What primary care is and what it covers

Many people use the words "primary care" for years without being sure what they cover. You may have a primary care provider, or you may be looking for one. Either way, it helps to know what the term means, because it explains what to expect from the person you see first when you have a health question. This article defines primary care using published definitions from a medical society, a federal website and the National Library of Medicine.

A working definition

The American Academy of Family Physicians (AAFP) defines primary care as "the provision of integrated, accessible health care services by physicians and their care teams who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community."

That sentence has several parts. The care is integrated, meaning the pieces fit together. It is accessible, meaning you can reach it. The clinicians are accountable for most of your everyday health needs. And the relationship is meant to last, which is what the AAFP calls a sustained partnership.

First contact

The AAFP says the primary care physician serves as the patient's first point of contact for undifferentiated health concerns. "Undifferentiated" means the concern has not yet been sorted into a category. You may not know whether a problem is minor or needs a specialist. First contact care means you start with one place that can look at the whole picture and help you decide what comes next.

MedlinePlus, a service of the National Library of Medicine, describes a primary care provider in similar everyday terms: "a person you may consult or see first for checkups and health problems."

Continuity over time

The AAFP lists continuity as one of the main features of primary care, described as sustained relationships over time. In practice, this means the same clinician or care team sees you across many visits, so they can know your history and notice changes over the years.

Whole-person care

The AAFP also says primary care physicians are trained for comprehensive, whole-person care that is not limited by the origin of a problem, an organ system or a diagnosis. In other words, a primary care physician is not limited to one body system or one kind of problem. The scope is the whole person.

Coordination across the health system

Primary care is not meant to handle everything alone. The AAFP says primary care physicians ensure coordination of care across the health system. MedlinePlus notes that your primary care provider may refer you to professionals in various specialties when necessary. A referral is the step where your primary care provider sends you to a specialist.

The team behind the physician

The AAFP's definition refers to physicians "and their care teams." It also lists the qualities it expects of primary care practices: person- and family-oriented, continuous, comprehensive, equitable, team-based, collaborative, coordinated, integrated, accessible, and high value. Not every word on that list will matter equally to every patient. Taken together, they describe care that is built around the person being seen, delivered by a group that works together, and organized so that nothing falls between the cracks.

This is why the definition is useful when you compare options. It gives you a set of plain words to ask about, rather than a vague sense that one practice feels better than another.

Who provides primary care

HealthCare.gov defines a primary care provider as a physician (an M.D. or a D.O.), or a nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services.

MedlinePlus adds that generalist doctors, OB/GYNs, nurse practitioners and physician assistants can all serve as primary care providers. If you have a health plan, MedlinePlus advises finding out which type of practitioner can serve as your primary care provider under that plan.

One more point from the AAFP: it states that the terms "primary care" and "family medicine" are not interchangeable.

Questions to ask when you look for primary care

You can use the definitions above as a checklist. Ask whether you can reach the practice when a new concern comes up, which is first contact. Ask whether you will see the same clinician over time, which is continuity. Ask how they work with specialists when a referral is needed, which is coordination. And ask what the practice covers, which tells you how comprehensive the care is.

There is no single right answer to these questions. What matters is that the answers match what you want from the relationship.

This article is general information and not medical advice. Talk with your doctor about your own care.