Expanding the boundaries of primary care for elderly people

This article reports the results of a qualitative evaluation of the Generalist Physician Initiative, designed to enhance the care of older people provided by primary care physicians in nine demonstration projects around the country. A theme entitled "Pushing the Comfort Zone" examines activities in which physicians engage before collaboration: selecting elderly patients, "opening cans of worms," recognizing patient and family expectations, and going outside the comfort zone. A second theme called "Linking with Collaborators" reveals activities in which physicians engage as they collaborate: teaming, using intervention agents as eyes and ears, communicating, and tracking patients. Findings indicate that social workers are logical collaborators with primary care physicians as contemporary practice is expanding to be more holistic.