I have linked to this article in the past. I am currently updating my talk on Guidelines: A Skeptic’s Viewpoint. I plan to feature The Paradox of Primary Care
Provision of the majority of care through ongoing person-focused, contextualized primary care relationships can allow care to be integrated and prioritized across acute and chronic illness, preventive, psychosocial, and family care. That health care is not organized this way in the United States may be an important factor in the high cost and low performance of the US health care system compared with other systems based on primary care.
Repeatedly I have made the point that performance measures miss too many important parts of quality. Quality medical care includes a broad conceptualization and many dimensions. Primary care relationships can make a huge difference.
Unless we switch the focus of medical care to primary care (from subspecialty care), no tweaking of the system will really make a difference. Now reread the quoted lines. They are gold.
