The Long-Term Necessity of a Primary Care Relationship

An excerpt from Medical Answers Now!: How Direct Primary Care Guarantees Fast Access to Your Doctor.

You need a doctor for more than just urgent medical questions and treatments. The doctor-patient relationship is crucially important. You should recognize that the value of having a primary care physician extends well beyond securing quick access for life’s unexpected emergencies.

Americans receive medical care in many ways. Too often in the United States, the delivery of healthcare is done in a manner that is piecemeal, inefficient, and unnecessarily expensive. It is not uncommon for people to receive initial care from multiple providers in disparate medical practice settings and institutions. They may go to urgent care walk-in clinics as their primary first stop for illnesses and emergency departments at hospitals for even minor injuries. In addition, they may see a cardiologist for their high blood pressure, an endocrinologist for simple type 2 diabetes, an allergist for seasonal allergies, and an orthopedist for chronic knee pain. It is also increasingly common for people to utilize some kind of telemedicine service, which puts them on the phone or a video call with a physician they have never met to address an acute medical concern.

In this example alone, a patient without a primary care physician may be seeing seven different physicians and medical groups for very common and routine conditions. As you might imagine, this widely dispersed care is inefficient, costly, and creates a situation that makes it nearly impossible for providers to smoothly coordinate the patient’s care.

There is a better way—a first stop for all medical questions and needs. A medical home where the majority of medical concerns are diagnosed and treated by a single physician and where any specialty care that is required is coordinated on behalf of the patient. Primary care physicians or PCPs are the doctors who fulfill this role for their patients. They are most often trained in family medicine, internal medicine, pediatrics, or general practice and are well-equipped to handle the majority of health issues that patients may have. They are also alert to triage or refer their patients to any number of other physician specialists when needs arise. Not surprisingly, common things occur commonly.

Primary care physicians “specialize” in common conditions and health needs. A discussion of the value of primary healthcare must begin with a definition of the practice. A functional definition is found in a text by Cruz-Cunha and associates: Primary care involves the widest scope of healthcare, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care.

Primary care is generally accepted to be the foundation of any effective healthcare system. Effective and efficient healthcare begins with a single primary physician who has an ongoing relationship with the patient, a detailed knowledge of their medical and personal history over time, and is trusted by the patient to be the first source of information, advice, diagnosis, and treatment of their health needs. In the context of this relationship, patients are statistically more likely to receive timely preventive screenings, early detection and treatment of diseases, and well-balanced health education and are more likely to be encouraged in lifestyle modification and healthy lifestyle. Primary care improves health, prevents illness and death, and is also associated with a more equitable distribution of health in populations.

During the COVID-19 pandemic, individuals with primary care relationships were better able to receive appropriate medical care, diagnosis, and treatment of COVID-19 infection and had a medical consultant to explain confusing mitigation guidance and mandates as questions arose. Primary care physicians also serve as a medical home for their patients, referring and coordinating consultations of specialists and explaining/interpreting the recommendations of these specialists to their patients.