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Book and Media Reviews
June 2, 2010

Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-first Century

JAMA. 2010;303(21):2192-2196. doi:10.1001/jama.2010.741

Practice Under Pressure could not be more timely. Primary care is the foundation of a high-value, equitable health care system. Yet as the United States prepares for the most radical health reform since Medicare, primary care is in trouble. Insight into the daily work of primary care physicians (PCPs) is needed to turn this crisis into an opportunity.

Timothy Hoff, a sociologist at University of Albany School of Public Health, has written a concise, compelling examination of the work of primary care based on integration of qualitative data and published quantitative findings. Hoff interviewed 88 PCPs, residents, and students, as well as 2 nonphysician leaders. The book's power emanates from these narratives. It is organized into 3 sections: the work of primary care, the people doing it, and primary care reform.

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