delivery at 81st Annual Meeting of the Association of American Medical Colleges in Los Angeles, California, November 1, 1970, on the problems of organization of the academic health center. (IR)

The reasons for the University of Michigan's decision to end development of a health maintenance organization are outlined from its different perspectives as an employer, health care provider, and medical school. Among the considerations were employee attitudes, insurance costs, competition, and revenue sources of the medical school. (MSE)

A pilot program at the University of California, Davis, that incorporated skilled nursing facility training into the required curriculum of their primary care internal medicine residency is described. The goal was to increase the residents' knowledge in the care of geriatric patients. (MLW)

Lists issues in planning primary care education, e.g. fear of dilution of excellence, competition for resources, delivery of care, the teaching objective, M.D. and new health professional, benefit and service structure, financial structure, physical and administrative locus, marketing. Emphasis is on coordination of educational research, and…

The primary care pediatric residency program at the Dartmouth-Hitchcock Medical Center has developed a training program in rural primary care. Residents experience the many facets of rural practice and are introduced to community-oriented approaches to child health care. (Author/MLW)