Primary care: The “Sinew “of Medicine (Healthcare)

By | June 13, 2018

In order to understand and more effectively use our health care system, it is most important to appreciate these fundamentals:

Medicine (medical) actually has two usages.

Medicine (medical) is used broadly to mean the entire Health Care System (the term which will be used henceforth).

The Health Care System is divisible into two parts, also termed disciplines.

  1. Medicine (Medical) in its narrower usage, refers to those in the Health Care System who render patient care of a mostly non-surgical nature, and therefore do not usually perform operations.
  2. Surgical (Surgeons) refers to the members of the Health Care System who render patient care for conditions often requiring an operation to correct.

Members of the Medical and Surgical disciplines who provide clinical care to individual patients, are variously, equally, and interchangeably referred to as:

  • Practitioners (this term will be used henceforth).
  • Providers
  • Clinicians

The term used is based on personal preference.

All practitioners have one of three different degrees and training.

  • Medical Doctor (MD)
  • Physician Assistants (PA)
  • Nurse Practitioners (NP)

Medical Doctors and Physician’s Assistants are trained on the “Medical Model” (Medical and Surgical), whereas Nurse Practitioners are trained on the “Nursing Model” (Medical and Surgical).

Providers (Medical and Surgical) are further divided into two groups based on breadth and depth of their training:

  • General Care (Generalists), possess a broad understanding of Medical and Surgical care, but not as in-depth as the Specialists. Generalists refer to Specialists when patient care warrants.
  • Specialists, possess an in-depth understanding of their particular area of expertise.

Primary care refers to the provision of General Medical (non-surgical) care by providers to all patients, (Medical, Psychiatric, and those ultimately requiring Surgery).  They are intended to be the first to encounter and evaluate all individuals, acting as “gate keepers”, ensuring that everyone receives the care required.

The provision of care can be thought of as having two components:

  1. Strategy: the Medical, Psychiatric, and/or Surgical decision making of the particular case.
  2. Logistics: How the Medical, Psychiatric, or Surgical care will actually get done:
  • Communicating with other Health Care Providers and other service providers
  • Communicating with patients, families, significant others, authorities, et al.
  • Prescriptions, with sensitivity to cost, provisions of medical supplies (when able).
  • Insurance issues, scheduling, and transportation.
  • Filling out paperwork of various types.
  • Discussion of end of life care.

By providing coordination and oversight, of their patient’s overall health care, and giving foundation and framework to the entire health care system, Primary Care providers are the “sinew” of the entire Medical process.  Consider them to be “problem solvers”. If they are unable to find a solution, they know who can.

Primary care providers need your respect, and everyone should have one. 

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