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

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…

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…

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)

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…

Ambulatory care undergraduate medical education from 1979-91 is examined and two major problems are found: (1) difficulties in transfer of educational techniques from hospital to ambulatory care setting; and (2) problems in definition of ambulatory care, primary care, and community-oriented primary care. A framework for planning education and…

Evidence is presented to support the development of the nursing home as a required clinical educational site. Analogies and differences between the nursing home and the hospital in medical education are explored as a means of understanding the potential and limits of the nursing home's role in medical education. (Author/MLW)

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)

Concerns about health care costs and quality are focusing increasing attention on physicians and their continuing medical education (CME). These concerns have produced several calls for "a new definition," "a new vision," "repositioning," "reinventing," and "transforming" CME. However, differences in conceptualizations and vocabularies have…

Through Medicaid, the Health Maintenance Organization Act (HMO), and Prepaid Health Programs (PHP) approaches were established whereby the government can help alleviate the medical problems of the needy. A program to educate and train students in California in the philosophy, administration, and development of PHP was developed in response to…

This paper focuses on decentralized and regionalized health professional education programs (D/R HPEPs) as a means of affecting the health manpower distribution problem. The discussion is intended to serve as background material for the development of a plan to evaluate D/R HPEPs. The ideas and observations presented are drawn from conference…

The evolution and structure of the plan is described, along with economic and political factors influencing its development. Comparison of faculty numbers, clinic earnings, salaries, and research funding since 1958 shows rapid initial growth followed by marked slowing of growth. State and federal funding changes have also had significant effects.…