What is the Nephrologist's Role as a Primary Care Provider? We All Have Different Answers

Abstract

At the 2005 Annual Meeting of the American Society of Nephrology (ASN), the ASN Dialysis Advisory Group concluded after much discussion that the role of nephrologists as primary care providers to dialysis patients needed further study and discussion. Out of this discussion came an ASN membership survey, an extremely well-attended session at the 2006 Annual Meeting on Primary Care Issues for Nephrologists, and a series of articles to be published in CJASN , beginning with the current issue. The ASN membership survey, completed in March 2006, included responses from >300 ASN members, 97% certified in nephrology and 95% certified in internal medicine. About half of those responding were planning to recertify in Internal Medicine. Nearly two thirds of nephrologists provided most of the primary care to at least some of their dialysis patients, with the majority of this care being provided in the dialysis unit rather than in the physician's office. Only 15% of their dialysis units had written policies addressing the provision of primary care services to dialysis patients. The primary care services provided by nephrologists to dialysis patients included counseling regarding smoking, seat belts, safe sex, etc .; cancer screening, immunization (other than for hepatitis B); management of diabetes mellitus, cardiovascular …