Background and Objectives: Schools of medicine in the United States may overstate the placement of their graduates in primary care. The purpose of this project was to determine the magnitude by which primary care output is overestimated by commonly used metrics and identify a more accurate method for predicting actual primary care output. Methods: We used a retrospective cohort study with a convenience sample of graduates from US medical schools granting the MD degree. We determined the actual practicing specialty of those graduates considered primary care based on the Residency Match Method by using a variety of online sources. Analyses compared the percentage of graduates actually practicing primary care between the Residency Match Method and the Intent to Practice Primary Care Method. Results: The final study population included 17,509 graduates from 20 campuses across 14 university systems widely distributed across the United States and widely varying in published ranking for producing primary care graduates. The commonly used Residency Match Method predicted a 41.2% primary care output rate. The actual primary care output rate was 22.3%. The proposed new method, the Intent to Practice Primary Care Method, predicted a 17.1% primary care output rate, which was closer to the actual primary care rate. Conclusions: A valid, reliable method of predicting primary care output is essential for workforce training and planning. Medical schools, administrators, policy makers, and popular press should adopt this new, more reliable primary care reporting method.

This paper empirically analyzes the impact that the spread of casino gambling has on social capital in communities throughout the United States. Social capital is a networking process that translates into an individual's effectiveness in the community and workplace, and binds communities together. Several recent studies have also demonstrated a link between higher levels of social capital and quality of life. In this study, social capital is measured based on six dimensions: trust, civic, volunteerism, group participation, giving, and meeting obligations of family and friends. Using data from the DDB Needham database for the years 1978, 1988, and 1998, regression analysis is conducted on over 300 Metropolitan Statistical Areas throughout the United States to determine the impact that the spread of casino gambling has on social capital. The results of the analysis indicate that the presence of casino gambling significantly reduces social capital when a casino is located within 15 miles of a community, suggesting that a casino's location influences a community's quality of life and should be a consideration when deciding on the merits of gambling legalization.