n engl j med 368;4 nejm.org january 24, 2013 297 Internet access is virtually nonexistent. And the Cuban health care system also seems unreal. There are too many doctors. Everybody has a family physician. Everything is free, totally free — and not after prior approval or some copay. The whole system seems turned upside down. It is tightly organized, and the first priority is prevention. Althoug...

This paper examines the prevalence of vision problems and the accessibility to and quality of vision care in rural China. We obtained data from 4 sources: 1) the National Rural Vision Care Survey; 2) the Private Optometrists Survey; 3) the County Hospital Eye Care Survey; and 4) the Rural School Vision Care Survey. The data from each of the surveys were collected by the authors during 2012. Thi...

Traditional continuing medical education (CME) has been disconnected from the actual practice of medicine and has not focused on providing the most useful information in the most efficient way. Physicians have different information needs at different times. When asked at the end of a day of patient care, physicians will typically report having had one question for every four or five patients. H...

Sir, I read the brief report entitled, ‘Professional advice on common breastfeeding problems: a primary care study’ (March Journal) with some interest, but equal mystification. The article reminds me of many I have read in your Journal down the years where my interest has been aroused by the description of a potentially useful tool to improve practice, only to be frustrated by the absence of an...

BACKGROUND The visions of more integrated care have created new roles and accountabilities for organizations and professionals. Thus, professionals are increasingly expected to engage in boundary spanning activities in order to facilitate inter-organizational and inter-sectoral collaboration. However, this task can be difficult for individual actors and it is important to investigate the work a...

Recognizing the advantages of primary care as a means of improving the entire health system, this text comments on reforms of publicly funded primary health centers, and the rapid development of private forprofit providers in Sweden. Many goals and expectations are connected to such reforms, which equally require critical analyses of scarce resources, professional trust/motivation and business ...

The annual search for excellence in healthcare has begun once more with the opening of nominations for the ninth BMJ Awards, the competition in which the best initiatives from across the UK are invited to compete for the prestigious recognition. This year, as last, there are 15 entry categories covering the whole of medicine from bench to bedside, not forgetting that the way services are planne...

opinions may have been more equivocal than families state! But it would be greatly appreciated if GPs could make the time to obtain and read the Continuing Care criteria, so that they are in a position to give as informed a view as possible regarding this important matter. We have a shared task, to ensure that those who are eligible for the full funding of their care are enabled to obtain this ...

AIMS With the aging of populations in industrialized countries, managing osteoporosis in the primary care setting becomes increasingly important. General practitioners (GPs) are in an ideal position to identify and manage patients who are at an increased risk of osteoporosis and fracture. In a cross-sectional survey we studied whether German GPs (1) are aware of osteoporosis as an urgent health...

BACKGROUND A deep and comprehensive understanding of what patients value about having a personal doctor in primary care is lacking. OBJECTIVES To acquire a comprehensive understanding of the core values of having a personal doctor in a continuing doctor-patient relationship in primary care among long-term, chronically ill patients. METHOD In this qualitative study, 14 chronically ill patien...