Thomas L. Campbell – författare

I was a Medical Student in 1966 when the Millis Report on the training of the generalist physician was published,de?ning the concept of primary care. According to the Report, the primary provider has four major responsib- ities or roles. The ?rst role is that of initial contact care of the undiffer- tiated patient. The second is to provide comprehensive care based on the belief that the primary provider should be able to manage the overwhe- ing majority of problems with which patients present. Equally important is the third role—continuity and coordination of care within the health care system. Finally,the primary provider is responsible for demonstrating le- ership in the community. This Report’s description of a primary provider seems as relevant today as it was when it was written. In 1994,the Institute of Medicine’s assessment of primary care added the responsibility of family and community integration of care to the Millis Report description. Without question there are many challenges to a contemporary imp- mentation of this comprehensive description of primary care, beginning with the level of individual patients who so often suffer from complex pr- lems, such as mental disorders and obesity. Treating these conditions in a brief primary care visit is dif?cult. At the level of the larger system, re- bursement is often inadequate and can represent policies that are uns- portive of primary care, such as those that compromise payment for preventive services that help patients to quit smoking or lose weight.

I was a Medical Student in 1966 when the Millis Report on the training of the generalist physician was published,de?ning the concept of primary care. According to the Report, the primary provider has four major responsib- ities or roles. The ?rst role is that of initial contact care of the undiffer- tiated patient. The second is to provide comprehensive care based on the belief that the primary provider should be able to manage the overwhe- ing majority of problems with which patients present. Equally important is the third role—continuity and coordination of care within the health care system. Finally,the primary provider is responsible for demonstrating le- ership in the community. This Report’s description of a primary provider seems as relevant today as it was when it was written. In 1994,the Institute of Medicine’s assessment of primary care added the responsibility of family and community integration of care to the Millis Report description. Without question there are many challenges to a contemporary imp- mentation of this comprehensive description of primary care, beginning with the level of individual patients who so often suffer from complex pr- lems, such as mental disorders and obesity. Treating these conditions in a brief primary care visit is dif?cult. At the level of the larger system, re- bursement is often inadequate and can represent policies that are uns- portive of primary care, such as those that compromise payment for preventive services that help patients to quit smoking or lose weight.

Does a healthy family environment reduce the risk of illness to family members? Is there a relationship between common family patterns related to health and interactions between families and the health care system? Organized around a unique Family, Health and Illness Cycle developed by the authors, this timely volume discusses such salient issues as family experiences with health promotion and risk reduction, vulnerability and illness onset, illness appraisal, acute response, and adaptation to illness. Separate chapters consider each of these areas in terms of exemplar issues of current interest and con -cern, such as cardiovascular disease, cancer, diabetes, and bereavement. In addition, issues related to health care intervention and policy are addressed and important methodological issues in family and health are raised. Written in nontechnical language and including discussion questions and recommended readings, Families and Health is an ideal text for family studies and family psychology courses. "This book represents an important contribution to the task of disseminating the model. Addressed to a multidisciplinary audience of health providers, the text is an excellent introduction. It is also a well-referenced and interesting survey of applied clinical behavioral sciences." --The Literature of Medicine "This book, a gem in both value and clarity, makes an important contribution to relating health and illness to family structure and function. . . . An intensely referenced, authoritative basic science textbook that describes why caring for the family for the benefit of the patient is not only desirable but essential for excellent health care. . . . A well-written, readable, and authoritative approach to relationships between families, health, and illness." --The Journal of Family Practice "In 159 pages of easy-to-read and well-referenced text, the seven chapters cover the stages of the 'family health and illness cycle' initially developed by one of the author's, William J. Doherty. . . . This book is directed to undergraduate students as part of a 'series of textbooks designed to examine topics relevant to a broad view of family studies." --American Family Physician "This is a very useful text for acquainting newcomers to the health care field with the principles and complexities of that system and with the need for health care providers to attend to the transactional and reciprocal nature of their work with families. Incidentally, it would be informative as well to those already working in the field in multidisciplinary settings. The authors have done a remarkable job of placing the material in a historical context, tracing the evolution and influence of various theories on current modes of health care, summarizing the research literature and presenting it in a succinct manner, and elucidating the practical applications. The structure of the book is well organized and logical; the content is informative and highly relevant to the current health care scene." --Contemporary Psychology "Any teacher who is involved in the training of social workers, doctors, nurses, or any other professional involved in the delivery of health services will be pleased to discover this small book, which is a superb guide through the recent literature on the interface of family, health, and illness." --Family Systems Medicine "The excellent summary of family-oriented literature makes this book valuable to medical students and family practice residents. Experienced family physicians wishing to obtain a brief review of the current literature related to families and health may find this book useful as well." --Physician's Bookshelf "An excellent reference source for students and teachers. . . . The authors remain focused on their topic and illustrate the concept developed in each of the chapters." --Canadian Family Physician

Does a healthy family environment reduce the risk of illness to family members? Is there a relationship between common family patterns related to health and interactions between families and the health care system? Organized around a unique Family, Health and Illness Cycle developed by the authors, this timely volume discusses such salient issues as family experiences with health promotion and risk reduction, vulnerability and illness onset, illness appraisal, acute response, and adaptation to illness. Separate chapters consider each of these areas in terms of exemplar issues of current interest and con -cern, such as cardiovascular disease, cancer, diabetes, and bereavement. In addition, issues related to health care intervention and policy are addressed and important methodological issues in family and health are raised. Written in nontechnical language and including discussion questions and recommended readings, Families and Health is an ideal text for family studies and family psychology courses. "This book represents an important contribution to the task of disseminating the model. Addressed to a multidisciplinary audience of health providers, the text is an excellent introduction. It is also a well-referenced and interesting survey of applied clinical behavioral sciences." --The Literature of Medicine "This book, a gem in both value and clarity, makes an important contribution to relating health and illness to family structure and function. . . . An intensely referenced, authoritative basic science textbook that describes why caring for the family for the benefit of the patient is not only desirable but essential for excellent health care. . . . A well-written, readable, and authoritative approach to relationships between families, health, and illness." --The Journal of Family Practice "In 159 pages of easy-to-read and well-referenced text, the seven chapters cover the stages of the 'family health and illness cycle' initially developed by one of the author's, William J. Doherty. . . . This book is directed to undergraduate students as part of a 'series of textbooks designed to examine topics relevant to a broad view of family studies." --American Family Physician "This is a very useful text for acquainting newcomers to the health care field with the principles and complexities of that system and with the need for health care providers to attend to the transactional and reciprocal nature of their work with families. Incidentally, it would be informative as well to those already working in the field in multidisciplinary settings. The authors have done a remarkable job of placing the material in a historical context, tracing the evolution and influence of various theories on current modes of health care, summarizing the research literature and presenting it in a succinct manner, and elucidating the practical applications. The structure of the book is well organized and logical; the content is informative and highly relevant to the current health care scene." --Contemporary Psychology "Any teacher who is involved in the training of social workers, doctors, nurses, or any other professional involved in the delivery of health services will be pleased to discover this small book, which is a superb guide through the recent literature on the interface of family, health, and illness." --Family Systems Medicine "The excellent summary of family-oriented literature makes this book valuable to medical students and family practice residents. Experienced family physicians wishing to obtain a brief review of the current literature related to families and health may find this book useful as well." --Physician's Bookshelf "An excellent reference source for students and teachers. . . . The authors remain focused on their topic and illustrate the concept developed in each of the chapters." --Canadian Family Physician

Despite a well-publicized shift away from the traditional family structure, the family remains the most basic relational unit in society and the physician''s most potent ally. A family orientation in health care can provide a wider understanding of illness and a broader range of solutions than the classic biomedical model. FAMILY-ORIENTED PRIMARY CARE: A MANUAL FOR MEDICAL PROVIDERS offers practical guidance for the physician who would like to take greater advantage of this resource. The result is a readable guide, structured around step -by-step protocols that are vividly illustrated with case studies drawn from the author''s extensive collaboration at the University of Rochester School of Medicine.