Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

What is the Scope of Primary Care?


When something goes wrong with your health, it can be hard to figure out whether you can get the care you need from your primary care provider (PCP) or need to seek out a specialist.'  Even health care providers themselves are questioning and reconsidering the care that PCPs provide given new research, payment policies and training decisions.

On Obesity Notes, Dr. Arya Sharma reviews the role of PCPs and trained medical assistants in changing patients' behaviors related to weight loss.'  He cites recent research in which study participants who met with the assistants monthly, as well as with their PCPs every three months, were more likely to lose weight than those who met with only their PCPs. ' Dr. Sharma writes, 'While the paper does not discuss actual costs of this intervention (or its long-term cost-effectiveness), the results certainly suggest that weight management in primary care could be delivered at a reasonable and sustainable cost, even with very limited resources or training.

What about diagnosing or treating mental illness?'  On the AFP Community Blog, Dr. Kenny Lin writes that while annual depression screenings are now covered for Medicare patients, PCPs still have trouble integrating mental health care due to financial and logistical obstacles. ' He cites a paper published in the November 1st issue of American Family Physician that elaborates on these very obstacles.

Sebastian Tong, a fourth-year medical student and blogger at Future of Family Medicine, wonders if "maternity care [is] still part of the family medicine continuum." ' He believes the decision to split family medicine training into either an 'exposure track' or a 'competency track' with respect to maternity care could mean the end of PCPs providing maternity care. ' This is especially troubling since 'family doctors disproportionately provide maternity care to Medicaid and underserved patients,' he writes. ' 'Without maternity care, family medicine can no longer claim to provide the full continuum of comprehensive care.

What has your experience been, either as a doctor or patient?'  What falls in the realm of primary care and what requires specialty care?


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Inside Health Care posts feature recent news and blog posts from the health care community and are part of the Center for Advancing Health’s portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.

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susan256 says
November 30, 2011 at 4:05 PM

Primary care is less expensive then specialty care and in this moment in time, costs matter. So for many of us, we must seek out our care from PCPs and most times our questions can be answered. But is also requires patients to be engaged with the care of their health. Part of the doctor/patient relationship is about trust; feeling comfortable asking tough questions about costs, alternatives and what's best for me. If the relationship isn't there, chances are patients will end up paying more or not get the care they need.