Primary Care Practices:
Their Nature and Importance
for the Future of Healthcare
MGMT 5530 Physician Practice Management
The practice of medicine has seen a lot of changes in the last century. In the 1960s, more change was happening than the Cultural Revolution in the United States. Specialized medicine was starting to take shape, altering the size and scope of general practice. From this, there have been unintended consequences to how primary care is practiced. While congress passed the Patient Protection and Affordable Care Act in 2010 to reform healthcare, it was more concerned about tackling health insurance and did little to address the ...view middle of the document...
Before many of these specialties were established, medical care was mostly known to common people as that coming from a physician whose work involved an array of expertise as well as diagnosing and treating the vast majority of patient conditions (Hoff, 2010). The patients knew them like a next door neighbor. In fact, many general practitioners were located in a neighborhood house or apartment (Hoff, 2010). There was a more familial relationship established between doctor and patient. A physician would make house calls if the patient was unable to get out of the house, let alone out of bed. It was also quite common for these physicians to visit their patients when they went to hospital emergency rooms (Hoff, 2010). These doctors were afforded more autonomy in their practice. Office visits lasted longer, there were fewer entanglements with billing due to fewer insurance companies, and physicians could bill for what was thought to be adequate based on time spent for medical purposes, not based on quotas (Hoff, 2010). Granted, one can say that not only the practice of medicine was simpler, but the freedoms afforded to general physicians were too, due to a limited set of alternatives and a population that had not yet aged. In the middle of the 20th century, the baby boomer generation was born from the end of World War II up until the early 1960s. They were a large part of the population and were generally healthy, requiring only simple preventive care such as vaccinations, along with the occasional broken bone. Treatments for chronic conditions were much simpler as well. For example, diabetic care consisted not of the tens of pages of care guidelines now followed but of three basic procedures: regular blood glucose checks, proper management of insulin therapy, and patient physical exams (Hoff, 2010). Today, the American Diabetes Association includes blood pressure checks, as well as hemoglobin A1C and lipid panels from blood tests as established clinical goals. In addition, foot, eye, and renal screenings are measures not previously taken by general practitioners. The improvements are part of the drive for quality of care which utilizes the advances in technology as it applies to the health care sector. As a result, these would justify the need for specialized care (Hoff, 2010).
Modern General Practice
Today, primary care has been mostly shrunk down into three care settings. General and family practitioners diagnose and treat a wide variety of illnesses in patients of all ages (Austin, 2008). This is also called family health as it centers its care on what many of the core principles practiced by general practitioners of yesteryear. Pediatrics is another part of primary care, which focuses on children from infancy to teenage years. While they are mostly centered on preventive care through regular checkups and immunizations, they can also diagnose infections, injuries, and serious illnesses when needed (Austin, 2008). The third section of...