Documenting effective coordination of medical education programs in response to medical underservice

The Federal government has in the past initiated a variety of programs in an effort to address the issue of medical underservice throughout the United States. The results of two such programs sponsored by the University of Colorado Health Sciences Center are examined. Their federal and state support have been decreased at a time when encouraging progress was being made in reducing rural Coloradoans' inaccessibility to medical care, although much of the state remains designated a primary care health manpower shortage area. This paper challenges the Federal Government's policy of temporarily "seed" funding programs whose interventions require several years to complete, under the assumption that state legislatures will eagerly pick up financial support for all that document continuing need and effectiveness. It also describes the difficulties this policy and prevailing state legislative attitude pose for program evaluators in performing their professional function.