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History of Primary Healthcare in the US Essay

Primary care plays a central role in a healthcare delivery system of the United States. Compared to primary care services that include prevention, diagnostic and therapeutic services, secondary care services (hospitalization, consultation & routine surgery) and tertiary care services (trauma and burn treatment) are more complex and specialized, and the types of care are further distinguished according to duration, frequency, and level of intensity. Primary care in United States are delivered by three specialties family medicine, general medicine and general pediatric. In 2008, United States had among 954,224 total doctors of medicine, 784,199 were actively practicing and 305,264 were practicing in primary care specialties (32% of the total and 39% of actively practicing physicians). History of Primary Healthcare in the US Essay Paper. The proportion of specialists was over 60% of all patient care physicians. However, United States still lags behind other developed countries in both population health and health system performance. The history of primary care can be traced back a century in the United States which has expanded through the knowledge of physiology that led to biomedical model of disease. Reforms in medical education in 1910 setup a stage for creating a specialization within teaching hospitals. During 1990, the United States care organizations took UK NHS approach for using primary care physicians as gatekeepers but due to demographic differences, United States patients were not accustomed to obtaining a permission of a primary care physician before seeing a specialist. The reason for using physician as gatekeepers was to improve the quality of care and decrease the cost of services. There was increase in the demand for US primary physician in 1990, however, increase in paperwork outweighed the benefits. As per recent publications, the most of people in United States are skeptical about primary. History of Primary Healthcare in the US Essay Paper

healthcare providers claim to deliver comprehensive primary care including their ability to use technology for better treatment and care. Primary care doctors (generalists) usually lack respect in academic circles due to their operational challenges, such as administrative burdens, inflexible appointment schedules and brief visits hinder their performance which leads to lack of satisfaction from both the patient and the provider. To share some work load from primary care physicians, hospitalists and disease management programs were rolled in United States healthcare system to create a high-volume niche out of area of practice and replace broadly based activities of primary care physicians. Hospitalists movement is based on the idea that primary care physicians should hand over the care of their patients when admitted to hospital to team of doctors based in hospital rather than try to attend them themselves which is financial lucrative because most of the primary care doctors work in hospitals are paid well. The rapid advance of medical technology contributed to the demand for specialty services than primary care centers. History of Primary Healthcare in the US Essay Paper

In general, healthcare coverage in United States is provided through combination of private health insurance and public health insurance but it is worth noticing that health insurance providers provide higher insurance reimbursement for specialists relative to primary care physicians which contributes to the current imbalance. Many insurance companies pay more for hospital-based complex diagnostic and invasive procedures but not for routine preventive visits and consultations which makes difficult for primary care centers to attract patients. Policy makers and general public also has very little knowledge of the effectiveness of primary care and its impact on population health which often leads to unnecessary political commitment and disengagement of related sectors. Challenges faced in primary care that has hindered its development are dissatisfaction, long hours, high stress, poor reimbursement, and erosion of. History of Primary Healthcare in the US Essay Paper