Current emphasis on innovation in primary care has revealed conflicts between generalist clinicians and professionals in community medicine. Several problems are now evident in the combination of community medicine and family medicine. Three elements of a planned institutional approach to overcome problems in primary health care education at the University of Calgary, Faculty of Medicine, are discussed: the introduction of an integrated curriculum, de-emphasis of departments, and a center for ambulatory care.
Important multiple barriers exist between rural poor people and providers of medical services. These include attitudes, values, and beliefs of both groups and are related to their social positions. These generalizations are made specific in terms of a multiphasic screening program in Kentucky. Findings are reported and ways of increasing utilization of health services are discussed.
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