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This Week in Primary Care
The "What Is It?" Issue
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We want it for every American.
We say it’s time to invest in it. (And more and more states are passing laws to do just that!)
But what is it? How do we define high-quality primary care?
We appreciate the practicality and simplicity of the 4 C’s: primary care is first-contact, continuous, comprehensive, coordinated healthcare, provided to everyone regardless of age, organ system, or condition. This is the definition that legendary researcher Barbara Starfield used to establish that if a country invests in primary care, its people stay healthier, live longer, and spend less on healthcare.
Primary care is a patient’s first contact to the healthcare system - diagnosing new problems, providing most ongoing care, and connecting patients to trusted specialists when needed. Its strength lies in continuity: long-term relationships that allow clinicians to understand patients as whole people within their families and communities. Primary care is comprehensive, welcoming all patients and conditions and treating each patient holistically, and coordinated, guiding families through a fragmented healthcare system.
For a nuanced exploration of what primary care is and how it’s misunderstood, listen to this recent podcast episode from the New England Journal of Medicine. They open with a quote from Dr. Larry Green, a Colorado family physician, family medicine professor, and health policy expert: “Primary care floats on two boats simultaneously: skillful generalists — clinical generalists who know a bucketload of medicine — and longitudinal relationships.” Both are eroded as primary care is reduced to a checklist of algorithm-driven treatments for individual diseases, as cultural anthropologist and family medicine professor Dr. Rebecca Etz explains.
This trend is not new, and underinvestment in primary care has continued for decades. As the host, Dr. Lisa Rosenbaum, synthesizes: “We’ve been having the same conversation for over 25 years. So are there better ways to help people understand primary care well enough to fight for it?”
We think the answer is Primary Care for All Americans. We’re teaching people to organize high-quality primary care for themselves and their neighbors, educating their leaders and legislators along the way. Listen to the podcast. Get your friends and family to guess the four C’s. Come to next week’s Teach-In/Learn-In to talk with Dr. Marguerite R. Duane about how she’s providing first-contact, continuous, comprehensive, coordinated care to her patients in their homes. And email admin@primarycareforallamericans.org to get started with your neighbors!
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