Underserved - links at this site and others

The McLennan County FP Program

The following were the responses of Community Connections (SEARCH Program) faculty to questions posed by Robert Wood Johnson regarding Primary Care:

1. From your own experience...what are three of the greatest challenges/needs that the field of primary care faces today. Please list in priority order, with one being the greatest need.

Greatest need:

Primary Care's failure to meet the needs of underserved patients, particularly those at high risk of death or disability. Primary care practitioners can often identify these patients, but have no means of improving their chances of success in health or in life. This involves

1. basic access to care

2. development of innovative methods of identifying at risk patients

3. the need for innovative interventions

What do you think needs to be done for each of the challenges you listed AND who (groups, individuals) should be responsible for meeting these challenges.

Comprehensive health education for practitioners that begins with students in the at risk populations and extending throughout health training and out into the practice of these graduates, with liberal doses of exposure to and working with underserved populations, community leaders, and those with a passion for caring for the underserved. Example: Continuous Rural Medical Education for rural family doctors extending from before high school and far beyond just recruitment to rural practice.

Find practitioners with a passion for those patients and the ability to work with others, assist these practitioners with the development of management skills during and after formal training, gather them together to practice and perfect their methods, and fund them to apply these techniques as they adapt them to the local populations at risk.

The challenge is identifying principal investigators that can demonstrate that their primary motivation is passion for those at risk rather than the need just to support themselves or their infrastructure.

The innovative interventions will be developed by the above plan of collaborative discussions and work groups led by primary care practitioners held in conjunction with those responsible for resource distribution. Administrators and patients should be represented and in many cases should take leadership roles as well.

3. What would you like the Robert Wood Johnson Foundation to do (please be specific) to help meet any of the challenges listed above.

Identify, support, and gather these individuals and help train more replacement individuals rather than just attempting to duplicate successful programs that may longer be appropriate to the tremendous variety of at risk populations that are also constantly changing. Terminate relationships with individuals, groups, and institutions that seek dollars primarily rather than devoting their lives and resources to individuals and groups in need.

Robert C. Bowman, M.D., STFM Group on Rural Health