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May 16, 1986

Training Primary Care Physicians for the 21st Century: Alternative Scenarios for Competitive vs Generic Approaches

Author Affiliations

From the Department of Family Medicine, School of Medicine, University of Washington, Seattle.

JAMA. 1986;255(19):2631-2635. doi:10.1001/jama.1986.03370190115035

THE TITLE of this article could well be "The Primary Care Problem Revisited." We are still struggling with the predictable sequelae of an oversupply of specialists and a shortage of primary care physicians despite serious attempts to address the problem. It is now 20 years since the publication of three major national reports that together served as the impetus for the development of family practice: the Millis, Willard, and Folsom reports.1-3

Each chronicled the increasing deficit of generalist physicians trained and committed to the practice of continuing, comprehensive, and personal health care. They called for redirection of the nation's medical education system to train larger numbers of generalist physicians. It is 16 years since the formation of the American Board of Family Practice in 1969 and more than ten years since the initiation of federal grants to encourage the training of increased numbers of family physicians, general internists, and