February 1984

Attitudes of Internal Medicine Subspecialty Fellows Toward Primary Care

Author Affiliations

From the Department of Medicine, School of Medicine and the Department of Health Education (Dr Earp), Health Policy and Administration (Mr O'Malley), and Epidemiology (Drs Fletcher), School of Public Health, University of North Carolina, Chapel Hill.

Arch Intern Med. 1984;144(2):329-333. doi:10.1001/archinte.1984.00350140147021

• Subspecialists deliver a substantial proportion of primary care but little is known about how their training affects their attitudes toward this role. We surveyed a department of medicine to determine fellows' (N=34) attitudes toward primary care and how these compared with the attitudes of house staff (N=45) and faculty (N=66). Continuous, coordinated, and accessible care as departmental policy was almost unanimously endorsed by all physicians. In contrast, fellows less often supported the provision of such care for their own patients in actual clinical situations. Fellows were also less likely than either house staff or faculty to endorse primary care attributes for their own patients. Departments of medicine should examine how negative attitudes toward primary care develop in subspecialty fellows and whether these attitudes persist after fellowship.

(Arch Intern Med 1984;144:329-333)