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Roots of the Present Primary Care Crisis

Roots of the Present Primary Care Crisis Abstract America's medical establishment is experiencing a "primary care crisis'—an extreme dissatisfaction with existing methods of primary patient care.1 No doubt this crisis is partly the result of an expansion of the definition of disease to include aspects of life, such as job failure and unhappiness, which are not well addressed in scientific medical terms. This trend has extended the social role of the physician and has led to the development of new specialties, eg, family practice.2 Another factor leading to the current "crisis" is the latest in a series of antiscience movements.3 American medicine has from its inception chosen the abstract concept of "science" as a means of obtaining social recognition. Benjamin Rush's early attempt to substitute "the simplicity of science" for (English) autocratic tradition is an example of this effort.4 The profession's early struggle for legitimacy through science met with strong social resistance, primarily due References 1. Rogers DE: Primary care: Some issues. Bull NY Acad Med 1977;53:10-17. 2. Kunitz SJ: The historical roots and ideological functions of disease concepts in three primary care specialties. Bull Hist Med 1983;57:412-432. 3. Toulmin S: The historical background to the anti-science movement , in Civilization and Science in Conflict or Collaboration? New York, Elsevier Science Publishing Co Inc, 1972, pp 23-32. 4. Starr P: A sovereign profession , in Starr P (ed): The Social Transformation of American Medicine . New York, Basic Books Publishers Inc, 1982, p 42. 5. Boorstin DJ: The businessman as an American institution , in Boorstin DJ (ed): The Americans The National Experience . New York, Vintage Books, 1965, p 123. 6. Rothstein WG: The rise of homeopathy , in Rothstein WG (ed): American Physicians in the Nineteenth Century . Baltimore, The Johns Hopkins University Press, 1972, p 153. 7. Shortt SED: Physicians, science, and status: Issues in the professionalization of Anglo-American medicine in the 19th century. Med Hist 1983;27:51-68.Crossref 8. Rogers DE: Medical academe and the problems of primary care. J Med Educ 1975;50:171-181. 9. Joyce HE: The view of a family physician. Bull NY Acad Med 1976;52:1115-1120. 10. Shils E: Anti-science movement , in Civilization and Science in Conflict or Collaboration? New York, Elsevier Science Publishing Co Inc, 1972, p 52. 11. Featherstone HJ, Petersdorf RG: The medical specialist as a primary care provider. Mt Sinai J Med 1978;45:620-627. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Roots of the Present Primary Care Crisis

Graner, John L.
Archives of Internal Medicine , Volume 146 (1) – Jan 1, 1986
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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360130052004
Publisher site
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Abstract

Abstract America's medical establishment is experiencing a "primary care crisis'—an extreme dissatisfaction with existing methods of primary patient care.1 No doubt this crisis is partly the result of an expansion of the definition of disease to include aspects of life, such as job failure and unhappiness, which are not well addressed in scientific medical terms. This trend has extended the social role of the physician and has led to the development of new specialties, eg, family practice.2 Another factor leading to the current "crisis" is the latest in a series of antiscience movements.3 American medicine has from its inception chosen the abstract concept of "science" as a means of obtaining social recognition. Benjamin Rush's early attempt to substitute "the simplicity of science" for (English) autocratic tradition is an example of this effort.4 The profession's early struggle for legitimacy through science met with strong social resistance, primarily due References 1. Rogers DE: Primary care: Some issues. Bull NY Acad Med 1977;53:10-17. 2. Kunitz SJ: The historical roots and ideological functions of disease concepts in three primary care specialties. Bull Hist Med 1983;57:412-432. 3. Toulmin S: The historical background to the anti-science movement , in Civilization and Science in Conflict or Collaboration? New York, Elsevier Science Publishing Co Inc, 1972, pp 23-32. 4. Starr P: A sovereign profession , in Starr P (ed): The Social Transformation of American Medicine . New York, Basic Books Publishers Inc, 1982, p 42. 5. Boorstin DJ: The businessman as an American institution , in Boorstin DJ (ed): The Americans The National Experience . New York, Vintage Books, 1965, p 123. 6. Rothstein WG: The rise of homeopathy , in Rothstein WG (ed): American Physicians in the Nineteenth Century . Baltimore, The Johns Hopkins University Press, 1972, p 153. 7. Shortt SED: Physicians, science, and status: Issues in the professionalization of Anglo-American medicine in the 19th century. Med Hist 1983;27:51-68.Crossref 8. Rogers DE: Medical academe and the problems of primary care. J Med Educ 1975;50:171-181. 9. Joyce HE: The view of a family physician. Bull NY Acad Med 1976;52:1115-1120. 10. Shils E: Anti-science movement , in Civilization and Science in Conflict or Collaboration? New York, Elsevier Science Publishing Co Inc, 1972, p 52. 11. Featherstone HJ, Petersdorf RG: The medical specialist as a primary care provider. Mt Sinai J Med 1978;45:620-627.

Journal

Archives of Internal Medicine – American Medical Association

Published: Jan 1, 1986

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