The Uncertain Future of Primary Medical Care
Authors: David Mechanic
Journal: Annals of Internal Medicine (2009)

Editorials7 July 2009The Uncertain Future of Primary Medical CareDavid Mechanic, PhDDavid Mechanic, PhDFrom Rutgers, The State University of New Jersey, New Brunswick, NJ 08901.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-1-200907070-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The United States needs a strong primary medical care capacity as we engage the challenges of health care reform, expand insurance coverage, and constrain medical costs without sacrificing quality. Research over decades has repeatedly demonstrated that primary care services that provide continuing access to care are associated with superior population health outcomes (1, 2). Nonetheless, the future of U.S. primary care is uncertain, many clinicians report high levels of frustration and dissatisfaction, and careers in primary care are increasingly unattractive to new medical graduates. In this issue, Linzer and colleagues (3) studied 422 family practitioners and general internists in 119 ...References1. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83:457-502. [PMID: 16202000] CrossrefMedlineGoogle Scholar2. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York: Oxford Univ Pr; 1998. Google Scholar3. Linzer M, Manwell LB, Williams ES, Bobula JA, Brown RL, Varkey AB, et al; MEMO Investigators. Working conditions in primary care: physician reactions and care quality. Ann Intern Med. 2009;151:28-36. LinkGoogle Scholar4. Mechanic D. Physician discontent: challenges and opportunities. JAMA. 2003;290:941-6. [PMID: 12928472] CrossrefMedlineGoogle Scholar5. Mechanic D. The organization of medical practice and practice orientations among physicians in prepaid and nonprepaid primary care settings. Med Care. 1975;13:189-204. [PMID: 1113557] CrossrefMedlineGoogle Scholar6. 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Mechanic D. Rethinking medical professionalism: the role of information technology and practice innovations. Milbank Q. 2008;86:327-58. [PMID: 18522615] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Rutgers, The State University of New Jersey, New Brunswick, NJ 08901.Grant Support: By the Robert Wood Johnson Foundation.Disclosures:Stock ownership or options (other than mutual funds): McKesson.Corresponding Author: David Mechanic, PhD, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, 30 College Avenue, New Brunswick, NJ 08901; e-mail, [email protected]rutgers.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWorking Conditions in Primary Care: Physician Reactions and Care Quality Mark Linzer , Linda Baier Manwell , Eric S. Williams , James A. Bobula , Roger L. Brown , Anita B. Varkey , Bernice Man , Julia E. 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