III: Elements of Effective Health and Social Service Systems

Policy Statement 35: Physical Health Care Systems

Increase positive health outcomes, reduce cost, and reduce transmission of communicable diseases by improving access to and raising the quality of existing public and private health care.

Recommendation B: Encourage community-based health care providers to offer comprehensive primary care.

Primary care means coordinated, continuous health care from a provider who is trained to manage most of a person's basic health care needs. For many, the primary care physician is "the family doctor," who may be trained in family medicine, internal medicine, or general pediatrics. A complete primary care program includes health promotion; screening; medical, dental, and mental health care; laboratory and diagnostic testing; hospitalization and inpatient services; specialty care; and medication. A quality, comprehensive primary care system has a number of features:

  • Care is based on continuous healing relationships;
  • Care is customized according to patient's need and values;
  • The patient is the source of control;
  • Knowledge is shared and information flows freely;
  • Decision-making is evidence-based;
  • Safety is a system priority;
  • Transparency is a necessity;
  • Needs are anticipated;
  • Waste is minimized; and
  • Cooperation among clinicians is a priority. [1]  

The primary care model is the treatment model most likely to maximize health outcomes for low-income people. [2]   As opposed to episodic, discontinuous, and fragmented care, primary care offers individuals a reliable source of health care with the convenience of a single point of access and "one-stop shopping" for most health needs. The regular relationship with a provider can also promote prevention, treatment for general health care needs, and management of chronic and communicable diseases. An individual who knows his or her doctor personally-or at least has a regular clinic to visit-may be more likely to obtain treatment for a minor complaint or a chronic disorder before it becomes a serious or debilitating health issue.

A physician who serves as a gateway to other treatment providers is also well-positioned to coordinate care for those patients who have co-occurring mental health and substance abuse issues. (See recommendation d, below, for more on coordination of care.) When care is episodic or handled by a number of different providers who have no connection with each other, the patient is more likely to receive redundant treatment or-even worse-treatment which conflicts with that of another provider.

  1. No citation found for FN_crossing-the-quality-chasm-a-new-health-system-for-the-21st-century! .

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  2. Ibid.

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