An Institute of Medicine committee has developed a definition of primary care as part of its 2-year study of the future of primary care. The study addresses the opportunities for and challenges of reorienting health care in this country to place greater emphasis on the function of primary care.
As a first step in the development of that strategy, this interim report describes the contemporary context of care, reviews earlier definitions of primary care, sets out the committee's critical assumption, and presents a definition of primary care that is intended to be useful to health care professionals, health plan developers, policymakers, educators of health professionals, and the public as they confront the rapid changes in health care that are now under way and are likely to continue for the next 5–10 years. The definition will also serve as a guide during the rest of the committee's study.
The provisional definition of primary care adopted by the IOM Committee on the Future of Primary Care follows:
Primary care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.
Each term in the definition is summarized in a box on pages 16–17 and is explained in the text following the box. The definition is based on a 1978 IOM definition (IOM, 1978), but it stresses the importance of the patient-clinician relationship (a) as understood in the context of the patient's family and community and (b) as facilitated and augmented by teams and integrated delivery systems.