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Article |

Primary Care: Concept, Evaluation, and Policy

Carol D. Berkowitz, MD
Arch Pediatr Adolesc Med. 1994;148(2):230-231. doi:10.1001/archpedi.1994.02170020116026.
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Primary Care: Concept, Evaluation, and Policy is a comprehensive treatise that should be obligatory reading for all physicians and for legislators planning the future of health care in the United States.

Dr Starfield, in this well-written and easily readable book, objectively reviews the concept of primary care in its entirety. She constructs the argument for primary care starting with a historical review. Within the book's first chapter, the need for restructuring from a primary medical to a primary health care model is introduced. Such a change requires new focus (eg, from illness to health), new content (eg, from treatment to health promotion), new organization (eg, from specialists to generalists), and new responsibility (eg, from professional dominance to community participation).

To evaluate the rationale and the success of such a change, Dr Starfield reviews the 1978 Institute of Medicine approach to assessing the success of a health care system, noting accessibility,


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