The Robert Wood Johnson Foundation (RWJF) launched the Generalist Provider Research Initiative in 1993 as part of an overall strategy to increase the number of generalist physicians relative to specialists. It was authorized by RWJF's Board of Trustees for up to $3 million and managed internally by RWJF staff with technical assistance early on from the University of Wisconsin-Madison School of Medicine.

The Generalist Provider Research Initiative supported a series of research projects that addressed determinants of the generalist/specialist ratio and opportunities for — and constraints to — change.

RWJF staff hoped that the findings of the projects would provide policy makers, educators, and health care providers with the information they needed to take action to strengthen the role of generalists in the delivery of primary care and alter the imbalance in generalist versus specialist services.

Key Results
The Generalist Provider Research Initiative funded a total of 12 studies (see the Project list for links to Grant Results on each study). The research agenda consisted of the following nine topic areas:

1. The consequences of generalist versus specialist care on the costs of care and medical outcomes.
2. The market dynamics of the use of various forms of labor resources in the health care sector.
3. Possible public and private actions to be taken to limit the number of specialists.
4. Determinants of patient preferences for generalist versus specialist care.
5. Determinants of residency choice.
6. Factors that influence the job satisfaction of generalist physicians.
7. Factors that affect the choice of generalists to practice in underserved areas.
8. The relative impact of changes in medical school admission processes, medical training environments, and practice entry incentives on the supply and distribution of generalist physicians.
9. The impact of changes in the organization of health care on the demand and need for generalists.

Project directors disseminated their findings through numerous publications they generated — many of them in refereed journals such as the Journal of the American Medical Association, the Journal of General Internal Medicine, and the American Journal of Public Health.

Some of the findings received widespread coverage in medical newsletters and in mass media such as the New York Times, the Boston Globe, and National Public Radio.

RWJF Strategy
The Generalist Provider Research Initiative was one of four programs launched by RWJF in the early 1990s to address the issue of bolstering the percentage of generalist physicians.

The other three programs were the:

• Generalist Physician Faculty Scholars Program.
• The Generalist Physician Initiative.
• Practice Sights: State Primary Care Initiative.