The Primacy of Primary Care

A simple question illustrates the medical community’s need for the systematic support provided by the primary care community.  The first question asked by every non primary care medical team or system in their initial evaluation of a patient is “who is your primary?”.  This question is asked before the history of illnesses, medicines, surgeries or hospitalizations.  Why?, because it frees the “non primary” system from the role of care coordination.  This freedom is then taken for granted.  Is there a symptom associated with the non primary system intervention? Is there a difficult to explain result?  Is the patient upset?  Was there a side effect from the procedure?  Did another medical condition flare up in conjunction with the non primary system intervention?  Was a result missed by the non primary team but was also forwarded to the primary’s office as “communication insurance”?  The simple response by the non primary system to any perceived “determinate or indeterminate issue”…”call your primary”.  Taken to the extreme, the non primary system often defines the role of the primary team as that team which does “whatever it is I (the non primary team) do not like to do”.  As altruists, we primaries have accepted this role because the patient needs at least one team looking out for their interests.


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