A Pound of Primary Health Care

Health care. Very few phrases envelope so many different aspects of an area of discipline. It can be confusing to know where to go to and when, and this issue has led to a cascade of health problems for our population and our population’s health care system. Emergency room or primary care? And where does preventative care fit in? Here’s an overview of a few facets of the system, and how they differ from each other.

Why Not Just Visit Emergency?

Most emergency departments offer a wide range of services available at all hours, without the requirement of an appointment. However, many ER visits are avoidable as patients are seeking non-urgent care or care that could have been treated and even prevented by primary health care. These avoidable visits result in higher costs, longer emergency department waits, and fewer resources available to the patients who actually require emergency services. Interestingly enough, misuse of the emergency department is equally committed across all ages, regardless of whether or not they are insured. This population-spanning issue has even spurred an “Urgency or Emergency” ad campaign in New Mexico coordinated by the Albuquerque Coalition for Healthcare Quality and funded by the Robert Wood Johnson Foundation.

It is essential to provide and spread education about appropriate times to facilitate emergency services, walk-in to an urgent care clinic, or wait to make an appointment with your general practitioner.

So when do you visit the emergency room?

Examples are incidences of:

– Difficulty breathing

– Uncontrolled bleeding

– Loss of consciousness

– Severe burns

– Chest pains

– Broken bones

When do you visit urgent care?

Any time that you experience a change in your health status which needs attention, but will not be an immediate threat to your health.

Examples of these incidents are:

– Migraines

– Back pain

– Earaches

– Sprains

– Rising fever

– Minor lacerations

Primary Health Care / Primary Care: The Same But Not!

Primary health care is an extensive and broad model designed to cater not only to the individual and their family but to their community as well. Primary health care is meant to be an accessible community based system, responding to the to social issues of the population it is serving.

Primary health care works to:

– Prevent illness and be promotive of health (as opposed to working solely in a curative manner as seen in primary care)

– Focus on maximizing individual and community involvement in the planning and operation of services as well as in the integration of health development with social and economic development

– Integrate rehabilitative and therapeutic care into patient’s daily lives

The presence of primary health care is essential to building healthy public policy and strengthening community action. This also allows for an equal distribution of care available to the local public. Individual and community involvement can also be seen through their participation through building beneficial public policy, creating supportive environments (such as in programs at community centers), and strengthening community action. It is the action of the local individuals as a group, which encourages increased community participation and support for each other, furthering positive health habits at the local level. Not only can primary health care’s focus on health promotion be seen on an external level through community action and public policy, this can also be seen on an internal level via the promotion of personal skills through education by medical professionals.

Primary care emphasizes the curative focus of medicine and mostly occurs in the clinical setting (i.e. your GP’s office, the local walk-in urgent care clinic, or the emergency department).

Primary care:

– Often is the initial point of contact between individual and medical personnel when the individual experiences a change in health status.

– Is not as comprehensive as primary care due to the acute nature of clinical visits

– Refers individuals to the services available through primary care as well as to home health care

The Take-Home, Part 1

There is a time and a place for preventative care, just as there is a time and a place for emergency medicine. The bottom line is that health statuses will always change. And when they do, stop and think. Is this something which requires long term care in my home? Can I wait until tomorrow to make an appointment at my doctor’s office? Can I drive to a walk-in urgent care clinic? Or should I call 911 and go straight to emergency? Your decision impacts not only you, but your community as well.