Most visits to a doctor are visits to a primary care physician–typically a family doctor, general internist, or sometimes a general pediatrician or obstetrician-gynecologist–who is responsible for the patient’s routine medical care. If you develop a productive, satisfying relationship with your primary care practitioner, you will be well along the way to effective communication with all your health care providers, present and future.
Let’s start by looking at what primary care is, and why it’s important. This is almost holy ground for me. My first job after school was to work on an Institute of Medicine study that developed the authoritative definition of primary care, still widely cited decades later. We said primary care is “accessible, comprehensive, coordinated, continuous, and accountable care.”
In other words, the primary care practitioner is your portal to the health care system and, more than that, oversees all your health care, from episode to episode, as your agent. You can, for example, use him or her to:
- refer you to any type of specialist and, afterward, help you decide whether to undertake a procedure the specialist recommends
- answer any of your questions about changes in your health or about health-related ideas you’ve encountered, and
- give you useful instructions for preventing disease or managing your own self-care in light of your lifestyle and resources.
This is a terrific deal! Researchers have found that primary care is “associated with superior health outcomes.” Yet, it generates only a tiny fraction–less than seven percent–of all health care costs.
Unfortunately, an emphasis on high-tech procedures has led to a nearly alarming shortage of primary care physicians in the United States. You may have trouble finding one. Increasingly, patients are turning to nurse practitioners and other non-physicians to meet their primary care needs–a topic we’ll be discussing shortly.
If you go on the alert for information about primary care, here are some terms you can expect to encounter:
- teamwork, considered the essence of effective primary care
- partnership, what patients are seen as expecting from their primary care practitioner, along with good communication and tools for self-management of their health conditions
- medical home, a new term for primary care, often applied to poor people, and
- patient surveys, used by more and more primary care practices to make sure patients’ experiences are positive.
For more information, you may want to consult my guide, featured on this blog. It discusses such topics as how to present a problem to a physician (section 1, down-loadable at no charge) and how to find the right doctor (section 2, available along with section 3 on how to evaluate the doctor’s advice, for $5).