A plan to put primary-care doctors in the driver's seat. Interview by Richard L. Peck

The Institute of Medicine has developed a report outlining a plan to produce more primary-care physicians; reimbursement of commonly accepted health education and preventive medicine procedure is proposed. Dr. E. Harvey Estes, Chairman of the Study Team, reviews the recommendations offered by the Institute to achieve this goal. The Institute directs many of its suggestions at restructuring the reimbursement system. If the federal, state and private organizations reimbursed primary care physicians and specialists on a more equal scale, regardless of geographic location, there would be more incentive for new doctors to enter primary care and to practice in underserved communities. Third-party payors are encouraged to reimburse physicians and physician extenders at the same rate to reinforce the fact that they are all part of a practice team. In addition, it is recommended that third-parties reduce the number of fractional reimbursements and bureaucratic delays that currently take place. Estes concludes that primary care should have sufficient financial incentive to attract and maintain well-trained physicians.