At its winter board retreat, the board of the Society for General Internal Medicine proceeded with plans to create a brand new movement called the SGIM Clinical Practice Task Force. Listed as part of the "landscape scan" justifying this task force were the diminishing interest in primary care practice, "blaming the victim" (see the August N Engl J Med article by Jordan Cohen and others at AAMC blaming primary care training programs for the diminishing attractiveness of primary care), the existence of forces pitted against generalists' giving high quality care to their patients, including organizational forces such as managed care and large health care organizations, and the growing malaise of battered primary care givers facing increasing unfunded mandates such as "pay for performance".
SGIM sees these forces as countering its mission, and is making a plan to ally with other generalist organizations to counter these forces. Dr. Greg Rouan is now in charge of this task force. An eNews went out recently, inviting any SGIM members interested in participating in this task force to register their interest. You can do so by going to www. SGIM.org.
Through this and other task forces, SGIM is also seeking to: 1) survey the literature for how generalists vs. specialists manage chronic disease, especially multiple diseases in the same patient; 2) lobby Congress to get better payment for cognitive services for beleagured generalists in the upcoming RUC; 3) explore better models for delivering primary care.
Wally Smith, MD
A nurse is an essential partner to patient care - Some years ago when my father underwent bypass surgery, he was anxious, depressed and in pain as he lay in the hospital bed tied to IV catheters and tubes....
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