primary care

[ImSoStreesedOut]

if u were asked to define and describe primary care in your own words, what would u say????

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[szhao]

Primary care physicians usually include family practice, internal medicine, pediatrics, and at times OB/GYN physicians. It is important to note, however, that the last three of the above specialties are not technically general medicine specialties. These specialties are primary care, but NOT general medicine.

Source: http://en.wikipedia.org/wiki/Primary_care

 

[Law2Doc]

Primary care physicians usually include family practice, internal medicine, pediatrics, and at times OB/GYN physicians. It is important to note, however, that the last three of the above specialties are not technically general medicine specialties. These specialties are primary care, but NOT general medicine.

Source: http://en.wikipedia.org/wiki/Primary_care

I'm unclear what that last sentence, which is from the wiki reference, even means. But I agree with the rest of the definition.

 

[silverlining1]

I'm a tad confused as well. That definition makes sense to me in general, but as far as the US News rankings go (research, primary care), I'm not sure which to really look at. I would like to go into surgery, which doesn't sound like either category - any advice on how I can understand rankings in this domain?

 

[Law2Doc]

I'm a tad confused as well. That definition makes sense to me in general, but as far as the US News rankings go (research, primary care), I'm not sure which to really look at. I would like to go into surgery, which doesn't sound like either category - any advice on how I can understand rankings in this domain?

You can definitely get into surgery from any allo school. And surgery is certainly not primary care. But in general, look at the research rankings, the list with Harvard, Hopkins, UCSF etc at the top of the list. Rankings themselves are meaningless, but this at least gives you a rough idea of the prestige pecking order. The primary care rankings, which are based in part on the percentage of people who go into primary care, and puts schools like Harvard, Hopkins, Cornell, etc fairly low on the list, don't really tell you whether the schools that top that list do that focus better or whether folks get boxed into those fields.

 

[dutchman]

if u were asked to define and describe primary care in your own words, what would u say????

Where you find the most disgruntled doctors

 

[silverlining1]

You can definitely get into surgery from any allo school. And surgery is certainly not primary care. But in general, look at the research rankings, the list with Harvard, Hopkins, UCSF etc at the top of the list. Rankings themselves are meaningless, but this at least gives you a rough idea of the prestige pecking order. The primary care rankings, which are based in part on the percentage of people who go into primary care, and puts schools like Harvard, Hopkins, Cornell, etc fairly low on the list, don't really tell you whether the schools that top that list do that focus better or whether folks get boxed into those fields.

Thanks - that was quite helpful!

 

[DropkickMurphy]

The people who most ER patients should be seen by.

 

[WatchingWaiting]

Primary care is the central point of contact for insured people with the healthcare system. Primary care is the person you see for regular follow-up and initial evaluation of your lower back pain, your high blood pressure, the cough you've had for the last few weeks, and most other non-emergent medical symptoms you feel. That primary care provider then refers you to a nephrologist when you go into kidney failure or a general surgeon when the CT scan done to work-up your abdominal pain reveals a mass or an orthopod when you come in with hip pain after a fall, etc. ER docs are your first point of contact with the healthcare system for more acute presentations or if you don't have insurance and don't have enough money to pay out of pocket for a primary care doctor.

 

[MDDOWhatever]

if u were asked to define and describe primary care in your own words, what would u say????

While it's true that the most widely accepted definition of "primary care" is what the first reponse posted said... Family Practice, OB/GYN (usually), Psychiatry (usually), Internal Medicine, Pediatrics, I personally think there is a much better definition.

That definition would be "generalist."

At the risk of starting a flame war, I think every doc needs to be a good generalist first and a specialist second. I also think that the trend is returning to that, as more academia realizes that the better a generalist any physician is, the better the patient is served.

Primary care (or "generalism") is very much a part of emergency medicine, for instance.

This reminds me of a story that a friend of mine told me, who works for an airlines. They had a medical emergency on one of his flights while in the air, and it was necessary to find a doctor. There were two on board. The nature of the emergency required a phone conversation with an emergency coordinator on the ground, who asked my friend to find out what kind of docs each of them were. One was a pediatrician and the other was a pathologist. The coordinator said something to the effect of "oh christ, at least give me the doc who deals with living people."

Not knocking pathology here, but just saying I would feel really inadequate as a doc (regardless of what I "specialize" in) if I couldn't deal with the most fundamental aspects of medicine at any time. I think that can be done though, even in most specialties. I hope we see a return of the generalist as what docs strive to become first, with great clinical skills to back it up.

Anyway, sorry for the soapbox moment... just wanted to present another viewpoint of "primary care" beyond the board/certification answer.

 

[HelenaP]

The people who most ER patients should be seen by.

On the other hand, working in a primary care office, I have fielded calls including:

"I just found grandma lying on the floor. She said she fell 2 days ago. I tried to clean her up a bit, but she doesn't look too good. What should I do with her?"
and
"My husband cut his foot pretty bad with the lawnmower. It just won't stop bleeding. Should we come in to the office?"

So some people are just genuinely confused about the whole ER concept.

 

[Law2Doc]

Not knocking pathology here, but just saying I would feel really inadequate as a doc (regardless of what I "specialize" in) if I couldn't deal with the most fundamental aspects of medicine at any time. I think that can be done though, even in most specialties. I hope we see a return of the generalist as what docs strive to become first, with great clinical skills to back it up.

Anyway, sorry for the soapbox moment... just wanted to present another viewpoint of "primary care" beyond the board/certification answer.

In the olden days (up through the 80s), all physicians did a year of internship in general medicine, where they learned to be generalists, before moving into their respective specialty residencies. So if that pathologist was an older guy, he would be rusty, but trained on living people. As the world has evolved and there is now simply too much info to know in each field to dedicate a whole year of training to non-specialty info, this internship year has gone by the wayside. Medicine has realized that you can have poorly trained specialists who have decent generalized knowledge, or well trained specialists with none, and have chosen the latter. To a very large extent, primary care docs (especially FP and internists) have the role of deciding when they are out of their league, and their patient needs to be sent to a specialist. In a hospital situation, where you have division of labor, and each specialty focuses on its own turf, this works out fine. On an airplane, not so much.