The Coastal Research Group

Development

In 1990, a group of persons interested in family and community medicine, medical school reform, and advocacy for rural, inner city and other geographical areas of need, were invited to rural Wisconsin for the First National Conference on Primary Health Care Access. Since then, similar groups have been invited to assemble each Spring.

Over the years, many of the pioneers, key strategists, researchers and policy makers who have promoted the idea of community-responsive medical education have participated in one or more of the National Conferences. (Many have participated in ten or more of the 20 conferences held through 2009.)

The National Conferences have continuity in the conference faculty from year to year. The conferences are limited to approximately 55 participants. Persons who enroll in the conference series are invited to renew their space in each subsequent conference.

The major product of the National Consortium is the National Project on the Community Benefits of Family Medicine Residency Programs, launched in August, 2000, and its associated National Workshops, held since 2001, both of which are described elsewhere on that website. Information derived from the National Project has been incorporated into each subsequent National Conference.

Other recurring National Grand Rounds relate to issues in the Funding of Family and Community Medicine and to National Physician Workforce Policy Development.

Policy Background

Lack of access to health care is a problem in most rural, inner-city, lower socioeconomic, and minority communities. That lack of access is in part due to the decline in the numbers of general practitioners and family physicians and the increase in medical subspecialists, who typically do not locate in inner city or rural areas. The subspecialization of medicine increased in every decade of the 20th century. That specialization appears to be accelerating, and with it the decline in percentage of primary care providers when compared with subspecialists. (Many areas continue to experience an absolute decline in numbers of primary care providers.)

Paul R. Young, M.D., of the American Board of Family Practice, Lexington, Kentucky, talks with J. Jerry Rodos, D.O.. Dr. Young presented the 10th G. Gayle Stephens Lecture in Kaua'i. Dr. Rodos was dean of Chicago College of Osteopathic Medicine and subsequently was consultant to the Director of the National Health Service Corps.

Trends suggest that current levels of funding for primary care activities are inadequate for turning the tide of subspecialization, and such new resources as might be commanded are marginal. The most hopeful approach is likely to be the encouragement of strategies for increasing the cost-effectiveness of current levels of effort and the forging of strategic linkages between health care sectors such as primary care training programs, community-based health care delivery systems and primary health care professionals specifically trained to practice in communities of chronic physician shortage.

Such strategies and such linkages are the content of the National Conferences.