Primary care, process improvement and turmoil

Sanne Magnan, Leif I. Solberg, Katherine Giles, Thomas E. Kottke, John W. Wheeler

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


The Current health care environment in the United States is in turmoil, especially in regions that are further ahead in the transition from fee-for- service to managed care. This article examines turmoil within primary care during a health-maintenance-organization-sponsored and federally funded randomized trial of using continuous quality improvement for adult clinical preventive services. The external and internal changes in structure and leadership occurring in primary care clinics are profound and prevalent. The sponsors of the project have responded to the turmoil by encouraging greater leadership involvement within the clinic and by supporting more skill building for change management.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalJournal of Ambulatory Care Management
Issue number4
StatePublished - Oct 1997


  • Change
  • Continuous quality improvement
  • Preventive services
  • Primary care
  • Turmoil


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