primary care

Introduction

• Primary care provides both first contact for a person with an new health concern & continuing care of medical conditions, not limited by cause, organ system, or diagnosis

• Primary care may be provided by a physician/medical doctor or a nurse practitioner
• Most primary care physicians are specialized in internal medicine, family practice, geriatrics or pediatrics
  • Gynecologists may serve as primary care providers for women
  • Allergists may serve as primary care providers for patients with asthma
  • Nephrologists may serve as primary care providers for patients on renal dialysis
• health care provided by a patient's family physician is more effective than health care provided another physician in reducing emergency department use

Notes

• workload for primary care physicians increased in the UK by 18% from 2007-2014
• demand for clinical care coupled with more complex patient care, increasing administrative tasks, pressure to meet quality performance measures, & increasing documentation requirements contribute to increased workload
• preception among medical school graduates is that primary care is stressful, pressured, low-status, with excessive administration
• diagnostic uncertainty present in > 2/3 of primary care visits
• team-based or integrated primary care may reduce emergency department visits & hospitalizations among chronically ill
• greater access to & investment in primary care services are associated with higher healthcare system quality & lower costs
  • U.S. has not invested substantially in primary care
  • spending on primary care services is even lower for older patients & those with chronic health conditions
• optimal panel size unknown
• low-value care not associated with patient care experience ratings
• when a primary care physician leaves practice, patients might turn to urgent care or emergency departments to replace primary care visits
• quality improvement measures to integrate behavioral health into primary care has no effect on patient outcomes

More general terms

• medical specialty

More specific terms

• adult primary care (APC)
• home-based primary care (HBPC)
• senior health clinic care model

Additional terms

• annual physical examination; annual health examination