A Cautionary Thrust Toward Primary Care

At both a national and a global level there is a recent push toward primary care. Since primary care focuses on proactive rather than reactive medicine as well as holistic/integrated population care the belief is that effective primary care will prove to be a more efficient method of prevention and will decrease healthcare expenditure. Primary care generally relates to the level of care preceding specialized care and focuses on prevention of problems so specialized care never becomes necessary. Examples of the shift toward primary care are visible throughout the U.S. in programs such as incentive based primary care residency programs and globally through public health measures.

The idealism and optimism that surround the primary care effort make it seem like a transition from secondary and tertiary care to primary will be the solution to a significant portion of healthcare problems. Yet the issue is not in the effectiveness of the primary health care measures but rather in the execution. The effectiveness and strategy of implementation become crucial in primary care and without efficiency the entire concept collapses upon itself.

Many external factors inhibit and prevent effective primary care. Corruption and inappropriate expenditure of allocated funds, access to care, and social, political, and cultural barriers are all opposing factors to successful primary care. In addition, it is very difficult to force healthcare workers to sustain a high quality of care without direct control and enforced consequences. Perhaps primary care is the ideal solution but conditions, especially in the healthcare arena, are far from ideal. Consequently, the potential of primary care measures to combat fundamental healthcare issues will be very difficult to actualize.

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