Primary Care vs Specialty Care


I have attached a reference list of articles that deal with the value of primary

care. It is less than comprehensive. I hope it helps. Tom Rosenthal


Dietrich AJ, Nelson EC, Kirk JW, Zubkoss M, O'Connor GT. Do Primary Physicians Actually Manage Their Patients' Fee-for-Service Care? JAMA 1988 Jun. 3; 259(21):31459


Fiscella K, Franks P, Zwanziger J, Mooney C, Sorbero M, Williams GC. Risk Aversion

and Costs. A Comparison of Family Physicians and General Internists. JFP 2000 Jan.



Franks P, Clancy CM, Nutting PA. Sounding Board - Gatekeeping Revisited - Protecting patient from overtreatment. NEJM 1992 Aug. 6;327(6):424-29


Fries JF, Koop CE, Beadle CE, Cooper PP, England MJ, Greaves RF, Sokolov JJ, Wright D, and the Health Project Consortium. Reducing Health Care Costs by Reducing the Need and Demand for Medical Services. NEJM 1993 July 29;



Greenfield S, Rogers W, Mangotich M, Carney MF, Tarlov AR. Outcomes of Patients with Hypertension and Non-insulin-dependent Diabetes Mellitus Treated by Different Systems and Specialties. JAMA 1995 Nov. 8; 274(18):1436-44


Greenfield S, Nelson EC, Zubkoff M, Manning W, Rogers W, Kravitz RL, Keller A, Tarlov AR, Ware JE. Variations in Resource Utilization Among Medical Specialties and Systems of Care. JAMA 1992 Mar 25;267(12):1624-30


Handley MR, Stuart ME. An Evidence-Based Approach to Evaluating and Improving Clinical Practice: Guideline Development. HMO Practice 1994 March; 8(1):10-19


Horner RD, Matchar DB, Divine GW, Feussner JR. Relationship Between Physician Specialty and the Selection and Outcome of Ischemic Stroke Patients. Health Services Research 1995 June; 30(2):275-94


Howie JGR, Heaney DJ, Maxwell M, Walker JJ, Freeman GK, Rai H. Quality at general practice consultations: cross sectional survey. British Journal of Medicine 1999 September 18;319:738-43


Kenagy JW, Berwick DM, Shore MF. Service Quality in Health Care. JAMA 1999 Feb 17;281(7):661-5


Kroger JS. Evaluating Quality Performance in Alternate Health Care Delivery Systems. JAMA 1994 May 25; 271(20):1620-2


McCann KP, Bowman MA, Davis SW. Morbidity, Mortality, and Charges for Hospital Care of the Elderly: A Comparison of Internists' and Family Physicians' Admissions. J of Fam Prac 1995 May; 40(5):443-8


Naylor CD. What Is Appropriate Care? NEJM 1998 June 25;338(26):1918-20


O’Malley AS, Mandelblatt J, Gold K, Cagney KA, Kerner J. Continuity of Care and the Use of Breast and Cervical Cancer Screening Services in a Multiethnic Community. Archives of Internal Medicine 1997 July 14; 157(13):1462-70


Paauw DS, Wenrich MD, Curtis JR, Carline JD, Ramsey PG. Ability of Primary Care Physicians to Recognize Physical Findings Associated with HIV Infection. JAMA 1995 Nov. 1; 274(17):1380-2


Pacala JT, Boult C, Hepburn KW, Kane RA, Kane RL, Malone JK, Morishita L, Reed RL. Case Management of Older Adults in Health Maintenance Organizations. JAGS 1995 May:43(5):538-42


Raddish M, Horn SD, Sharkey PD. Continuity of Care: Is It Cost Effective? The American Journal of Managed Care 1999 June;5(6):727-34


Rosenblatt RA, Hart LG, Baldwin LM, Chan L, Schneeweiss R. The Generalist Role of Specialty Physicians. Is There a Hidden System of Primary Care? JAMA 1998 May 6; 279 (17):1364-70.


Rosenblatt RA. Editorials - Specialists or Generalists On Whom should we base the American Health Care System? JAMA 1992 Mar 25;267(12):1665-66


The Future of Family Practice. A report by American Medical Association Council on Long Range Planning and Development. AMA 1988


Safran DG, Tarlov AR, Rogers WH. Primary Care Performance in Fee-for-Service and Prepaid Health Care Systems. JAMA 1994 May 25; 271(20):1579-86 Schroeder SA. The Medically Uninsured - Will They Always Be With US? NEJM 1996 Apr. 25; 334(17):1130-3


Schwartz WB, Mendelson DN. No Evidence of an Emerging Physician Surplus. JAMA 1990 Jan 26;263(4):557-60


Selby JV, Grumbach K, Quesenberry CP, Schmittdiel JA, Truman AF. Differences in Resource Use and Costs of Primary Care in a Large HMO According to Physician Specialty. HSR 1999 June; 34(2):503-18


Specialty Distribution of US Physicians - The Invisible Driver of Health Care Costs. NEJM 1993 April 1;328(13):961-3


St. Peter RF, Reed MC, Kemper P, Blumenthal D. Changes in the Scope of Care Provided by Primary Care Physicians. NEJM 1999 Dec. 23;341(26):1980-2010


Starfield B, Powe NR, Weiner JR, Stuart M, Steinwachs D, Scholle SH, Gerstenberger A. Costs vs. Quality in Different Types of Primary Care Settings. JAMA 1994 Dec. 28;272(24):1903-08


Tallia AF, Swee DE, Winter RO, Lichtig LK, Knabe FM, Knauf RA. Family Practice Graduate Medical Education and Hospitals" Patient Care Costs in New Jersey. Academic Medicine 1994 September; 69(9):747-53 (filed under Graduate Medical Education)


Tamblyn R, Abrahamowicz M, Brailovsky C, Grand’Maison P, Lescop J, Norcini J,Girard N, Haggerty J. Association Between Licensing Examination Scores and Resource Use and Quality of Care in Primary Care Practices. JAMA 1998 Sept. 16;280(11):989-6


Vanselow NA. Editorial – Primary Care and the Specialist. ? JAMA 1998 May 6; 279 (17):1394-5


Weiner JP, Parente ST, Garanick DW, Fowles J, Lawthers AG, Palmer RH. Variation in Office-Based Quality A Claims-Based Profile of Care Provided to Medicare Patients with Diabetes. JAMA 1995 May 17; 273(19):1503-8