Since its establishment as a national philanthropy in 1972, the Robert Wood Johnson Foundation has consistently pursued the goal of increasing the access of all Americans to health care services. It has given a high priority to expanding the number of Americans having health insurance coverage—for example, by funding a series of surveys providing data on uninsured Americans, a variety of programs to make it easier for children to obtain health insurance, and a number of policy development and public education initiatives to keep health insurance coverage in the public eye.
Insurance coverage is only one factor determining access to health care services, of course. Over the years, the Foundation has addressed a range of problems that hinder access. One area that has commanded particular attention is development of a health care workforce capable of providing, and willing to provide, services to people without a regular source of health care, especially those living in rural areas. The Foundation has endeavored to increase the number of physicians practicing primary care and has played an important role in developing the fields of nurse practitioner and physician assistant. It also has funded programs to increase the number of minority physicians and other health practitioners, largely on the ground that they tend to serve minority patients.
Beyond trying to increase the supply of health practitioners able to aid underserved populations, the Foundation also has sought ways to make the distribution of health practitioners more equitable. A major program to encourage health practitioners to work in rural areas was Practice Sights. In this chapter, Irene Wielawski, an award-winning journalist, the evaluator of the Foundation's Reach Out® program, and a frequent contributor to the Robert Wood Johnson Foundation Anthology series, examines this ambitious 10-state effort.