There’s a section in the November 13 edition of NEJM that’s currently gratis OA: Perspective roundtable: redesigning primary care, by Thomas H Lee, Thomas Bodenheimer, Allan H Goroll, Barbara Starfield, and Katharine Treadway, N Engl J Med 2008(Nov 13); 359(20): e24 [PubMed Citation] [HTML]:
U.S. primary care is in crisis. Primary care physicians must care for more and more patients, with more and more chronic conditions, in less and less time, for which they are compensated far less than subspecialists. They must absorb increasing volumes of medical information and complete more paperwork than ever, as they try to function in a poorly coordinated health care system. As a result, their ranks are thinning, with practicing physicians burning out and trainees shunning primary care fields. In a roundtable discussion moderated by Dr. Thomas Lee, four experts in primary care and related policy — Drs. Thomas Bodenheimer, Allan Goroll, Barbara Starfield, and Katharine Treadway — explore the crisis, as well as possible solutions for training, practice, compensation, and systemic change.
For some additional comments, see: The doctor is out? by Cervantes, Stayin’ Alive, November 18, 2008.