meisinger

In honor of National Primary Care Week, I was asked to respond to the question “Why is primary care the future of health care?” I assert that the future of health care is health, and primary care is the present and future of everyone’s health.

 

This week medical schools including University of Utah and Tulane observe Primary Care Week, so we asked members of our community to reflect on this year’s theme, “primary care: the future of health care.” We’ll be posting their responses here throughout the month of October.

By Kirsten Meisinger, M.D.

In honor of National Primary Care Week, I was asked to respond to the question “Why is primary care the future of health care?” I assert that the future of health care is health, and primary care is the present and future of everyone’s health.

Why such a bold assertion?

The countries with the best health outcomes have shown that access to primary care is the common denominator for excellence. People become and stay healthy when they have just the right amount of health care, when and where they need it, and for little to no cost. Outcomes from countries who have been able to provide this kind of primary care to their citizens are a powerful indication that whole person care, in the context of their family and community, is the path to health that health care systems will be obliged to follow in order to succeed.

The WHO defines health as “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” Primary care is the only specialty responsible for the complete health of the patient for the length of his or her life and across the breadth of his or her existence.

Achieving complete physical, mental and social well being is best approached by viewing the patient in the context of their family and their community and moving past the four walls of the exam room and beyond the patient-doctor interaction. Keeping people in a state of health is a nearly impossible task for a single provider. It requires longitudinal partnerships with primary care teams.

These teams pluck expertise from each member to assemble a set of services that engage, challenge and push patients to embrace health and not just react to disease.

Some primary care providers across the allied health professions have already adopted this model; others are poised to do so in the near future. Meanwhile, we are beginning to see some payers and some state governments shift their focus away from the fee-for-service payment model and toward overall patient outcomes and the care it takes to get the patient there. In this way, the focus will naturally move from disease to health. And primary care, when done well, maintains health best.

In our teams, built to take small steps over time through longitudinal relationships, we watch and wait as a patient whose chronic pain once threatened his ability to walk now smiles and jumps in exercise class. We lead patients to a place where they control their bodies, not their numbers, and discover on their own that a simple daily walk will lift their spirits and bring their numbers back in line. Like the river that made the Grand Canyon, these small steps change the landscape of patients’ health over time. Primary care leads them there. Primary care is the future of health, so it has to be the future of health care.

Kirsten Meisinger, M.D., is medical director at Union Square Family Health Center, a community health center within the Cambridge Health Alliance, where she has practiced since 1999. Dr. Meisinger earned her medical degree from Case Western Reserve University and completed a family medicine residency at the Greater Lawrence Family Health Center. She speaks fluent Portuguese, Spanish and French.

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