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October 1974

The Internist and Primary Care

Arch Intern Med. 1974;134(4):780-781. doi:10.1001/archinte.1974.00320220182030

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One of the major problems to be resolved for the future of internal medicine is to increase greatly its contribution to the delivery of primary care and not simultaneously forfeit its singular contribution to the development of important advances in clinical medicine. This is both a difficult and an urgent problem: difficult because the primary care activity and the investigative activity are widely separated in the spectrum of functions that internists perform; and urgent because the public—as represented by government at local, state, and federal levels—is pressing hard for more easy-access, low-cost primary care and looking skeptically at scientific research that does not have a specific contractual pay-off written into the terms of the financial support. Internal medicine, with its tradition for a highly analytic and therefore slower and more reflective health care pattern, is unsympathetically viewed by the cost-benefit analysts who want more health care at less cost. As

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