Is ‘Primary Care’ just a concept?
By A/Prof Lauren Ball
I am a passionate primary care researcher, and I love to communicate my research with other people. But I face a problem – most people do not have a good understanding of what ‘primary care’ is.
The Australian Medical Association states that ‘primary health care’ is the front line of the health care system and usually the first level of contact for individuals, their family and community with the national health system.
Some people interpret primary care to mean ’general practice’, i.e. visiting the doctor. However, the Australian Institute of Health and Welfare says that the primary care workforce is vast and diverse, and includes general practitioners, nurses, and a range of allied health professionals such as chiropractors, optometrists, pharmacists and physiotherapists.
These definitions are helpful but limited by a traditional model of health care. Rising rates of chronic and complex medical conditions require a continuing focus on self-management strategies that help patients have healthy behaviours. There are promising studies of primary care services that expand to reach people in their home using initiatives such as texting, website portals and personalised health coaching. The problem is that these initiatives don’t always recognise existing support available.
Our research has found that most people start looking for health advice on the internet (including social media), followed by friends and family and then finally a health professional. It means that while primary care may be the first level of contact with the health system, it’s not the first level of communication with a ‘support system’.
Expanding the concept of primary care to include all care accessed by individuals could enable a more patient-centred approach to health care. After all, many decisions about healthy behaviours are made outside of the traditional definition of primary care. Personal trainers, social media influencers, blogs, shopping advertisements, news and media for many people act are the ‘first-line’ in health care changes.
Perhaps primary care is best described as a concept rather than a setting. Efforts to make ‘first-line’ support evidence-based, cost-effective and patient-centred would arguably improve the health of Australians, regardless of location, cost or interaction.