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Health System Reform, Primary Care, and the Need for Research

William Ross Gillanders, MD; Robert D. Gillette, MD
JAMA. 1994;271(19):1482-1483. doi:10.1001/jama.1994.03510430034023.
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To the Editor.  —We share the concern of Franks et al1 that research in primary care is grossly underfunded in relation to the need and agree that "strengthening the role of primary care practitioners in the health care system will facilitate access to more affordable, high-quality health care for all Americans." However, their assertion that "simply expanding primary care services... without restructuring the provision of primary care is likely to be prohibitively expensive" needs qualification. Family physicians already provide effective and cost-effective primary care and will do more of it once financial and other disincentives to recruiting more family practice residents disappear. Research is needed to describe more fully what they do and how it can be improved, but there is no need to discard decades of experience and reinvent the wheel. Costs are likely to escalate if anyone who wants to adopt the primary physician label is permitted

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