Primary care is the point of entry into the health services system and the locus of responsibility for organizing the care of patients and populations over time. This involves difficult problems, which are lucidly discussed by Barbara Starfield. Her book has four purposes: to help practitioners of primary care understand what they do and why, to provide a basis for the training of primary care practitioners, to stimulate research that will provide a more substantive basis for improvements in primary care, and to help policy makers understand the difficulties and challenges of primary care and its importance. No other text provides so clear an account of the concept of primary care. In addition to discussing systems of primary care and alternative ways of evaluating them, Starfield addresses important issues such as practitioner-patient communication, information systems and medical records, referral processes, personnel, managed care, financing, quality assessment and community orientation. Her text will be of exceptional value to anyone interested in critical thinking about the field of primary health care.
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