Primary health care encompasses the physicians and support staff that serve as the critical interface with the health-care system for most patients. Providers are specially trained for the unique demands of diagnosing and providing continuing care for a defined set of patients with a variety of complaints and diseases.
Definition
Primary care providers are those who offer the first contact and continuing care for patients, as defined by the American Academy of Family Physicians. In doing so, they must be prepared for the treatment of any undiagnosed sign, symptom or disease. Furthermore, they are not limited by the problem's origin. They must be trained and prepared to handle complaints from biological or psychological origin. Primary care practice also encompasses health promotion and the prevention of disease.
Primary Health-Care Doctors
Traditionally primary health care is provided by generalist physicians. These are specially trained doctors who devote their practice to the continuing care of a defined population of patients. These services are performed primarily by physicians trained in the fields of family medicine, general internal medicine or general pediatrics. These specialized training programs prepare doctors for their role in the comprehensive and continuing care required of primary care providers.
Additional Providers
In some circumstances, providers not trained in the fiends of family medicine, internal medicine or pediatrics will serve in a primary care role. This is true in cases where there are specific patient needs, such as during the treatment of a complicated chronic disease or during patient rehabilitation. Additionally, non-physicians might serve as primary care providers. This would include care by nurse practitioners, physician assistants and others who meet the definition of providing first contact and comprehensive, continuing care.
Prevention as Primary Care
With the advances and success of modern medicine, many patients are living much longer with chronic diseases. This places a great burden and stress on medical resources. Treatment of chronic disease is predicted to be the leading cause of disability and the most expensive part of health care by 2020, according to the World Health Organization. As many of these conditions are preventable, a great emphasis is now being placed on the incorporation of prevention into primary health care. Initiatives focusing on early detection and prevention have shown improvement in chronic conditions such as heart disease, diabetes and asthma.
Provider Shortage
The burden of an increased aging population with more chronic diseases has led to a shortage of primary care providers. This has been worsened by a relative decrease in the number of medical students choosing careers in primary care specialties. The American Medical Association predicts a shortfall of as many as 21,000 primary care doctors by 2015. Recognizing this significant potential problem, steps have been taken to increase the number of primary care doctors, including provisions in the American Recovery and Reinvestment Act and Affordable Care Acts.
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