Patrick Mattingly

There were two specific points that participants in Workshop C wanted to bring forward and with them some action-oriented proposals. First, in the educational arena, the group felt that the most valuable thing to be done at this point is to make visible, to promote, and to support working COPC systems in health care delivery and education. This exposes health students to a professional role model that is different from the more technically oriented role model so dominant today. Efforts should be taken to avoid getting bogged down in the issues of resources or whether there are many or a few such examples. Some number—probably small given the present context—of major medical centers, currently engaged in some or all elements of COPC, should be identified and promoted in order that there be some such role models visible.

In an effort to promote COPC role models, members of Workshop C suggested that COPC advocates become involved more actively in residency review committees so flexibility and participation in community oriented experience can be built into the primary care residency guidelines in family practice, internal medicine, and pediatrics.

Again, by way of encouraging visibility of COPC the group suggested that, in addition to the detailed proceedings resulting from this conference, broad circulation be given to a synopsis of the principles, essential features, desirable characteristics, and objectives that have been enunciated. This publicity, if you will, should also include a brief synopsis of the most relevant studies that have been cited, particularly those that include data concerning the effectiveness of COPC. And one step beyond that, it was proposed that along with some baseline bibliography, generated by those of us assembled, an effort be made to create some form of literature guide on an ongoing basis, perhaps quarterly, that will give interested individuals reference to the literature in COPC.

The second point stressed by this group had to do with the question of providers and personnel involved in COPC. There needs to be a better appreciation of the large numbers of nonphysicians and multiple levels of health workers that are already involved in COPC in this country. Specifically, the group felt that there needs to be some assurance that, from the beginning, efforts at developing COPC by different health professionals (nurses, allied health professionals, physicians, epidemiologists, and others) be integrated rather than parallel.

In conclusion, the participants of Workshop C agreed that every effort, no matter how nascent or how unorthodox, attempting to promote what would generally be described as COPC should be encouraged and supported.