Each of the four presentations in this year's series challenged traditional perspectives and drew important connections. In the first forum, Increasing the Supply of Generalist Physicians: Theory versus Practice, panelists debated the meaning of the term "generalist" and questioned the assumptions on which educational and governmental policy initiatives are founded. Discussion also pointed to the role of telecommunication (i.e., telemedicine and teleconferencing) in the training and support of generalists. Telemedicine was featured in the last forum of the year, Telemedicine and Access to Care: A Demonstration. The presentation by Eric Tangalos, a primary-care physician at the Mayo Clinic, suggested that, once people understand what telemedicine is and what it can do, policy debates will replace demonstrations of the technology on center stage.
The forum Shared Decision-Making Programs: Interactive Video for Patients highlighted another relatively new communication technology that delivers tailored information to individual patients via videodisc player, minicomputer, and video monitor. To make a case for the informed choices that interactive programs promote, Gary Schwitzer, a former medical news producer and correspondent at Cable News Network (CNN), provided insights into the generation and limitations of health information conveyed through the mass media.
Theo Schofield, a lecturer at Oxford University Medical School and general practitioner in the Oxford region, discussed another kind of shared decision making: that between professionals and the community they serve. In the forum Primary Care, Health and the Community, he offered an alternative to the notion that community health problems require medical solutions and provided compelling examples in the process.
This report is intended to convey the core ideas from each forum to a diverse audience. In the interest of fidelity, brief introductions to each presentation are followed by excerpts from speakers' remarks. A videotape of Telemedicine and Access to Care: A Demonstration has been produced because the telemedicine demonstration is best represented in a more dynamic format. A limited number of videotapes are available upon request from The Annenberg Washington Program.