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Supplement: The Future of Primary Care |

Defining the Future of Primary Care: What Can We Learn from Patients?

Dana Gelb Safran, ScD
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From The Health Institute at Tufts-New England Medical Center and Tufts University, Boston, Massachusetts.

Acknowledgments: The author thanks Angela Li for dedicated assistance in the preparation of this article and Hong Chang, PhD, for analytic support.

Grant Support: The Massachusetts Study of Primary Care Performance and the Study of Choice and Quality in Senior Health Care was supported by grant R01 HS08841 from the Agency for Healthcare Research and Quality and grant 035321 from the Robert Wood Johnson Foundation. The Study of Choice and Quality in Senior Health Care was supported by grant R01 HS09622 from the Agency for Healthcare Research and Quality and the National Institute on Aging. A previous version of this article was commissioned by the Robert Wood Johnson Foundation for the Future of Primary Care Conference (held in Glen Cove, New York, October 2001).

Requests for Single Reprints: Dana Gelb Safran, ScD, Division of Clinical Care Research, The Health Institute, Tufts-New England Medical Center, 750 Washington Street, NEMC #345, Boston, MA 02111.

Ann Intern Med. 2003;138(3):248-255. doi:10.7326/0003-4819-138-3-200302040-00033
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From the earliest definitions of the term primary care to the most recent, all have stressed that primary care is predicated on a sustained relationship between patients and the clinicians who care for them (15). Most definitions have indicated that the primary care provider can be a single clinician or team and have not delineated particular clinical disciplines to which primary care belongs. Beyond the requirement for sustained clinician–patient relationships, primary care has been defined to encompass the following essential elements: accessibility, continuity, integration, a whole-person orientation, comprehensiveness, and clinical management (15). Drawing on information obtained from adults nationwide, I examine the status of primary care relationships in the United States, identify key strengths and limitations as experienced and reported by patients, and propose possible directions for improving performance and outcomes in primary care.

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