The Patient Centered Primary Care Collaborative has announced that the theme for their summer stakeholders’ meeting is PCMH in Community. I have been interested in the role of primary care in community for many years so this piqued my interest. When I looked at the topics, it is apparent that the definition of community for the stakeholders (mostly large corporations and large medical organizations) is somewhat different from my definition.

At the STFM conference in Vancouver, I was reminded that the “Community Health Center Movement” of the 1960s was a product of a desire to achieve social justice on the part of some far-sighted individuals. One of the first community health centers was in Bolivar County, Mississippi. The staff discovered that to improve the health of the surrounding population required more than a stethoscope and a black bag full of medications. To affect infant mortality the had to lobby for clean water. Noticing that malnutrition was a very real problem, they distributed nutritious food. Learning that actual laws precluded activities that resulted in improved health, they worked for changes in those laws.

The founder of the movement, Jack Geiger, pointed out that there is a difference between facilities that are in the community (such as subway stops) and true community institutions. In looking at the agenda for the PCPCC meeting, I don’t know that the health reform movement has trickled down to the community just yet.

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