What is Primary care?
Primary care along with the primary care providers are the front lines of medicine and for many, they are the initial point of contact with the healthcare system. They are usually the first to see patients as they present into the system, evaluating and treating a gamut of medical issues and complaints from the minor to the complex and everything in between. Their unique positioning and ability allow them to study the patient’s medical and social history, develop a trusted rapport, and participate in a collaborative management.
Primary care professionals are, essentially, the quarterbacks of healthcare. They ensure patients get the right care, at the right time in the right setting, in a patient centric manner in congruence with the patient values.
Why is primary care important?
A PCP provides:
- Preventive care services centered around regular health checks all designed to heed off the preventable consequences of many diseases
- Evaluate and treat medical conditions, acute and chronic
- Promote and teach healthy lifestyle choices,
- Make referrals to medical specialists, when needed.
Research has shown that adults (in the US) who have a primary care provider are 19% less likely to die prematurely than those patients only seeing a specialist for their care. Additionally, Primary care is provided at a lower cost. Here again research has demonstrated that people who have a primary care provider save 33% on healthcare over their peers who only see specialists
Primary care in crisis
For all its proven value and worth the profession is in a crisis. Data analysis has revealed that while 55% of office visits take place in a primary care setting, only 4-7% of healthcare dollars go to primary care; highlighting the gross underfunding of primary care reimbursement compared to other specialties, and a contributing factor to why so few medical students choose this path
Hope for Primary Care
The American Journal of Medicine in an article recommends 7 steps that the profession, health care systems, academic medicine, governmental agencies, and insurers (including the Centers for Medicare and Medicaid Services) could take to revive primary care. They are:
- Discarding the Artisan Model: First, medicine as a profession must discard the artisan model of primary care
- Promoting a New Vision: primary care medicine must actively promote a new and positive vision of primary care physicians as specialists
- Changing Medical Groups: medical groups need to fundamentally change the work of primary care physicians by applying systems approaches
- Training Programs: training programs must expose students and residents to desirable primary care practices
- Improving Professional Lifestyles: medical groups need to improve the professional lifestyles of primary care physicians.
- Financial Incentives: state and local governments should recognize that the lack of primary care physicians is an impending crisis for health care
- Finally, payers need to better compensate primary care physicians