A trusting relationship between patient and health care provider is based on the understanding that medical practitioners are trained in the healing arts. Patients trust the practitioners to treat them based on this expertise. Primary health care has made its mark in history expanding the patient-provider relationship to include the patient in the decision-making process. While other medical specialties practice patient-centered medicine, this is at the heart of primary care.
Features
Primary care is the entry point into the health care delivery system. Primary care providers act as gatekeepers, assisting patients in their health and wellness process. The key features of the primary care interaction along with alleviation of common ailments and disabilities are accessibility, continuity, patient-centered decision-making and long-term relationship.
The World Health Organization (WHO) describes primary health care as a division of care that goes beyond the medical interface to include community-based health care needs such as family planning, provision of proper food and water supplies and education in preventative medicine and sanitation.
Function
The ongoing relationship between patient and provider indicative of primary care is essential to the health care system. The role that primary health care plays rests on its emphasis of lifelong, personal relationships between patients and their providers.
Primary care's "first contact" function provides an entry point into the health care delivery system. The gatekeeper nature of primary care sustains the rest of the health care system through its referral process. A patient has relatively easy access to making an appointment with her primary care physician. Then the primary care physician advises the patient in terms of her medical care, which may include a referral to a specialist who may be less accessible.
History
According to the Institute of Medicine of the National Academies, it wasn't until 1961 that the term "primary care" was first introduced. Seventeen years later, the WHO developed a comprehensive overview describing primary care as essential to the welfare of underserved communities. In 1984, the Institute of Medicine expanded its earlier definition to include primary care's emphasis on community needs, setting the stage for the comprehensive system it is today.
Providers
The Institute of Medicine indicates that primary health care is provided through the combined efforts of generalist physicians, non-generalist physicians offering some primary care services, nurse practitioners and physician assistants. The main primary care providers are licensed physicians--either M.D. or D.O.--which include family practitioners, pediatricians, internal medicine doctors and obstetricians and gynecologists.
Community Health Centers
Community health centers or CHCs promote the goals of primary care by providing comprehensive health care to underserved communities. The U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) provides strict guidelines governing the operation and nature of CHCs. HRSA states that for a medical center to qualify to be a CHC the majority of its board of directors must be patients from the community in which the center is located. In addition to medical care, the CHC must provide support services such as welfare and Medicaid education, transportation information, comprehensive social assistance and language translation.
References
- "History of Medicine: A Scandalously Short Introduction"; Jacalyn Duffin; 2004
- American Academy of Family Physicians: Primary Health Care
- "Primary Care: America's Health in New Era"; Institute of Medicine; 1996
- "A Manpower Policy for Primary Health Care: A Report of a Study"; Institute of Medicine; 1978
- "Defining Primary Care: An Interim Report"; Institute of Medicine; 1994
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