Strong Primary Care System

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

Out of the government budget of 132.4 billion for health, $50.6 billion was spent on primary health care in 2011-2012 which is 38.2% of the budget ( AIHW 2014).Primary health care is team based care consisting of health professionals such as medical practitioners, nurses and midwives, and allied health professionals such as medical practitioners, psychologists and optometrists. There are principles put in place to ensure adequate and professional care is being provided by the primary health care system and it is the principles which are most of importance

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

There is an imbalance between primary and specialty care services in the U.S. health care delivery system.

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

Currently, there is still a large shortage of primary care practitioners in the United States. The margin between available providers and those in need continues to grow. Many people without proper access to care have to delay seeking help for what ails them ("Health Wanted," 2012). Glicken & Miller (2013) state that approximately 16,000 primary care providers would be necessary to meet the existing demand. Rural communities would represent the area of greatest need followed closely by low-income urban areas. The number of underserved individuals is estimated to have reached fifty-seven million. This demand will only increase, as 52,000 primary care providers are expected to be needed by the year 2025 (Glicken & Miller, 2013, p.1883-1889).

The United States has been slow in addressing the need for an effective primary care health care system either due to special interest groups or the lack of a political “window of opportunity” to take on this challenge. In January 2000, an article in JAMA,

The United States of America has been known to be one of the most advanced countries in terms of our quality of medicine, medical programs, and medical advances. A person can walk into nearly any emergency room without the fear of being turned away or not getting care. With so many resources and cutting edge technology, it’s hard to believe that this health care system does not function to suit the needs of the populations that are most in need of care. Gaining access to long term, continuous health care has become an arduous task, especially over the past two years. Finding a primary care provider seems impossible nowadays, whether a person is insured or uninsured.

With the baby boomers aging, the need for primary care providers has been in high demand now more than ever.

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.

According to Freudenberg and Olden, one way to reduce the health disparities is by making the availability of primary care physicians better. (Buchbinder, 2012, p. 327) A primary care physician in the United States make less money than a specialist, so the amount of doctor's choosing to go in to primary care is significantly less than those who choose to enter a specialty. A primary care physician is like the captain at the head of a person's health they are in charge of screenings and counseling and to address the burden of chronic disease. In addition, which specialists if any are necessary to help manage the patient's disease if it is outside of the scope of practice for the primary care. Raising the amounts insurance pays to primary care

The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.

The article titled “Family Physicians Perceptions on How They Deliver Cost-Effective Care” presented a study on the effect of family physician supply on healthcare costs and outcomes. Primary care family physicians play a prime role in the provision of comprehensive, integrated, accessible healthcare services that necessitate needs of patients (WHO, 2003). A review by Starfield et al has shown that health is better in areas with more primary care physicians, people who receive care from primary care physicians are healthier, and the characteristics of primary care are associated with better health (Starfield, 2005). Other research has concluded that primary care physicians play a significant role in reducing the mortality rate (Shi et al. 2003).

The American Academy of Family Physicians suggests that there is no single definition that can completely define primary care. Primary care has several definitions because it is a multi layered approach and network of services experienced in the early stages of an individual’s entry into the health care system. Primary care involves primary care practices, primary care physicians, non-primary care physicians, and non-physician primary care providers (1). They fall under the scope of providing individuals with first contact care and entry into the complex world of health care. There are three levels of care, which are comprised of primary, secondary, and tertiary care. They are are ranked not only

Primary health care, supports and help individuals to make the most important decision of their health because of the advice they receive from different health care professionals who have the right skills to provide that supports. (Sinclair, Rochon, Leatt,2005).With the level and accessibility of specialized health care professionals, individuals re able to manage their chronic disease, and their needs are being meet.