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$1 Million Grant Will Fund Training In Primary-Care Medicine, Geriatrics

By Robert J. Campbell

The Medical School recently received more than $1 million to train physicians to teach primary-care medicine and geriatrics, a Medical School official said yesterday.

The goal of the fellowship program, established by the Henry J. Kaiser Family Foundation, is to prepare physicians to become competent teachers of diagnostic and clinical medicine in general practice and in treatment of older patients, Dr. Mitchell W. Spellman, dean for medical services, said yesterday.

The grant's emphasis on primary-care medicine and geriatrics reflects changes in the delivery of medical care and in the age-composition of the population, Dr. Daniel C. Tosteson, dean of the Medical School, said yesterday. He said the trend toward comprehensive health centers, which emphasize preventive medicine, requires the training of more primary-care physicians.

The percentage of the U.S. population over 65 years old has almost tripled since the turn of the century and now accounts for 30 per cent of all health-care expenditures.

Comeback

"The burgeoning divisions of general medicine has really outstripped the supply of qualified faculty in primary care," Dr. Thomas Delbanco, director of the primary care fellowship, said yesterday. Many present primary-care physicians have not received any special training in the field, he added.

The Kaiser Foundation began a primary-care fellowship program last October to train five Harvard physicians. The expanded grant provides $830,000 to train 20 physicians to teach primary-care medicine and $258,000 to train three physicians to teach geriatrics.

All 23 participants in the program will enroll in a five-month core curriculum that links geriatrics and primary care medicine. The curriculum includes courses in biostatistics, decision theory, microeconomics and computer science.

Among Friends

They will also pursue research projects and participate in weekly seminars.

Current research projects in primary-care medicine include improving decision-making for emergency-room patients with chest pains; studying the cost-effectiveness of the standard practice of taking blood cultures of hospital patients with fevers; and determining the appropriate hospital stay for cardiac patients in an intensive-care unit.

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