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<div class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a></span><br><br><br>
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<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="maroon" size="5"><span style="FONT-WEIGHT: bold; FONT-SIZE: 16pt; COLOR: maroon; FONT-FAMILY: Arial">Redesigning Primary Care<br><br></span></font></b></p>
<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Crisis and Change<br>N Engl J Med 2008;359:e24, November 13, 2008</span></font></b></p>
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<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Website: <a href="http://content.nejm.org/topics/primary-care.shtml" target="_blank"><font color="navy"><span style="COLOR: navy">http://content.nejm.org/topics/primary-care.shtml</span></font></a> </span></font></p>
<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">"…In the United States, primary care is in crisis. The ranks of primary care physicians are thinning, with many burning out and trainees shunning primary care fields. The following articles examine the current state of primary care in the U.S. and discuss potential solutions in the areas of training, practice, compensation, and systemic change…."</span></font></p>
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<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Perspective Roundtable from the New England Journal of Medicine</span></font></b></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Video: <a href="http://www.nejm.org/perspective/primary-care-video/" target="_blank"><font color="navy"><span style="COLOR: navy">http://www.nejm.org/perspective/primary-care-video/</span></font></a> <br>
<br>PDF<b><span style="FONT-WEIGHT: bold"> </span></b><a href="http://content.nejm.org/cgi/reprint/359/20/e24" target="_blank"><font color="navy"><span style="COLOR: navy; TEXT-DECORATION: none">Transcript of Video</span></font></a> at:<b><span style="FONT-WEIGHT: bold"> </span></b></span></font><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/reprint/359/20/e24.pdf" target="_blank"><font color="navy"><span style="COLOR: navy">http://content.nejm.org/cgi/reprint/359/20/e24.pdf</span></font></a></span></font><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> </span></font></b></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">"….. Primary care physicians must care for more and more patients, with more and more chronic conditions, in less and less time, for which they are compensated far less than subspecialists. They must absorb increasing volumes of medical information and complete more paperwork than ever, as they try to function in a poorly coordinated health care system.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">As a result, their ranks are thinning, with practicing physicians burning out and trainees shunning primary care fields. <br>
In a roundtable discussion moderated by Dr. Thomas Lee, four experts in primary care and related policy — <br>Drs. Thomas Bodenheimer, Allan Goroll, Barbara Starfield, and Katharine Treadway — explore the crisis, as well as possible solutions for training, practice, compensation, and systemic change…."</span></font></p>
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<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><b><font face="Arial" color="maroon" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: maroon">THE FUTURE OF PRIMARY CARE</span></font></b></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">The editors asked several experts to share their perspectives on the crisis in U.S. primary care. <br>
Their articles address the issue from six different angles:</span></font></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2085" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">The Need for Reinvention</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
</span></font><span><b><font face="Arial" color="navy" size="1"><span lang="EN" style="FONT-WEIGHT: normal; FONT-SIZE: 9pt; COLOR: navy">T.H. Lee, network president for Partners Healthcare System and an associate editor of the New England Journal of Medicine</span></font></b></span></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2086" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">Sustaining Relationships</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
<span><b><font face="Arial" color="navy"><span style="COLOR: navy">K. Treadway, </span></font></b></span></span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Harvard</span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> Medical School</span></font><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"></span></font></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2086-a" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">Transforming Practice</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
<span><b><font face="Arial" color="navy"><span style="COLOR: navy">T. Bodenheimer</span></font></b></span><span><b><font face="Arial" color="navy"><span style="FONT-WEIGHT: normal; COLOR: navy">, Center</span></font></b></span><span><b><font face="Arial" color="navy"><span style="COLOR: navy"> </span></font></b></span><span><b><font face="Arial" color="navy"><span style="FONT-WEIGHT: normal; COLOR: navy">for Excellence in Primary Care at the University of California, San Francisco.</span></font></b></span><span><b><font face="Arial" color="navy"><span style="COLOR: navy"></span></font></b></span></span></font></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2087" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">Reforming Physician Payment</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
<span><b><font face="Arial" color="navy"><span style="COLOR: navy">A.H. Goroll, </span></font></b></span></span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Harvard</span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> Medical School</span></font><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"></span></font></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2087-a" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">Refocusing the System</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
<span><b><font face="Arial" color="navy"><span style="COLOR: navy">B. Starfield, </span></font></b></span></span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Bloomberg</span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> School of Public Health at Johns Hopkins</span></font><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"></span></font></p>
<p style="BACKGROUND: white; MARGIN-LEFT: 0.5in"><u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://content.nejm.org/cgi/content/full/359/20/2087-b" target="_blank"><b><font color="navy"><span style="FONT-WEIGHT: bold; COLOR: navy">Lessons from the U.K.</span></font></b></a></span></font></u><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br>
<span><b><font face="Arial" color="navy"><span style="COLOR: navy">M. Roland, </span></font></b></span></span></font><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">director of the National Primary Care Research and Development Centre, University of Manchester, UK</span></font><font face="Arial" color="navy" size="2"><span lang="EN" style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"></span></font></p>
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<p style="MARGIN-TOP: 10.5pt; MARGIN-LEFT: 0.5in"><b><font face="Arial" color="navy" size="1"><span style="FONT-WEIGHT: bold; FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial">Open for Comments November 12–26, 2008<br></span></font></b><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><a href="http://www.nejm.org/perspective/primary-care-video/?query=TOC" target="_blank"><font color="navy"><span style="COLOR: navy">http://www.nejm.org/perspective/primary-care-video/?query=TOC</span></font></a> </span></font></p>
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