Primary Care
The following definitions relating to primary care should be taken together. They describe the care provided to the patient, the system delivering care, and the clinicians providing primary care. Together they form a framework where patients can access efficient, equitable, and effective primary care services of the highest quality leading to better care, better health, and lower costs.
Definition #1 - Primary Care
Primary care isthe provision of integrated, accessible health care services by physicians and their health care teams who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. The care is person-centered, team-based, community-aligned, and designed to achieve better health, better care, and lower costs.
Primary care physicians specifically are trained for and skilled in comprehensive, first contact, and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis. Additionally,primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, schools, telehealth, etc.). Primary care is performed and managed by a personal physician who often collaborates with other health professionals, and utilizes consultation or referral as appropriate. Primary care provides patient advocacy in the health care system to accomplish cost-effective and equitable care by coordination of health care services. Primary care promotes effective communication with patients and families to encourage them to be a partner in health care.
Definition #2 - Primary Care Practice
A primary care practice serves as the patient's entry point into the health care system and as the continuing focal point for all needed health care services. Primary care practices provide patients with ready access to their own personal physician and health care team. It includes care that is: Person and family-oriented, continuous, comprehensive and equitable, team-based and collaborative, coordinated and integrated, accessible, and high value.
Primary care practices meet the needs of patients with differentiated and undifferentiated problems and manage the vast majority of patients' concerns. Primary care practices are generally located in the community they serve, thereby facilitating access to health care while maintaining a wide variety of specialty and institutional consultative and referral relationships for specific care needs. The primary care practice structure often includes a team of physicians and other health professionals.
Definition #3 - Primary Care Physician
A primary care physician is a specialist in family medicine, general internal medicine or general pediatrics who provides definitive care to the undifferentiated patient at the point of first contact, and takes continuing responsibility for providing the patient's comprehensive care. This care may include chronic, preventive and acute care in both inpatient and outpatient settings. Such physicians are specifically trained to provide comprehensive primary care services through residency or fellowship training in acute and chronic care settings.
Primary care physicians devote most of their practice to providing primary care services to a defined patient population. The primary care practice style is such that the personal primary care physician serves as the entry point for the patient's health care needs - not limited by problem origin, organ system, or diagnosis. Primary care physicians advocate for the patient in coordinating the use of the entire health care system to benefit the patient.
Definition #4 - Non-Primary Care Physicians and Other Clinicians Delivering Primary Care Services
Physicians without training in the primary care specialties of family medicine, general internal medicine, or general pediatrics may sometimes provide patient care services that primary care physicians usually deliver. These physicians may focus on specific patient care needs related to prevention, health maintenance, acute care, chronic care or rehabilitation. These physicians, however, do not offer these services within the context of comprehensive, first contact and continuing care.
Non-primary care physicians' contributions may be necessary to meet specific patient needs. However, the absence of full-scope primary care training requires that these individuals work in close consultation with primary care physicians. An effective primary care system may utilize these physicians as members of the health care team while a primary care physician maintains responsibility for the team's success and the comprehensive, ongoing health care of the patient.
Nurse practitioners, physician assistants, and other clinicians may render primary care services to meet the needs of specific patients. They should provide patient care as part of a collaborative team where the ultimate responsibility for the patient resides with the primary care physician. (1975) (2006)
Definition #5 - Primary Care Team
Patients are best served when their care is provided by an integrated practice care team led by a primary care physician. Health professionals work together as an interprofessional, interdependent team in patients' best interests to support comprehensive care delivery. They manage the care of an individual patient and a population of patients using an interprofessional, collaborative approach to health care. The team should support enhanced communication and processes that empower all staff to effectively utilize the skills, training, and abilities of each team member to the full extent of their professional capacity.
*In this document, the term physician refers only to doctors of medicine (M.D.) and osteopathy (D.O.).
Use of Term
The AAFP recognizes the term "primary care" and that family physicians provide services commonly recognized as primary care. However, the terms, "primary care" and "family medicine" are not interchangeable. "Primary care" does not fully describe family physicians' activities nor the practice of family medicine. Similarly, primary care departments do not replace the form or function of family medicine departments. (1977) (January 2022 COD)
