Perspective

Perspective Roundtable

Redesigning Primary Care

Thomas H. Lee, M.D., Thomas Bodenheimer, M.D., Allan H. Goroll, M.D., Barbara Starfield, M.D., M.P.H., and Katharine Treadway, M.D.

N Engl J Med 2008; 359:e24November 13, 2008

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Contributors

U.S. primary care is in crisis. Primary care physicians must care for more and more patients, with more and more chronic conditions, in less and less time, for which they are compensated far less than subspecialists. They must absorb increasing volumes of medical information and complete more paperwork than ever, as they try to function in a poorly coordinated health care system. As a result, their ranks are thinning, with practicing physicians burning out and trainees shunning primary care fields. In a roundtable discussion moderated by Dr. Thomas Lee, four experts in primary care and related policy — Drs. Thomas Bodenheimer, Allan Goroll, Barbara Starfield, and Katharine Treadway — explore the crisis, as well as possible solutions for training, practice, compensation, and systemic change.

A video of the discussion and reader comments can be seen at www.nejm.org.

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Citing Articles (4)

Citing Articles

1. 1

   A. Gray, S. Goodacre, M. Seah, S. Tilley. (2010) Diuretic, opiate and nitrate use in severe acidotic acute cardiogenic pulmonary oedema: analysis from the 3CPO trial. QJM 103:8, 573-581
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   Kurt C. Stange, Paul A. Nutting, William L. Miller, Carlos R. Jaén, Benjamin F. Crabtree, Susan A. Flocke, James M. Gill. (2010) Defining and Measuring the Patient-Centered Medical Home. Journal of General Internal Medicine 25:6, 601-612
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   Eli Y. Adashi, Philip A. Gruppuso. (2010) Commentary: The Unsustainable Cost of Undergraduate Medical Education: An Overlooked Element of U.S. Health Care Reform. Academic Medicine 85:5, 763-765
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   Mohan Nadkarni, Siddharta Reddy, Carol K. Bates, Blair Fosburgh, Stewart Babbott, Eric Holmboe. (2010) Ambulatory-Based Education in Internal Medicine: Current Organization and Implications for Transformation. Results of A National Survey of Resident Continuity Clinic Directors. Journal of General Internal Medicine
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