Institute of Medicine Releases Primary Care Study

On March 12, 1996, the Institute of Medicine released its long awaited report, "Primary Care: America's Health in a New Era."

The report calls for fundamental changes to "improve and expand primary health care in the United States."

The report's detailed strategy recommends:

• Establishing a set of common proficiencies in primary care practice for all trainees regardless of the discipline.

   

• Adopting uniform methods and measures to monitor the performance of health care systems and individual clinicians in delivering primary care.

   

• Obtaining support from all public and private health care payers for education and training in health professions.

   

• Using payment methods that promote primary care, in order to reimburse physicians and other health care providers.

   

• Stimulating action by state governments to eliminate or reduce restrictions that prevent collaborative practice with nurse practitioners and physician assistants in providing primary care services.

   

• Establishing a primary care research infrastructure that would include a lead federal agency, data collection standards and a national data base, and research networks of primary care practices for studying the health care and health status of patients in 'real-world' settings.

The report also redefined primary care: "The provision of integrated, accessible, health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of the family and the community."

While this report does not address chiropractic specifically, it does offer a specific set of criteria for primary care. In addition, nurses and physicians assistants are being given greater consideration in the delivery of primary care.

The recommendations made in this report may now be used in chiropractic colleges and by individual DCs to better adapt to the evolving role that primary care is playing in all forms of health care delivery. The debate on chiropractors as portal-of-entry/primary-care providers has been given new information for consideration and reaction.