A Manpower Policy for Primary Health Care Report of a Study (1978) / Chapter Skim
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Chapter 2: Primary Health Care Defined
Chapter 2: Primary Health Care Defined
Pages 15-28
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From page 15... ...
1/ The committee found these views helpful to its own efforts to construct a definition of primary care and to develop criteria for determining whether primary care is being delivered. One conclusion drawn from the definitional analysis and discussion was that primary care is distinguished from other levels of personal health services by the scope, character, and integration of the services provided.
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From page 16... ...
THE DEFINITION The five attributes essential to the practice of good primary care are accessibility, comprehensiveness, coordination, continuity, and accountability. ACCESSIBILITY OF SERVICES Accessibility is especially important at the primary care level because primary care practitioners are the initial and most constant providers of health services.
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From page 17... ...
The arrangement is known to the patients and to the covering provider who routinely transmits patient information back to the practitioners. However, a practitioner who leaves town without ensuring that patients are informed of coverage arrangements, or even without arranging for coverage, is not practicing adequate primary care.
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From page 18... ...
Most obstetricians and gynecologists neither practice nor desire to practice primary care as defined in this paper, although they could do so if they wished. Similarly, the internist or pediatrician who has a subspecialty interest should provide total care for the majority of patients' complaints and be willing to care for patients in the appropriate setting -- whether the hospital, chronic care unit, or the home.
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From page 19... ...
Referral of patients to others for services that should be within the scope of the primary care unit promotes discontinuous and fragmented care. Failure of the primary care practitioner to seek results from referral sources and to incorporate this information into the patient's record or failure to accommodate and adapt to the patient's preferences also destroy continuity.
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From page 20... ...
In addition, the professional staff of the primary care unit should establish a policy of providing appropriate information to the patient about risks and possible undesirable effects of treatment, and about unexpected or undesirable outcomes, so that the patient can make informed decisions about proposed care. Also, the physician has an obligation to maintain appropriate financial accountability, including adequate professional liability coverage.
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From page 21... ...
Is access to primary care services provided 24 hours a day, seven days a week?
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From page 22... ...
Are patients encouraged to ask questions about their illness and their care, to discuss their health problems freely, and to review their records, if desired? Does the practice unit accept patients without regard to race, religion, or ethnic origin?
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From page 23... ...
6. Are patients encouraged and assisted in providing for their own care and participating allies in their own health plan (for example, through instruction in a_ :_ _ , ~ , exercise, accident prevention, family planning, and adolescent problems)
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From page 24... ...
1. Do the practitioners in the unit furnish pertinent information to other providers serving the patient, actively seek relevant feedback from consultants and other providers, and serve as the patient's ombudsmen in contacts with other providers?
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From page 25... ...
1. Do the practitioners in the unit assume responsibility for alerting proper authorities if a patient's problem reveals a health hazard that may affect others in the community (for example: discovery of exposure to toxic chemicals in an industrial plant; discovery of a communicable disease)
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From page 26... ...
8. Does the provider maintain financial accountability by keeping accurate records and having adequate professional liability coverage?
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From page 27... ...
" 2. See staff paper, "Roles of Other Professions in Primary Care.
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