Primary Medical Care in the United States: Present Status and Future Prospects

The steady decline in primary physicians in the United States is documented. The increasingly severe maldistribution of physicians is examined in relation to the effect this has on primary care. The effect on the poor, rural people, and minority group people is particularly serious. Four approaches to the solution of this problem are identified and discussed in some detail: an increase in the output of physicians, an increase in the supply and use of ancillary support personnel, reform in the organization of medical care, and the creation of a new specialty of family practice. Special attention is devoted to the likely contribution of the Neighborhood Health Center and Health Maintenance Organization movements to solution of current problems in primary medical care.