Between 1996 and 2001, Fitzhugh Mullan, MD, with the People-to-People Health Foundation, Millwood, Va., researched and wrote an oral history of generalist medical practice in the United States.
Based on these oral histories, Mullan reported that primary care is a vital yet potentially endangered part of the health care fabric in the United States.
He also observed:
- Primary care practitioners are feeling the pressures of the widespread reorganization of the health care system.
- Primary care physicians now serve as gatekeepers in the new managed care systems, whereby they are expected not only to provide excellent medical care, but also to be the adjudicators of medical expenditures, which places them in an onerous and unpopular role.
- Although pressures have led some individuals to change fields, the generalists profiled in this study shared a strong commitment to the concept of primary care.