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          R 0 U G H  D R A F T     Lawrence K. Coffin--January 16, 19b7


          Dr. Elwood kicked off the session witn the comment that the RNP was an unusual
          piece of legislation             worded and sumed up that this was conducive
          for innovation and creativity.  Others felt that it was for
          We would like to today find out what is working for the respective programs
          or what is not working for them and what are their expectations.  The program
          is presently under analysis or the premises on which it was established and the
          pi*lem  of health physician obsolescence.  Dr. George D. Johnson of Spartanburg,
          South Carolina felt that there was a disparity between the physician and research
          is not as great as the disparity between education and the people that demand
          medical care. The average physician does not deal with the heart, cancer,  stroke
          aspects as much as others.  Need to spend more time on the education process and
          the aid of medical students to circulate among the poor classes to educate.  He
          feels that there is a matter of apathy, ignorance and indifference in the patient
          population.  Dr. ftuxm Clifford Gtueley of Cincinnati, Ohio felt that there was a
          problem of identifying the questions to be asked in the area of heart disease,
          cancer, and stroke creating more challenging, continuing education courses might
          be a tool for identifying these problems. Dr. Elwood asked the question is  there
          any attempt to bridge the distance gap.  Dr. George Johnson again felt that the
                              is
          general practitioner/required, in most medical schools, to take so many hours
          of postgraduate courses.  This group has done the most to keep abreast of the times.
                                            a day
          The guy who has to see 75 patientsi-not because he wants to but because he has to--
          is being neglected and is hard to reach.  Dr. Leonard Policoff of Albany, New York
          found that there was a lack of information in the physician population--not/because
          of their desire but because they were swamped.  They plan to set up an ongoing
          learning center--if they become operational in the community which the physician
          can go to at his convenience to find an answer to a question on a particular
          problem.  Dr. Lee A. Christoferson of Fargo, North Dakota felt t at most areas
          have kept the physicians informed but there is a distance problem--they do not





         enough developed so that he can use these facilitiest to the fullest of his

         training.  The quality of the lab at his disposal has not been the best.
         Lines of n referral iK should be clearly delineated--to develop better cooperation

         among the medical facilities as they presently exist and this _
         feels that the regional medical programs will accomplish one of the many things.

         Dr. Elwood asked if anyone 2m had set up a method of evaluating the physicians

         for effectiveness.  Dr. Christoferson asked the question is this censorship of

         who is qualified to do this.  Dr. Grueley hoped that the tRrmxRmng*xaixliRimpin
         paramedical people would address themselves to the problem in their area and
         that they will set up the Guidelines and they will in essence be
         Dr. Elwood felt that the program is helping to fill the knowledge gap but what
         he is hearing at the present time does not support this.  Dr. William O'Bryan
         of WICHE indicated that :LkmyxwRxmxm@x we are using public tax money and jthat
         first they ought to make a survey of medical facilities to see if there is Actually
         a knowledge gap--information vs. education.  In information we can inform the
         physician but the physician will have to use this information to educate himself.
         He also felt that the trauma is quite as important as t heart, cancer, stroke--
         these people are not as well informed as they could be.  Mrs. Edith B. Jones of
         Bethesda, Maryland felt that the use of the medical group to determine the areas