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March 11, 1983

The Case for Community-Oriented Primary Care

Author Affiliations

From the Departments of Social and Administrative Medicine and Family Medicine, School of Medicine, University of North Carolina, Chapel Hill.

JAMA. 1983;249(10):1279-1282. doi:10.1001/jama.1983.03330340021024

"COMMUNITY-oriented primary care" (COPC) is a new term being used to describe generically a style of medical practice already well represented in the United States and around the world. Recently, a conference of the Institute of Medicine (IOM) devoted itself to the COPC idea, examined past successes and failures, and debated possible strategies for further development.1 Drawing in part from that conference, I will attempt to explain the concept and some of the problems it faces and speculate on its future.

What It Is  Community-oriented primary care may be found in a variety of settings. The most familiar American examples are probably the neighborhood health centers that were part of the "war on poverty" of the 1960s.2,3 Most of these, and other sponsored programs that followed in the 1970s, adopted at least some elements of COPC.4-6 The concept is also represented in medical groups affiliated with health maintenance