Definition and Overview
Primary care consultations involve regular meetings and check-ups with a primary care physician, also commonly known as a general practitioner or a family doctor. The primary care physician, as the name implies, is the patient’s first contact and provides general healthcare advice and medical prescriptions as well as arranges for specialist care in the event of more serious concerns, illnesses, and injuries. In the event where a physician is not present, a patient can go to a registered nurse, a clinical officer, or a licensed pharmacist who can also provide primary care consultations.
Primary care physicians can collaborate with other types of physicians and even surgeons in providing healthcare services. They can be consulted for a wide range of issues, including communicable and non-communicable diseases, chronic or acute conditions, mental health issues, and preventive care and management.
In many parts of the developed world, primary care consultations are provided for free. In the United Kingdom, patients enjoy free primary care consultations through the National Health Service (NHS).
Who Should Undergo and Expected Results
Patients of all ages, genders, and socio-economic classes can visit a primary care physician for a broad range of complaints and medical issues. The International Classification of Primary Care, or ICPC, provides a method of classifying the reasons for encounter (RFE), along with how the consultation is performed, the type of interventions prescribed by the physician, and how the problems are managed.
Patients experiencing symptoms in the following areas, according to the ICPC, can come in for one or more consultation sessions with their primary care physicians or providers:
- Blood, spleen, blood forming organs
- Digestive system
- Circulatory system
- Musculoskeletal system
- Neurological system
- Respiratory system
- Female genital system and breast
- Male genital system
Primary care providers can also be consulted for:
- Social problems
- Psychological problems
- Endocrine, metabolic, and nutritional issues
- Pregnancy, childbirth, and family planning
Primary care physicians can also diagnose and treat the following common chronic conditions:
- Thyroid dysfunction
- Back pain
- Chronic obstructive pulmonary disease
Primary care consultants can also administer vaccinations and provide health education services.
How is the Procedure Performed?
The primary care physician is often the first healthcare professional patients go to for any health-related complaint. Depending on the procedures observed by the clinic or hospital, the patient might first need to set an appointment, but in some cases, the patient can just drop by the medical facility and wait in line for a primary care physician to be available. There are also cases where the primary care physician provides more convenient services to his or her patients, such as making house calls.
According to the University of Bristol Medical School Centre for Academic Primary Care, a simple structure for primary care consultations can be followed. Below is their prescribed structure:
1. Initiating the Session * Making necessary preparations * Building rapport * Determining the reasons for the consultation * Gathering Information
2. Exploration of the patient’s problems to discover the: * Biomedical perspective * Patient’s perspective * Background information
3. Physical examination
4. Explanation and planning * Providing accurate information * Ensuring that the patient understands the diagnosis * Planning the treatment or management program
5. Closing the Session
During the first part of the consultation, the physician will ask the patient general questions about the main complaint. Typical questions include the first instance when the symptoms were felt, the location of the pain or discomfort, and how the symptoms are interfering with the patient’s day-to-day life. If the physician already sees the patient regularly for check-ups, he or she might already have a record of the patient’s health and family history. In the event that the patient is seeing a particular physician for the first time, additional questions about health and family history will also be discussed.
The interview may be followed by a physical examination. The technique can vary depending on the nature of the complaint. Blood pressure levels, breathing patterns and heart rate are typically observed while the eyes, ears, mouth, nose, limbs, and other body parts are visually inspected.
Again, depending on the nature of the complaints, the primary care doctor can also order for specialized diagnostic procedures, which might include the following:
- Laboratory tests (to assess blood, urine, stools, and other bodily fluids and excretions)
- Imaging procedures (such as MRI, x-ray, and CT scans)
If the diagnosis can be made during the interview and physical examination stage, the doctor will inform the patient about this. Treatment, including medication, can also be prescribed at this stage. If diagnostic tests were ordered, the patient will be asked to return at a later time when the results will be discussed.
If the patient is suffering from a condition that can be addressed by a specialist, the primary care physician will arrange for referrals and will facilitate the necessary exchange of information between his office and that of the secondary care specialist.
Possible Risks and Complications
Primary care consultations are generally safe, with the patient having the option to see another primary care professional in the event of discomfort or if a second opinion is desired.
- World Health Organization
- International Classification of Primary Care
- Institute of Medicine: “Primary Care: America’s Health in a New Era”
- American Academy of Family Physicians
- American Medical Association: “Definition of Primary Care”
- United Kingdom Department of Health: “Defining primary health care”
- United Kingdom National Health Service
- University of Bristol Medical School Centre for Academic Primary Care