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The Characteristics of Primary Care
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2. Nice to Know:

Primary care refers to first-contact care that deals with the majority of health problems occurring for individual patients. 

Primary health care is a broader concept that extends primary medical care to also address health issues in a community, using preventive and public health approaches.  

Many groups have proposed criteria for judging good quality primary health care. For example, the WHO suggested that it should be

Likewise, the College of Family Physicians of Canada has proposed Four Principles of Family Medicine. These focus mainly on primary care - the narrower conception:

  1. The family physician is a skilled clinician. "Family physicians demonstrate competence in the patient-centered clinical method; they integrate a sensitive, skillful, and appropriate search for disease…"
  2. Family medicine is a community-based discipline. "Family practice is based in the community and is significantly influenced by community factors…"
  3. The family physician is a resource to a defined practice population. "The family physician views his or her practice as a 'population at risk', and organizes the practice to ensure that patients’ health is maintained whether or not they are visiting the office…"
  4. The patient-physician relationship is central to the role of the family physician. "Family physicians have an understanding and appreciation of the human condition, especially the nature of suffering and patients’ response to sickness. They are aware of their strengths and limitations and recognize when their own personal issues interfere with effective care…"

Dr. Ian McWhinney (U Western Ontario) has proposed nine characteristics of the Good Family Physician: Family Doctors . . .

  1. …are committed to the person rather than to a particular body of knowledge, group of diseases or special technique;
  2. …seek to understand the context of the illness;
  3. …see every contact with their patients as an opportunity for prevention or health education;
  4. …view their practice as a “population at risk”
  5. …see themselves as a part of a community-wide network of supportive and health care agencies;
  6. …should ideally live in the same community as their patients;
  7. …make house-calls to the pastient's home;
  8. …attach importance to the subjective aspects of medicine;
  9. …are managers of resources.

Finally, Dr. Peggy Leatt ( U Toronto) has proposed challenging criteria from the patient's perspective that will define the achievement of an integrated system:

How will patients know when an integrated health care system exists?
When they:

Links: Back to Primary Care
            CANMEDS 2000: the roles of the contemporary physician
            Romanow report (which talks of primary care)