Primary care at a crossroads.

In response to concerns about the future of primary care, the Robert Wood Johnson Foundation sponsored a meeting in October 2001 in Glen Cove, New York, of 45 leaders in primary care and other health sectors. The purpose was to discuss the current and future challenges to primary care and to develop new and innovative ideas about how primary care might meet the needs of our current and future population. The premise of the meeting was that primary care is at a crossroads, which could lead to a new renaissance or a continued decline. Principles and ideas need to be identified to construct new primary care systems. As background for the meeting, 15 papers were written by experts in health care policy and primary care. Included in this supplement are revised versions of 4 of these papers, which present an overview of the current crisis, the implications of patients' views of primary care, the Chronic Illness Model as one possible solution, and a prediction of a tiering in the way primary care is delivered in the future. The final paper presents ideas and suggestions, based in part on the discussions at the meeting, about opportunities to move toward another renaissance of primary care.