Person Centered Medicine and the Primary Care Team – securing continuity of care

Abstract

In the community, patients consult family physicians, nurses, physiotherapists, pharmacists and other allied health professionals for all the health problems that patients decide to present with. The principle of primary health care is that there is no operational selection of health problems, in terms of diagnosis, organ system, severity of patient category: it is for all patients, with all possible health problems, in all stages [1]. The everyday reality of primary health care is, nevertheless, that patients seek professional care for only a small minority (around 10 %) of the health problems they experience [2, 3] and most of these are treated within the primary care setting. As the community is where most of the people, with most of health problems are most of the time, it is the obvious place to promote health and prevention and to detect and manage diseases. This lends to primary health care its quintessential focus: that of individuals, who, in the context of their living and family environment, make contact for a variety of illness and disease, often over many years. This makes person-centered medicine a core characteristic of primary health care. This brings to primary health care the need to respond to individual reasons for contact and to do so consistently over time. Consistency is related to ‘continuity of care’ [4]. As primary health care is multidisciplinary in nature, the challenge for responsiveness and consistency is for the team and not only for the individual provider. Here, we analyse the role of ‘responsiveness’, ‘continuity of care’ and team work’ in securing an approach that is centered on the person in the provision of (primary care) medicine.