“Primary care” is a term many people recognize, but if asked to define it, they’ll have some vague answers at the ready. It’s yet another term that’s widely disseminated and thought to be understood when in reality, everyone just goes along.
But it’s easy to understand why there’s confusion, much of the healthcare system is anything but clear, and primary care is the linchpin of a complicated web that spans myriad health needs.
What Does It Include?
Primary care is where people go when they’re feeling unwell for the first time, or when they feel as if they need preventive medicine or are just curious about their health. Primary care includes a broad spectrum of treatment for all age ranges, diagnosing and treating acute illness, facilitating preventive care through wellness checks and vaccinations, assessing early signs of other potential conditions, and even referring patients to specialists if the concern presents itself beyond their expertise.
Many people don’t realize how extensive the role of a primary care physician is; in fact, a primary care doctor has to be equipped to diagnose and treat what are often considered basic health-related matters, common colds, injuries, rashes, gastroenteritis, diagnoses but also chronic disease management, diabetes, coronary artery disease, hypertension asthma. Additionally, they prevent any onset of medical issues with physical exams, vaccinations, and wellness checks over a patient’s lifetime, providing guidance about nutrition and exercise in childbearing years, adult years and geriatrics.
It’s important to establish a primary care definition so that patients understand how it’s different from urgent care or specialist medicine from the get-go. It’s about an ongoing relationship with one or a small group of caregivers who know your health history inside out; who knows your goals and desires; who can spot trends or concerns that otherwise would go undetected.
But One Thing That Needs to Be Emphasized
But what’s not emphasized enough about primary care is how it becomes more effective when there’s continuity involved. If a patient sees the same doctor, or the same practice, over months and years, they’ll become familiar with their baseline health tendencies; family history; responses to particular treatments.
For example, over years with the same doctor, they may have gotten a flu shot and noted its side effects and how they responded differently than other patients in the office who reported being less sensitive. They could note a sudden weight gain that’s not attributable to lack of exercise but rather to some other medication-induced impact.
They could note an underwhelming response to certain medications based on how others their age responded without consideration in what’s good for the patient might not necessarily work for everyone else.
Therefore, continuity makes for efficient healthcare; the primary care physician has access to all their tests, responses over time; there’s a narrative already created. From the patient perspective, there’s no longer a need to reiterate basic information each time one goes to seek help.
Prevention, Prevention, Prevention
On top of all this, the most important thing anyone should think about with doctors is not turning to them when they’re sick. The prevention that comes from primary care is huge – even if most people think of doctors as people who treat them when they’re unwell.
An enormous part of the job is keeping well people well – with routine physicals and screenings facilitated by a primary care provider (PCP), risk factors are assessed early on and interventions are needed before it becomes something serious down the line.
Prevention involves age-appropriate cancer screenings (mammograms 40+; pap smears starting at 21; prostate screenings starting at 50); cardiovascular risk assessments (cholesterol by 35; hypertension by 40); diabetes risk assessment by 45; bone density exams by 65; mental health considerations throughout (depression screening recommended for all).
Prevention is also concerned with vaccinations (childhood series through age 18; shingles vaccine suggested starting at age 60) and even general assessment about weight gain/loss or exercise habits (obesity screens from age 2; substance use concerns from age 12). But for adults, even simple vaccinations like the Tdap from ages 19-64 is assessed periodically every ten years (without anything else going on) since a PCP keeps track over time.
The issue with prevention is that it doesn’t feel as urgent as resolving something that’s acutely ill. Going to the doctor for a checkup when nothing hurts does not have quite the same attitude shift that seeking treatment for something painful does. But research shows that preventive treatment can reveal serious conditions much sooner and at less costly resolutions so it’s worth it.
But What If There Are Chronic Conditions?
Especially for patients with chronic health issues, diabetes, heart disease, arthritis, respiratory distress, primary care becomes essential. Associated with chronic illness are costs that can be mitigated through consistent preventative communication, assessed concerns and multidisciplinary approaches.
Chronic issues are monitored best with consistency; they’re not sudden conditions; they’re longstanding ones that require life adjustments which can be monitored proactively instead of reactively. Medication changes; lifestyle changes, diet changes which may require specialist intervention (dietician/nutritionist) or lessening weight for overworked joints, which requires other specialists as well (orthopedist). Primary care serves as the quarterback where everything intersects, where medication use overlaps with nutrition overlaps with physical ability.
For example, there’s vastly better outcomes for individuals who keep regular PCP appointments compared to those who go but only when symptoms arise since those who engage regularly have fewer ER visits and fewer hospitalizations, a tribute not only to more nuanced expectations but also expectations set long term by their doctors who advocate on their behalf.
The Access Issue
Access to quality primary care has become more problematic over time. Not only are there doctor shortages in rural areas instead of minutes away in cities where patients can wait weeks or even months for an appointment but insurance prevents whom people can see better than going directly without a PCP.
But in reality, the model for whom primary care best works can take on various forms. Expanding offices include Nurse Practitioners and Physician Assistants who can assist in primary care functions similar to PAs for specialists.
There are telemedicine options that expand what’s possible and innovative developments in various communities (community health centers or direct primary care options which work without insurance) that highlight different benefits for different structures.
Yet ultimately access is part of the solution, for as long as people can get affordable primary care regularly without issue, and within reason, they’re more prone to engage than avoid.
Maximizing Primary Care
Patients need to do their part to get most out of primary care as well. It’s one thing for caregivers to help preventive care through screenings but if patients don’t show up for annual exams (even while feeling well) it’s less effective.
It’s also important to choose one’s primary care person wisely; not every caregiver has effective communication patterns with all patients; it’s important to find similar abilities so that an A+ effort satisfies both parties with resultant implications longitudinally.
From everything from a conservative approach toward certain medical intervention against other aggressive measures whatever works best should be organized so that patients feel comfortable returning.
The better rapport established before someone feels off-kilter best works before any interventions are needed; it creates a cohesive net, there’s someone out there who knows you medically inside and out, which best makes informed decisions if something ever gets complicated along the way. That’s what primary care means and why it needs to be better understood as part of lasting health solutions.
