FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 344:2021-2025 June 28, 2001 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Editorial by Lee, T. H. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Since its publication in the Journal in 1961, "The Ecology of Medical Care," by White et al.,¹ has provided a framework for thinking about the organization of health care, medical education, and research (Figure 1). This conceptualization, inspired in part by careful reporting on the part of British general practitioners,² suggested that in a population of 1000 adults, in an average month, 750 reported an illness, 250 consulted a physician, 9 were hospitalized, 5 were referred to another physician, and 1 was referred to a university medical center. These data have been used repeatedly by investigators, authors of . . . [Full Text of this Article]

Methods

Data

Analytic Strategy

Results

Discussion

Address reprint requests to Dr. Green at the Robert Graham Center, Policy Studies in Family Practice and Primary Care, 2023 Massachusetts Ave., NW, Washington, DC 20036.

References

This article has been cited by other articles:

• Mehrotra, A., Wang, M. C., Lave, J. R., Adams, J. L., McGlynn, E. A. (2008). Retail Clinics, Primary Care Physicians, And Emergency Departments: A Comparison Of Patients' Visits. Health Aff (Millwood) 27: 1272-1282 [Abstract] [Full Text]  
• Lindblad, A. S., Clemons, T., Lindblad, R. W., Sykes, R., Meador, K. J., Odenkirchen, J. C., Hart, R. G. (2008). Applicability of NINDS-sponsored studies to community-based physician involvement. Neurology 70: 1688-1690 [Abstract] [Full Text]  
• Voigt, R. G., Johnson, S. K., Hashikawa, A. H., Mellon, M. W., Campeau, L. J., Williams, A. R., Yawn, B. P., Juhn, Y. J. (2008). Why Parents Seek Medical Evaluations for Their Children With Mild Acute Illnesses. CLIN PEDIATR 47: 244-251 [Abstract]  
• Derom, E., van Weel, C., Liistro, G., Buffels, J., Schermer, T., Lammers, E., Wouters, E., Decramer, M. (2008). Primary care spirometry. Eur Respir J 31: 197-203 [Abstract] [Full Text]  
• Tierney, W. M., Oppenheimer, C. C., Hudson, B. L., Benz, J., Finn, A., Hickner, J. M., Lanier, D., Gaylin, D. S. (2007). A National Survey of Primary Care Practice-Based Research Networks. Ann Fam Med 5: 242-250 [Abstract] [Full Text]  
• Stange, K. C., Phillips, W. R. (2007). In This Issue: Real Change Is Real Hard in the Real World. Ann Fam Med 5: 98-100 [Full Text]  
• Westfall, J. M., Mold, J., Fagnan, L. (2007). Practice-Based Research--"Blue Highways" on the NIH Roadmap. JAMA 297: 403-406 [Full Text]  
• Binns, H. J., Lanier, D., Pace, W. D., Galliher, J. M., Ganiats, T. G., Grey, M., Ariza, A. J., Williams, R., for the Primary Care Network Survey (PRINS) Partic, (2007). Describing Primary Care Encounters: The Primary Care Network Survey and the National Ambulatory Medical Care Survey. Ann Fam Med 5: 39-47 [Abstract] [Full Text]  
• Ship, J. A., Curro, F. A., Caufield, P. W., Dasanayake, A. P., Lindblad, A., Thompson, V. P., Vena, D. (2006). Practicing dentistry using findings from clinical research: You are closer than you think.. Journal of the American Dental Association 137: 1488-1491 [Full Text]  
• Newton, W. P., DuBard, C. A. (2006). Shaping the Future of Academic Health Centers: The Potential Contributions of Departments of Family Medicine. Ann Fam Med 4: S2-S11 [Abstract] [Full Text]  
• Hamilton, W., Britten, N. (2006). Patient agendas in primary care.. BMJ 332: 1225-1226 [Full Text]  
• Galatti, L., Sessa, A., Mazzaglia, G., Pecchioli, S., Rossi, A., Cricelli, C., Schito, G. C., Nicoletti, G., Caputi, A. P. (2006). Antibiotic prescribing for acute and recurrent cystitis in primary care: a 4 year descriptive study. J Antimicrob Chemother 57: 551-556 [Abstract] [Full Text]  
• Adelman, A. M. (2006). Speeding Research From Bench to Bedside in Primary Care. DOC News 3: 3-3 [Full Text]  
• Peterson, K. A., Fontaine, P., Speedie, S. (2006). The Electronic Primary Care Research Network (ePCRN): A New Era in Practice-based Research. J Am Board Fam Med 19: 93-97 [Abstract] [Full Text]  
• Phillips, R. L (2005). Primary care in the United States: problems and possibilities. BMJ 331: 1400-1402 [Full Text]  
• van den Berg, B., Grievink, L., Stellato, R. K., Yzermans, C. J., Lebret, E. (2005). Symptoms and Related Functioning in a Traumatized Community. Arch Intern Med 165: 2402-2407 [Abstract] [Full Text]  
• Elder, N. C., Jacobson, C. J., Zink, T., Hasse, L. (2005). How Experiencing Preventable Medical Problems Changed Patients' Interactions With Primary Health Care. Ann Fam Med 3: 537-544 [Abstract] [Full Text]  
• van Weel, C., Rosser, W. W (2005). Unquoted, unchallenged, general practice research will be casting pearls before swine. Fam Pract 22: 471-473 [Full Text]  
• Callahan, S. T., Cooper, W. O. (2005). Uninsurance and Health Care Access Among Young Adults in the United States. Pediatrics 116: 88-95 [Abstract] [Full Text]  
• Green, L. A. (2005). Prescription for Health: Round 1 Initial Results. Ann Fam Med 3: S2-S3 [Full Text]  
• Cifuentes, M., Fernald, D. H., Green, L. A., Niebauer, L. J., Crabtree, B. F., Stange, K. C., Hassmiller, S. B. (2005). Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors. Ann Fam Med 3: S4-S11 [Abstract] [Full Text]  
• Bodenheimer, T., Young, D. M., MacGregor, K., Holtrop, J. S. (2005). Practice-Based Research in Primary Care: Facilitator of, or Barrier to, Practice Improvement?. Ann Fam Med 3: S28-S32 [Abstract] [Full Text]  
• Hannaford, P. C, Simpson, J. A, Bisset, A. F., Davis, A., McKerrow, W., Mills, R. (2005). The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract 22: 227-233 [Abstract] [Full Text]  
• Ferrer, R. L., Hambidge, S. J., Maly, R. C. (2005). The Essential Role of Generalists in Health Care Systems. ANN INTERN MED 142: 691-699 [Abstract] [Full Text]  
• Bortz, W. M. (2005). Biological Basis of Determinants of Health. Am. J. Public Health 95: 389-392 [Abstract] [Full Text]  
• Saver, B. G., Poplin, C. M., Cykert, S., Fleming, M., Johnson, M. S., South-Paul, J., Rustin, T. A., Whitcomb, M. E., Cohen, J. J., Fincher, R.-M. E. (2005). Attracting students to primary care.. NEJM 352: 93-95 [Full Text]  
• Hamilton, W., Sharp, D. (2004). Diagnosis of lung cancer in primary care: a structured review. Fam Pract 21: 605-611 [Abstract] [Full Text]  
• Orzano, A. J., Scott, J. G. (2004). Diagnosis and Treatment of Obesity in Adults: An Applied Evidence-Based Review. J Am Board Fam Med 17: 359-369 [Abstract] [Full Text]  
• Temte, J. L., Zinkel, A. R. (2004). The Primary Care Differential Diagnosis of Inhalational Anthrax. Ann Fam Med 2: 438-444 [Abstract] [Full Text]  
• Kuzel, A. J., Woolf, S. H., Gilchrist, V. J., Engel, J. D., LaVeist, T. A., Vincent, C., Frankel, R. M. (2004). Patient Reports of Preventable Problems and Harms in Primary Health Care. Ann Fam Med 2: 333-340 [Abstract] [Full Text]  
• Rosser, W. W., van Weel, C. (2004). Research in Family/General Practice is Essential for Improving Health Globally. Ann Fam Med 2: S2-S4 [Full Text]  
• van Weel, C., Rosser, W. W. (2004). Improving Health Care Globally: A Critical Review of the Necessity of Family Medicine Research and Recommendations to Build Research Capacity. Ann Fam Med 2: S5-S16 [Abstract] [Full Text]  
• De Maeseneer, J. M., De Sutter, A. (2004). Why Research in Family Medicine? A Superfluous Question. Ann Fam Med 2: S17-S22 [Abstract] [Full Text]  
• Green, L. A. (2004). The Research Domain of Family Medicine. Ann Fam Med 2: S23-S29 [Abstract] [Full Text]  
• Phillips, R L Jr, Bartholomew, L A, Dovey, S M, Fryer, G E Jr, Miyoshi, T J, Green, L A (2004). Learning from malpractice claims about negligent, adverse events in primary care in the United States. Qual Saf Health Care 13: 121-126 [Abstract] [Full Text]  
• Elder, N. C., Meulen, M. V., Cassedy, A. (2004). The Identification of Medical Errors by Family Physicians During Outpatient Visits. Ann Fam Med 2: 125-129 [Abstract] [Full Text]  
• Future of Family Medicine Project Leadership Commi, (2004). The Future of Family Medicine: A Collaborative Project of the Family Medicine Community. Ann Fam Med 2: S3-S32 [Abstract] [Full Text]  
• Task Force 1 Writing Group, , Green, L. A., Graham, R., Bagley, B., Kilo, C. M., Spann, S. J., Bogdewic, S. P., Swanson, J. (2004). Task Force 1. Report of the Task Force on Patient Expectations, Core Values, Reintegration, and the New Model of Family Medicine. Ann Fam Med 2: S33-S50 [Abstract] [Full Text]  
• Cifuentes, M., Green, L. A (2004). Obesity trial: knowledge without systems. BMJ 328: E272-E274 [Full Text]  
• Hamilton, W., Sharp, D. (2004). Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract 21: 99-106 [Abstract] [Full Text]  
• Gutman, J. D., Kotton, C. N., Kratz, A. (2003). Case 29-2003 - A 60-Year-Old Man with Fever, Rigors, and Sweats. NEJM 349: 1168-1175 [Full Text]  
• Mechanic, D. (2003). Is The Prevalence Of Mental Disorders A Good Measure Of The Need For Services?. Health Aff (Millwood) 22: 8-20 [Abstract] [Full Text]  
• White, K. L. (2003). Two Cheers for Ecology. Ann Fam Med 1: 67-69 [Full Text]  
• Fryer, G. E. Jr, Green, L. A., Dovey, S. M., Yawn, B. P., Phillips, R. L., Lanier, D. (2003). Variation in the Ecology of Medical Care. Ann Fam Med 1: 81-89 [Abstract] [Full Text]  
• (2003). Family Medicine Residency and Academic Medical Center. Ann Fam Med 1: 123-123 [Full Text]  
• Dovey, S., Weitzman, M., Fryer, G., Green, L., Yawn, B., Lanier, D., Phillips, R. (2003). The Ecology of Medical Care for Children in the United States. Pediatrics 111: 1024-1029 [Abstract] [Full Text]  
• van Weel, C. (2003). Dietary advice in family medicine. Am. J. Clin. Nutr. 77: 1008S-1010 [Abstract] [Full Text]  
• Bates, D. W., Ebell, M., Gotlieb, E., Zapp, J., Mullins, H.C. (2003). A Proposal for Electronic Medical Records in U.S. Primary Care. J. Am. Med. Inform. Assoc. 10: 1-10 [Abstract] [Full Text]  
• Silenzio, V. M. B. (2002). What Is the Role of Complementary and Alternative Medicine in Public Health?. Am. J. Public Health 92: 1562-1564 [Full Text]  
• Graham, R., Roberts, R. G., Ostergaard, D. J., Kahn, N. B. Jr, Pugno, P. A., Green, L. A. (2002). Family Practice in the United States: A Status Report. JAMA 288: 1097-1101 [Abstract] [Full Text]  
• Dovey, S M, Meyers, D S, Phillips, R L Jr, Green, L A, Fryer, G E, Galliher, J M, Kappus, J, Grob, P (2002). A preliminary taxonomy of medical errors in family practice. Qual Saf Health Care 11: 233-238 [Abstract] [Full Text]  
• Grumbach, K., Bodenheimer, T. (2002). A Primary Care Home for Americans: Putting the House in Order. JAMA 288: 889-893 [Abstract] [Full Text]  
• Mechanic, D. (2002). Removing Barriers To Care Among Persons With Psychiatric Symptoms. Health Aff (Millwood) 21: 137-147 [Abstract] [Full Text]  
• Grumbach, K. (2002). The Ramifications Of Specialty-Dominated Medicine. Health Aff (Millwood) 21: 155-157 [Full Text]  
• Goldberg, W., Goldfrank, L., Smith, P. C., Green, L. A., Lanier, D., Yawn, B. P. (2001). The Ecology of Medical Care Revisited. NEJM 345: 1211-1212 [Full Text]  
• Lee, T. H. (2001). Ecology in Evolution. NEJM 344: 2018-2020 [Full Text]