Teaching the fundamentals of primary care: a point of view.

In the United States today, major forces in society and within medicine are uniting in support of an enlarged pool of primary care physicians and a heightened status for primary care in medical practice. In the unsettled contemporary medical world, it is little noticed that, during its rise to prominence, primary care has changed from what was basically an administrative concept into one of a sophisticated generalism; the pressure for its new form arises from difficulties in current health care delivery and subspecialty medicine. Generalism takes as its theme the patient rather than the disease and is most appropriate for the contemporary world of chronic disease. It requires new forms and places of training, including postgraduate didactic teaching, so that doctoring is as specifically taught as medical science.