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Other Approaches to Primary Care Training
- J. Thomas Cross Jr., MD, MPH
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
The articles in the 1 December 1993 Annals [1-3] were timely and of great interest to those of us beginning our careers in internal medicine. Most internists would agree with Drs. Petersdorf and Goitein [2] that “the general internist continues to be the best primary care physician for adults.” They also state that recent gains in family medicine residencies reflect enrollment students' beliefs that they provide more breadth than do the current internal medicine residency.
What all three articles failed to address, however, is that we in internal medicine have an excellent answer to this contention. Since the 1960s, programs in combined internal medicine and pediatrics have produced “general and family” practitioners who provide both breadth and depth in internal medicine and pediatrics! These persons are fully trained internists and pediatricians and thus have the ability to provide comprehensive outpatient as well as inpatient care to patients of all ages. They receive pediatrics training in addition to the same training as categorical internal medicine residents receive. These programs provide trainees with the ability to treat complex, multisystem disease, not usually provided in traditional family practice residencies. The trainee has the added advantage of being able to treat the “whole family”
As a graduate of such a program, I believe that it is an excellent alternative to the standard family practice, internal medicine, and pediatrics residencies. Most of our graduates go on to provide primary care to smaller communities where they are often the only internist or pediatrician. Some graduates choose to pursue subspecialty training in either internal medicine, pediatrics, or, occasionally, both. This option should remain available. Persons in policymaking positions should carefully examine the program as an alternative to our present training methods.
J. Thomas Cross, Jr., MD, MPH
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
