An Introduction into Primary Care

Primary Care is a very interesting and challenging field. Primary Care Physicians are not only the gate-keepers and front-liners in providing care for the community in general. They also play a big role in the treatment of all kind of illnesses ranging from acute to chronic diseases from head to toe and from womb to tomb. Primary Care Physicians are one of the key players of a multidisciplinary team which includes not only the Primary Care Physicians but also the staff nurses, medical assisstants, dieticians, pharmacists, physiotherapists, occupational therapists and clerks/ administrators. Most importantly, Primary Care Physicians are very special in the sense that they not only treat people with diseases, but they also treat healthy people via opportunistic health promotion clinics/ programmes.


Primary Care focuses and emphazises on:


1) A Patient Centred Approach

• Primary Care Physician deals with patients holistically and comprehensively by treating the patients as a whole taking into account both the patient aspect and disease aspect and also including the impact of the illness on the patients daily activities and their family dynamics. 
• It is pertinent to explore the patients Ideas, Concerns and Expectations (ICE) in relation to the illness to ensure that all aspects of the illness are being covered as a whole. 
• The main focus of Primary Care is adapting a transparent and non-judgemental consultations based on a Patient-Centred approach rather than a Doctor-Centred approach using a combination of all the relevant consultation models.
• About 50 - 75% of presentations to Primary Care have an underlying psychosocial component. Hence it is very important to address and explore the psychosocial aspects of the illness as a part of a holistic approach to the patients care. 

2) Patient Concordance and Patient Empowerment

• Primary Care aim to develop a sustained partnership with patients in the treatment and management of their illness.
• The main focus is to develop a shared and mutual agreement between the Primary Care Physician and the patient whereby the patients themselves are encouraged to come up with a solution on how to manage their illness with some assisstance.
• Patients are also encouraged to know about their illness inside out with regards to the diagnosis, management and complications by including the elements of empowering patient education and lifestyle changes in the management plan on top of organizing relevant investigations, prescribing appropriate medications and arranging for follow-ups or referrals in accordance with the Malaysian Clinical Practice Guidelines (CPG) as well as providing safety nettings before ending the consultation (PLIMA).

At the end of the day, the most important aspect of Primary Care is to establish a good rapport with patients in aiming to win and sustain patients confidence in order to optimise patients concordance and empowerment for the best interest of the patient as a whole. As primary care physicians practising in the realm of a well-educated and high-tech society, we should anticipate that patients would expect up-to-date sound advices, thoughtful recommendations, and effective interventions from their primary care providers. Hence, medical students should take the opportunity to make the most of this Primary Care posting not just for passing exams, but also to prepare yourself to work in the real world ahead of you.