SUSTAINING THE DEVELOPMENT OF PRIMARY-CARE IN ACADEMIC MEDICINE

This article is the report of the Working Group on Sustaining the Deve lopment of Academic Primary Care, one of the six subgroups of the Advi sory Panel on the Mission and Organization of Medical Schools (APMOMS) sponsored by the Association of American Medical Colleges (AAMC). To begin, the group draws a distinction between primary care and generali sm. Primary care is a core domain of health care and, in the context o f emerging integrated systems, will increasingly be a multidisciplinar y shared function, Non-subspecialized physicians, or ''generalists,'' are a key element in the provision of primary care, but do not act alo ne. Core competencies for primary care are central to the education of all physicians. Therefore, irrespective of workforce goals:for genera list physicians, primary care should have a strong, central position i n the medical school so that graduates can receive a sound general med ical education and can be prepared for any specialty and for lifelong learning in an evolving health care system. For primary care to achiev e that position, medical schools must integrate primary care into thei r missions, strategic plans, operation, organization, academic adminis trative structures, curriculum development, faculty development (both school-and community-based), resource development, alliances with appr opriate clinical services networks, financial policy, and evaluation a nd educational monitoring systems. The group briefly describes the ele ments of those changes and also proposes ways that the AAMC and medica l school leaders could promote the central role of primary care in med ical schools.