Goals, Scope, and Philosophy of Family Practice and Primary Care Medicine
The American Academy of Family Physicians and the National Academy of Sciences’ Institute of Medicine has established the following definitions to better explain the goals, scope and philosophy of Family Practice and Primary Care.
Family practice is the medical specialty which provides continuing and comprehensive health care for the individual and family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family practice encompasses all ages, both sexes, each organ system, and every disease entity. Providers include family physicians, physician’s assistants, and family nurse practitioners.
These clinicians possess unique attitudes, skills, and knowledge which qualify them to provide continuing and comprehensive medical care, health maintenance and preventive services to each member of the family regardless of sex, age or type of problem, be it biological, behavioral, or social. These specialists, because of their background and interactions with the family, are best qualified to serve as each patient’s advocate in all health-related matters, including the appropriate use of consultants, health services, and community resources.
Primary care at its most root definition is medical care delivered with the patient and the community first in mind. Primary care is traditionally the point of ‘first contact’ for the patient when a medical illness, issue or concern arises. Primary care not only treats the patient when they are ill, but works with the patient when they are healthy to establish strong health maintenance skills by practicing disease prevention and health education.
Primary care involves 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 the family and community.
Primary care is the care provided by clinicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, gender, or diagnosis. Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.). Primary care is performed and managed by a personal physician, physician’s assistant or nurse practitioner utilizing other health professionals, consultation and/or referral as appropriate.
Primary care provides patient advocacy in the health care system to accomplish cost-effective care by coordination of health care services. Primary care promotes effective provider-patient communication and encourages the role of the patient as a partner in their own health care decisions.
Primary Care Practice
A primary care practice serves as the patient’s first point of entry into the health care system and as the continuing focal point for all needed health care services. Primary care practices provide health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.).
Primary care practices are organized to meet the needs of patients with undifferentiated problems, with the vast majority of patient concerns and need being cared for in the primary care practice itself. Primary care practices are generally located in the community of the patients, thereby facilitating access to health care while maintaining a wide variety of specialty and institutional consultative and referral relationships for specific care needs. The structure of the primary care practice may include a team of physicians, physician’s assistants and nurse practitioners.
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