Graham Center Policy One-Pagers

These reports offer succinct summaries of research and perspectives pertinent to family practice advocacy and are produced by the Robert Graham Center: Policy Studies in Family Medicine and Primary Care in Washington, DC.

Dec 15, 2002 Issue
Family Physicians' Declining Contribution to Prenatal Care in the United States
A substantial decline in prenatal care by family physicians has occurred over the past 20 years in all geographic regions of the country. Even so, during the past two decades, family physicians and general practitioners (FP/GPs) have provided more than 2 million prenatal visits per year. As the field re-explores future scope, it should consider the erosion of the provision of prenatal care, its effect on the U.S. population and the specialty, and possibilities for revitalization of prenatal care in residency curricula and practice.

Dec 1, 2002 Issue
Family Physicians Are the Main Source of Primary Health Care for the Medicare Population
Of people 65 years and older who reported an individual provider as their usual source of health care, 60 percent identified a family physician or general practitioner. The Medicare population relies heavily on family physicians.

Aug 15, 2002 Issue
Title VII Funding is Associated with More Family Physicians and More Physicians Serving the Underserved
Title VII funding of departments of family medicine at U.S. medical schools is significantly associated with expansion of the primary care physician workforce and increased accessibility to physicians for the residents of rural and underserved areas. Title VII has been successful in achieving its stated goals and has had an important role in addressing U.S. physician workforce policy issues.

Jul 15, 2002 Issue
What Physicians Need to Know About Seniors and Limited Prescription Benefits, and Why
More and more often, seniors are faced with outpatient prescription benefits that have annual spending limits, and they may be forced to cut back on use of medications when they run out of benefits before the end of the year. Family physicians can play a valuable role by helping seniors choose the best value medications for their budgets and by checking whether or not seniors can afford their prescriptions.

Nov 1, 2001 Issue
Uncoordinated Growth of the Primary Care Work Force
Family physicians, nurse practitioners and physician assistants are distinctly different in their clinical training, yet they function interdependently. Together, they represent a significant portion of the primary care work force. Training capacity for these professions has increased rapidly over the physician assistant decade, but almost no collaborative work force planning has occurred.

Oct 15, 2001 Issue
Trumping Professional Roles: Collaboration of Nurse Practitioners and Physicians for a Better U.S. Health Care System
Professional turf battles have yielded variations in the scope of practice for nurse practitioners (NPs) that obstruct collaboration with physicians that would enhance patient care. Patients would be better served if NPs and physicians worked together to develop better combined models of education and service that take advantage of the benefits of both professions' contributions to care.

Sep 15, 2001 Issue
The Contemporary Ecology of U.S. Medical Care Confirms the Importance of Primary Care
More women, men and children receive medical care each month in the offices of primary care physicians than any other professional setting. There is an urgent need for health policies that encourage further innovation and implementation of first-rate primary care for everyone.

May 1, 2001 Issue
The United States Relies on Family Physicians Unlike Any Other Specialty
Designation of a county as a Primary Care Health Personnel Shortage Area (PCHPSA) depends on the number of primary care physicians practicing there. Without family physicians, an additional 1,332 of the United States' 3,082 urban and rural counties would qualify for designation as PCHPSAs. This contrasts with an additional 176 counties that would meet the criteria for designation if all internists, pediatricians and obstetrician-gynecologists in aggregate were withdrawn. The United States relies on family physicians, unlike any other specialty.

Mar 15, 2001 Issue
The Patient Safety Grid: Toxic Cascades in Health Care Settings
The Patient Safety Grid shows the fields where action is necessary in a comprehensive national effort to reduce harm from medical errors. Each segment of the grid is important and connected to others, sometimes forming a toxic cascade.

Mar 1, 2001 Issue
Toxic Cascades: A Comprehensive Way to Think About Medical Errors
Current thinking about threats to patient safety caused by medical errors is often focused on the immediate consequences of mistakes in the hospital setting that affect specific aspects of care, such as testing procedures or medications. Some mistakes, however, become apparent distant from where they were committed and only after a lapse in time. The model of a toxic cascade organizes an approach to making U.S. health care safer for patients by locating upstream sources and downstream consequences of errors within a comprehensive, multilevel scheme.

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