Jonathan Showstack, PhD, MPH; Nicole Lurie, MD, MSPH; Eric B. Larson, MD, MPH; Arlyss Anderson Rothman, PhD, MHS, FNP; Susan Hassmiller, PhD, RN
Acknowledgments: The authors thank the participants at The Future of Primary Care meeting, Glen Cove, New York, October 2001, who helped form and focus some of the ideas presented in this paper.
Note: The opinions and suggestions presented are those of the authors and may not necessarily represent those of other participants, the authors' own institutions, or the Robert Wood Johnson Foundation.
Grant Support: By grant 039940 from the Robert Wood Johnson Foundation.
Corresponding Author: Jonathan Showstack, PhD, MPH, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118-1944.
Current Author Addresses: Drs. Showstack and Anderson Rothman: University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118-1944.
Dr. Lurie: The RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202.
Dr. Larson: University of Washington Medical Center, 1959 North East Pacific Street, Box 356330, Seattle, WA 98195.
Dr. Hassmiller: The Robert Wood Johnson Foundation, Route 1 and College Road East, Princeton, NJ 08543-2316.
Three decades ago, a renaissance helped create the foundations of primary care as we know it today. In recent years, however, new challenges have confronted primary care. We believe that the current challenges can be overcome and may, in fact, present an opportunity for a new renaissance of primary care to address the needs of our population.
In this paper, we suggest seven core principles and a set of actions that will support a renaissance in, and a positive future for, primary care. The seven principles are 1) Health care must be organized to serve the needs of patients; 2) the goal of primary care systems should be the delivery of the highest-quality care as documented by measurable outcomes; 3) information and information systems are the backbone of the primary care process; 4) current health care systems must be reconstructed; 5) the health care financing system must support excellent primary care practice; 6) primary care education must be revitalized, with an emphasis on new delivery models and training in sites that deliver excellent primary care; and 7) the value of primary care practice must be continually improved, documented, and communicated.
At the start of the 21st century, a vital, patient-centered primary care system has much to offer a rapidly changing population with increasingly diverse needs and expectations. If we keep the needs of persons and patients clearly in sight and design systems to meet those needs, primary care will thrive and our patients will be well served.
Jonathan Showstack, Nicole Lurie, Eric B. Larson, Arlyss Anderson Rothman, Susan Hassmiller. Primary Care: The Next Renaissance. Ann Intern Med. 2003;138:268–272. doi: 10.7326/0003-4819-138-3-200302040-00036
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Published: Ann Intern Med. 2003;138(3):268-272.
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