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Notes

INTRODUCTION

1. Gerard F. Anderson, Jeremy Hurst, Peter Sotir Hussey, and Melissa Jee-Hughes, “Health Spending and Outcomes: Trends in OECD Countries, 1960– 1998,” Health Affairs, 2000; 19(3):150–157. [BACK]

2. World Health Report 2000. Available at: http://www.who.int/whr, accessed February 26, 2001. See also Barbara Starfield, “Is US Health Really the Best in the World?” Journal of the American Medical Association, 2000; 284:483–485. [BACK]

CHAPTER ONE

1. Fitzhugh Mullan. “The Mona Lisa of Health Policy: Primary Care at Home and Abroad,” Health Affairs, 1998; 17(2):118–26. [BACK]

2. Primary Care: America's Health in a New Era, ed. Molla S. Donaldson, Karl D. Yordy, Kathleen N. Lohr, and Neil A. Vanselow (Washington, D.C.: National Academy Press, 1996), p. 1. [BACK]

3. Institute of Medicine, A Manpower Policy for Primary Health Care (Washington, D.C.: National Academy of Sciences, 1978), pp. 16–20. [BACK]

4. There is a considerable body of literature on the cost, quality, and patient satisfaction related to primary care. Particularly useful in this regard is chapter 3 entitled “The Value of Primary Care” in Primary Care: America's Health in a New Era, ed. Donaldson et al.; Barbara Starfield, Primary Care: Balancing Health Needs, Services, and Technology (New York: Oxford University Press, 1998); and chapter 1 entitled “What Is Primary Care?” in Eric J. Cassell, Doctoring: The Nature of Primary Care Medicine (New York: Oxford University Press/Milbank Memorial Fund, 1997). [BACK]


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5. Barbara Starfield, “Primary Care and Health: A Cross-National Comparison,” Journal of the American Medical Association, 1992; 268:2032–2033. [BACK]

6. Avedis Donabedian as quoted by Fitzhugh Mullan in “A Founder of Quality Assessment Encounters a Troubled System Firsthand,” Health Affairs, 2001; 20(1):138. [BACK]

7. Peter M. Senge, The Fifth Discipline: The Art and Practice of the Learning Organization (New York: Doubleday Currency, 1990) p. 3. [BACK]

8. Important sources on the history of primary care in the context of the medical system in general are Rosemary Stevens, American Medicine and the Public Interest (Berkeley and Los Angeles: University of California Press, 1971; 1998), and Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982). The later chapters of John Duffy, The Healers: A History of American Medicine (Urbana: University of Illinois Press, 1976), are also helpful. The essays in John D. Stoeckle and George Abbott White, Plain Pictures of Plain Doctoring: Vernacular Expression in New Deal Medicine and Photography (Cambridge: MIT Press, 1985), tell a great deal about rural medicine in the pre–World War II period—particularly the chapter entitled “Primary Care in the 1930s” (pp. 52–80). [BACK]

9. Committee on the Cost of Medical Care, Medical Care for the American People: The Final Report of the Committee on the Cost of Medical Care, Publication No. 28 (Chicago: University of Chicago Press, 1932), p. 63. [BACK]

10. American Medical Association, Directory of Approved Internships and Residencies, selected years as cited by Stevens, American Medicine, and the Public Interest, p. 393. [BACK]

11. Kerr White, T. Franklin Williams, and B. G. Greenberg. “The Ecology of Medical Care,” New England Journal of Medicine, 1961; 265:885–893. [BACK]

12. This discussion of the history of family medicine is drawn from Family Practice: Creation of a Specialty: A Narrative of Events Leading to the Establishment of the American Board of Family Practice in 1969 and Reminiscences of Men Who Were on the Scene (Kansas City, Mo.: The American Academy of Family Physicians, 1980); Stanley R. Truman, M.D., The History of the Founding of the American Academy of General Practice (Kansas City, Mo.: Warren H. Green, Inc., and the American Academy of General Practice, 1969); R. Neil Chisholm, “The History of Family Practice” in Family Medicine: Principles and Practice, ed. Robert B. Taylor (Kansas City, Mo.: Springer-Verlag, 1978) pp. 7–12; and David P. Adams, “Evolution of the Specialty of Family Practice,” Journal of the Florida Medical Association, 1989; 76:325–329. [BACK]

13. For a more complete discussion of the history of the nurse practitioner and physician assistant professions please see chapter 3 of this volume, “The New Clinicians.” [BACK]

14. Association of American Medical Colleges, AAMC Data Book: Statistical Information Related to Medical Schools and Teaching Hospitals, January, 1999. Table B-13, p. 31. [BACK]

15. The Registered Nurse Population, March 2000: Findings from the National Sample Survey of Registered Nurses—March 2000 (Washington, D.C.: Department of Health and Human Services, Health Resources and Services


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Administration, Bureau of Health Professions, Division of Nursing), p. 50.This survey indicates that as of the year 2000, 102,829 individuals had received formal preparation as nurse practitioners; 91,591 of them were employed in nursing; and 58,512 were working in positions with the title of nurse practitioner. I have chosen to cite this latter figure in the text since it most nearly corresponds to the number of nurse practitioners working in that capacity. [BACK]

16. American Academy of Physician Assistants, Information Update, October 8, 1999, Alexandria, Va., p. 3. [BACK]

17. Sarah Brotherton, Frank Simon, Sandra Tomany, “U.S. Graduate Medical Education, 1999–2000,” Journal of the American Medical Association, 2000; 248:1121–1126. [BACK]

18. Robert M. Wachter and Lee Goldman, “The Emerging Role of ‘Hospitalists’ in the American Health Care System,” New England Journal of Medicine, 1996; 335(7):514–517. [BACK]

19. A. Fernandez, K. Grumbach, L. Goitein, K. Vranizan, D. H. Osmond, A. B. Bindman, “Friend or Foe?: How Primary Care Physicians Perceive Hospitalists,” Archives of Internal Medicine, 2000; 160(19):2902–2908. [BACK]

20. Mary O. Mundinger et al., “Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial,” Journal of the American Medical Association, 2000; 283:59–68. [BACK]

CHAPTER THREE

1. Joel Alpert, “The Ambulatory Pediatric Association,” Pediatrics, 1995; 95 (3): 422–426. [BACK]

2. John Noble, Lee Goldman, Sandra Marvinney, and David Dale, “The Society for General Internal Medicine from Conception to Maturity: 1970s to 1994,” Journal of General Internal Medicine, 1994; 9(8) (Supplement):S1–S44. [BACK]

CHAPTER FOUR

1. Henry K. Silver, Loretta C. Ford, and S. G. Stearly, “A Program to Increase Health Care for Children: The Pediatric Nurse Practitioner Program,” Pediatrics, 1967; 39:756–760; Henry K. Silver, Loretta C. Ford, and L. R. Day, “Pediatric Nurse Practitioner Program,” Journal of American Medical Association, 1968; 204:298–303; and Loretta C. Ford, “Nurse Practitioners: History of a New Idea and Predictions for the Future,” Nursing in the 1980s, ed. Linda Aiken (Philadelphia: J. B. Lippincott Co., 1982). [BACK]

2. U.S. Congress, Office of Technology Assessment, Nurse Practitioners, Physician Assistants, and Certified Nurse Midwives: A Policy Analysis (Washington, D.C.: U.S. Government Printing Office, 1986), and P. C. Myers, D. Lenci, and M. G. Sheldon, “A Nurse Practitioner as First Point of Contact for Urgent Medical Problems in a General Practice Setting,” Family Practice, 1997; 6: 412–417. [BACK]

3. The Registered Nurse Population, March 2000: Findings from the National Sample Survey of Registered Nurses (Washington, D.C.: Department of


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Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing), p. 50. For further information on this figure, see chapter 1, n. 15. [BACK]

4. Edward Sekscenski, Stephanie Sansom, Carol Bazell, Marla Salmon, and Fitzhugh Mullan, “State Practice Environments and the Supply of Physician Assistants, Nurse Practitioners, and Certified Nurse Midwives,” New England Journal of Medicine, 1994; 231:1266–1271; and L. J. Pearson, “Annual Update of How Each State Stands on Legislative Issues Affecting Advanced Nursing Practice,” Nurse Practitioner, 1999; 24:16–19, 23–24, 27–30. [BACK]

5. C. L. Hudson, “Expansion of Medical Professional Services with Non-Professional Personnel,” Journal of American Medical Association, 1961; 176: 839–841. [BACK]

6. Useful reflections on the history of the physician assistant profession include Ronald Berg, “More Than a Nurse, Less Than a Doctor ,” Look, September 6, 1966; Reginald D. Carter, “Socio-Cultural Origins of the P.A. Profession,” Journal of the American Academy of Physician Assistants, 1992; 9:655– 662; C. E. Fasser, “Historical Perspectives on P.A. Education,” Journal of the American Academy of Physician Assistants, 1992; 5:663–670; Steven Cornell “Once Upon a Time: Longtime P.A.s Talk about the History of the Profession,” Advance for Physician Assistants, July 2000, pp. 48–50; and Marianne Mellon, “P.A. Profile: Looking Backward,” P.A. Today, September 28, 1998, pp. 20–30. [BACK]

7. American Academy of Physician Assistants, Information Update, October 8, 1999, Alexandria, Va., p. 3. [BACK]

CHAPTER FIVE

1. The earliest history of the HMO movement is captured by Paul de Kruif's Kaiser Wakes the Doctors (London: Jonathan Cape, 1944). Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), gives a good description of the early modern HMO movement (pp. 393 ff.), and R. Adams Dudley and Harold S. Luft, “Managed Care in Transition,” New England Journal of Medicine (2001; 344:1087–1092), provides a review of the evolution of managed care through the late 1990s. The primarycare gatekeeper phenomenon is well explored in two articles: Kevin Grumbach et al., “Resolving the Gatekeeper Conundrum: What Patients Value in Primary Care and Referrals to Specialists,” Journal of the American Medical Association, 1999; 282: 261–266; and Thomas Bodenheimer, Bernard Lo, and Lawrence Casalino, “Primary Care Physicians Should Be Coordinators, Not Gatekeepers,” Journal of the American Medical Association, 1999; 281: 2045–2049. [BACK]

CHAPTER SEVEN

1. I am indebted to Clayton Christensen, Richard Bohmer, and John Kenagy who present this thesis in an article entitled “Will Disruptive Innovations Cure Health Care?” Harvard Business Review, September–October, 2000, pp. 102–112. [BACK]


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