The descriptive literature on primary health care reveals an abundance of articles, without documentation, extolling or disparaging different forms of primary care. Experimental studies have measured the effects of making a clinic setting more comprehensive. Making a clinic more comprehensive decrea

Primary health care: a review of the literature through 1972.

The author reviews the development of the concept of patient-care and how doctors are changing their thinking about the type of care they render their patients. He starts with a historical perspective followed by a description of a parallel development, then, how this concept was re-discovered during this century and finally how it is new used in medical literature. The old medical model of specific responses and specific cures is just no longer adequate; there is n need for a patient-centred approach where the patient as n unique person in his complete environment is cared for.

Patient-Centred Care: A Review of the Concept

The trend in medicine has been towards specialization which promotes a philosophy that extensive knowledge of a limited field is necessary for competence. Little emphasis has been placed on behavioral sciences as an important aspect for assisting the specialty physician in dealing with patients. Family medicine reverses this trend by emphasizing a breadth of medical knowledge with inclusion of behavioral sciences as a part of training. Behavioral sciences contribute heavily to the education of the family physician in the areas of character, culture, and counseling. The results is a humanistic physician with excellent skills in patient management. The inclusion of behavioral sciences in family medicine places this specialty at the forefront of a new direction in medicine and may well be emulated by other medical specialties.

Family medicine: behavioral science contributions.

To the Editor.— The survey by Brown et al 1 of the clinical content of general practice in Massachusetts revealed that 78% of patients were cared for outside the hospital and 25% of patient visits were for health maintenance problems. It was apparently on findings such as these that the authors concluded that a different type of training would be needed for future family physicians. We are afraid your readers will be misled by this conclusion; the proposed "different" training is precisely the orientation of many current family practice residencies. The AMA Ad Hoc Committee of Education for Family Practice recommended: Emphasis (should be placed) upon the ambulatory patient, upon diseases of high incidence, chronic diseases, emotional and behavioral problems, preventive medicine, health maintenance, and rehabilitation. 2 The modern family practice residencies carry out the above recommendations through the use of a model clinic as a training facility. 3 Preliminary

Clinic Training of the Family Physician

This study describes final year medical student preference in a three month elective program at the University of British Columbia in Vancouver, during the years 1970-1975. The students showed increasing preference for the community hospital elective experience compared to the alternatives. In 1970-1971, 35 students out of a class of 60 chose the community hospital. From a class of 75, 59 students chose the community hospital in 1974-1975. Reasons for this student preference and educational opportunities in the community are discussed. We strongly urge some community based training for all students whatever their final destiny may be.

Student acceptance of two family practice teaching programs.

The American Board of Family Practice was established early in 1969. Family practice, as the nation's 20th specialty, was thus formally recognized as having a legitimate place in the health-care system. General practice was not discarded. Rather, the establishment of the American Board of Family Practice constituted a formal request to bring general practice up to date, to standardize its training program at a level equivalent to the other specialties, and to recognize competence and formal training by means of examination and certification. Thoughtful educators and physicians from many disciplines wrote and conferred for a decade in order to make a decision that would be the most appropriate for the consumers as well as the providers of primary medical care. Most any new name would have been fitting to symbolize the upgraded or specialty status of the new general practitioners. The label of family practice was chosen because it carried

Roger I. Lienke

Papers

The Family Practice Model in Health Education