Primary and specialized care: implications for learning situations

Existing data suggest that there are differences between primary and specialized (consultant) care in clinical practice and in clinical decision-making. In addition, there are distinctions attributable to the nature of the two functions, the clinical settings, and the use of knowledge and technique. The most important difference, however, centers around the varying prevalence of disease between primary and specialized care and the practitioner's relative use of disease frequency in decision-making. Because of these differences, medical schools should develop primary care situations which are equally as valued as specialty care situations. Although the impact of substantial and attractive primary care curricula is unknown, their potential value in guiding appropriate students to enter primary or specialized care careers could be considerable.