What exactly is primary care? The American Academy of Family Physicians uses words like comprehensive, preventative and cost-effective. The National Institutes of Health describes primary care as long-term and non-emergency and includes a number of different providers: family practitioners, pediatricians, internists, obstetricians/gynecologists, nurse practitioners (NPs) and physician assistants (PAs). But lately, there have been a number of news stories that point to shifts in these traditional definitions and in what patients can (or should) expect to receive from these go-to providers.
In The Atlantic, primary care provider (PCP) Dave Chokshi writes that primary care is "the linchpin of the United States' health system," and "Our concept of [it] is undergoing a historic reinvention." The number one change, he writes, is a move away from payment-for-services-rendered to payment-based-on-health-outcomes. For those who are used to simply doing as the doctor says, this may be unfamiliar territory as it will require a deeper level of patient engagement from consumers. "Respecting patients' values and preferences, resolving conflicting opinions among specialists, and communicating with professional and family caregivers all fall within the purview of primary care," says Chokshi.
Oregon, Colorado and Massachusetts are experimenting with putting mental health therapists in the same office as PCPs so patients don't have to make a second appointment. In some cases, a person can meet with a psychologist in the same room where the primary care appointment took place. This eliminates hassle for patients and helps to reduce stigma about seeing someone for mental health concerns.
This is good news for both patients and doctors given that a recent study published in the Journal of the American Medical Association found that PCPs don't have the best tools for recognizing and treating the most common type of mental health concern, depression. It's estimated that 19 million American adults suffer from depression, and since people are most likely to see their primary care providers first, it makes sense that more should be done in the primary care setting to address mental health.
If you've got questions about seeking primary care, these Prepared Patient resources can help:
Deciding When to Seek Care – It can be hard to decide when to go to the doctor or other medical professional for a problem. These resources can help you make the call.
Do You Need a Yearly Checkup? – Checkups are good for establishing a relationship with your primary care clinician and for screening tests. Here is information on what tests you might need to stay healthy.
Depression: When Should You Get Help? – Depression is a common condition, especially in people with chronic illnesses. Here's how to recognize if you need help.