Achieving the Goals of Primary Care as Defined
The committee believes that all the attributes of primary care are highly desirable and achievable over time. It also believes that the degree to which current primary care practices match these attributes varies considerably. However, the committee did not want to propose a limited definition of primary care that sets goals that might be more immediately achievable by most practices but does not present challenging goals for the future. Neither did the committee want to establish a commendable “ideal” definition of primary care that bears little relationship to current realities.
In the committee's judgment, all practices deserving the primary care label can aspire to many of the attributes in the near term; indeed, some may already be there. In the spirit of continuous quality improvement, however, the committee members believe that all primary care activities deserving of the label ought to strive toward a fuller realization of these attributes. The pace of accomplishment will vary depending on a practice 's starting point, its circumstances, and its resources.
The committee has already indicated its belief that the achievement of the desired attributes of primary care will be easier in some form of integrated delivery system serving a defined population than in isolated practices without a defined member population (because of the potential advantages it would have for infrastructure support, for integration of personal health care services, and for institution of mechanisms for accountability). However, such arrangements do not exist in many primary care settings and may be a long time in coming. In the meantime, every practice can move forward toward meeting the goals of primary care.