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Do you really need a PRIMARY CARE DOCTOR ?

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Post by Chapalamed Fri May 29, 2015 9:00 am

The Value of Having a Primary Care Doctor
One primary care doctor per 10,000 people in the U.S. can decrease hospital admissions by 5.5 percent, emergency room visits by 11 percent and surgeries by 7 percent.


Primary care doctors provide accessibility as your first contact with the health care system.

By Michael Rabovsky, M.D. May 29, 2015 | 7:00 a.m. EDT + More

Do you want to live longer; enjoy better health; avoid unnecessary emergency room visits, hospitalizations and surgeries; and pay lower health care costs? I surmise that for nearly everyone, the answer is “yes.” Each of these goals can be attained through a relationship with a primary care doctor. Primary care doctors provide accessibility as your first contact with the health care system; accountability, addressing the vast majority of your health care needs; and coordination of care across settings, integrating your acute and chronic needs and guiding access to focused specialty care when needed. They promote health and prevention, and strive to develop a sustained partnership and personal relationship with you.

What may seem like a myriad of roles and responsibilities are actually the basic tenets of a typical primary care practice. As an example, just last week in my family medicine office, I treated patients from two weeks of age to 98 years of age. I partnered with my patients to help control their chronic conditions, including diabetes, coronary artery disease, asthma, hypertension, obesity and depression. I saw patients with acute issues such as back pain, sinusitis, asthma exacerbations, shingles, swollen knees and urinary tract infections. I assisted a patient in deciding the most appropriate treatment option for her newly diagnosed breast cancer, and helped another patient and his family transition to hospice care. I drained an abscess and froze a wart. I directed patients to specialty care when appropriate and tried to choose the right specialist for each patient. And I performed annual wellness exams and well-child visits. Throughout, I encouraged healthy lifestyles and verified that my patients were up-to-date on immunizations and health screenings. Similar to many primary care practices, my patients and I are supported by a dedicated team of nurse practitioners, nurses and medical assistants.

The Institute of Medicine defines primary care as "the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing this extended partnership with patients and practicing in the context of family and community.” Studies show that in states and areas of our country where there is more primary care, health outcomes are superior at a lower cost. People are less likely to be hospitalized, and there are lower death rates for cancer, heart disease and stroke. There are lower infant mortality rates, higher birth weights and higher immunization rates. Internationally, the United States has the most expensive health care system in the world, spending more money per capita than any other country. Sadly, however, according to the World Health Organization, the United States ranks only 24th in health care outcomes among industrialized countries around the world. Those countries with better health care outcomes are more focused on primary care with more primary care doctors per capita, providing better access and directing their patients through their health care system. Some of these countries achieve better outcomes at half our cost! To further underscore the value of primary care, it is estimated that one primary care doctor per 10,000 people in the U.S. can decrease hospital admissions by 5.5 percent, emergency room visits by 11 percent and surgeries by 7 percent.

Primary care doctors treat people, not diseases, with comprehensive, continuous and compassionate care and will be your advocate and guide through the health care system.  Find a primary care doctor with whom you feel comfortable talking and sharing your concerns. That doctor-patient partnership will help you live longer and enjoy better health.



Michael Rabovsky, M.D.
Michael Rabovsky, MD, is Interim Chairman of the Department of Family Medicine in the Medicine Institute at Cleveland Clinic and Medical Director of the Cleveland Clinic Beachwood Family Health and Surgery Center. His specialty interests include healthcare screening, preventive medicine and general family medicine. He attended medical school at the University of Maryland School of Medicine, Baltimore, Md., and he completed his residency at University Hospitals of Cleveland, Cleveland, Ohio.
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Post by Pedro Fri May 29, 2015 9:36 am

not here as described above. at our age we know what pretty much ails us of a major nature and we have immediate access to the specialists required. for those things that a gp can handle we personally have access to 2 competent practitioners-parasites and minor ailments. cruz roja for emerge like stitches,breaks, sprains,x-rays,ekg, etc.
NOB med treatment here is not necessary,especially since you don't need to go to a gp first before seeing the specialists
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Post by Chapalamed Fri May 29, 2015 9:43 am

"Primary care doctors treat people, not diseases, with comprehensive, continuous and compassionate care and will be your advocate and guide through the health care system, ESPECIALLY A NEW and VERY CONFUSING MEXICAN HEALTHCARE SYSTEM.   "

You're point of view is valid but even IMSS and SEGURO POPULAR now have PCPs in their clinics and institutions. They are their "gate-keepers".  

There will always be those who opt to "skip" establishing care with a PCP or chose not to maintain a relationship with one here in Mexico. Some fair well with that choice, many don't.  The fact is that statistically you are better off in the long run under the care of one than not.
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Post by Pedro Fri May 29, 2015 9:52 am

if you don't use the mexican healthcare system there is nothing to confuse and our specialists treat us persons with continuous and compassionate care.
the systems that you describe in the op apply to the us and canada,not here.
the 2 mexican health care systems you mention have always had gp's as the frontline-nothing new there.
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Post by Chapalamed Fri May 29, 2015 11:48 am

Do you want to live longer; enjoy better health; avoid unnecessary emergency room visits, hospitalizations and surgeries; and pay lower health care costs? I surmise that for nearly everyone, the answer is “yes.” Each of these goals can be attained through a relationship with a primary care doctor. Primary care doctors provide accessibility as your first contact with the health care system; accountability, addressing the vast majority of your health care needs; and coordination of care across settings, integrating your acute and chronic needs and guiding access to focused specialty care when needed. They promote health and prevention, and strive to develop a sustained partnership and personal relationship with you.
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Post by Chapalamed Fri May 29, 2015 11:51 am

Those countries with better health care outcomes are more focused on primary care with more primary care doctors per capita, providing better access and directing their patients through their health care system. Some of these countries achieve better outcomes at half our cost! To further underscore the value of primary care, it is estimated that one primary care doctor per 10,000 people in the U.S. can decrease hospital admissions by 5.5 percent, emergency room visits by 11 percent and surgeries by 7 percent.
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Post by Pedro Fri May 29, 2015 12:19 pm

i'd like to point out that we are in mexico not the excited states or canada where one is "forced" to go to a gp first.. everything you cite only has relevance NOB.
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Post by CanuckBob Fri May 29, 2015 12:26 pm

I would think most people, including myself, would prefer a GP to decide what specialist is required, if any, versus diagnosing ones self.
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Post by Chapalamed Fri May 29, 2015 12:26 pm

The stats cited are by the World Heath Organizaron.

México is part of the world

This post is for general information And interest

Not trying to convince you to have. PCP or debate the stats on this article.
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Post by Pedro Fri May 29, 2015 2:26 pm

CanuckBob wrote:I would think most people, including myself, would prefer a GP to decide what specialist is required, if any, versus diagnosing ones self.
if you have pre-existing conditions that require specialists attention,that is not self diagnosis. and a middleman is not needed.
when we first arrived, we had a gp and i had my second stroke only about 3 months after the first. i was told the protocols for stroke by the university of alberta stroke clinic[world renowned] and i already knew the symptoms from having had one. instead of doing what had to be done and since i was a bit freaky i let him send me to guadalajara for an mri. and even though his clinic is allegedly open 24/7 it wasn't. 6-7 hours were wasted. the protocol for an eschimic[sp] stroke is oxygen and glucose iv within the first 3 hours or more brain cells are lost. i got lucky. cruz roja at the time was not run by a doc like sam so i got back there and requested that they do this because they were not aware of the importance of this either.
yes give me caring specialists and a caring gp or 2 for other stough. the mri merely showed that the original stroke site had enlarged somewhat. he had my record from edmonton on file and didn't follow protocol,probably because he's a gp and not a cardiologist or neurosurgeon.
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Post by CanuckBob Fri May 29, 2015 3:50 pm

Well you should have stated your case as such from the beginning. For those of us without "pre existing" stuff it is preferable to have a GP to figure out what is "existing".........
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Post by Gamina Fri May 29, 2015 3:57 pm

If you don't need a specialist and have no GP, when you die an autopsy will be ordered to determine cause of death. With a GP, seen within 6-12 months, the GP can sign the death certificate without an autopsy. For me, I don't want to waste the inheritance money on an autopsy; I'd rather my heir get it all.
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Post by gringal Fri May 29, 2015 4:49 pm

I think it's a good idea to establish a relationship with a GP over a substantial period of time.  After seven years of occasional issues that require some treatment, my GP knows that I don't head for the doc unless there's something definitely wrong.  He also knows I pay attention to my body's messages and don't dramatize. As a result, if at some time in the future, I have to call him in the middle of the night and tell him I'm at death's door, he'll take it seriously and come right over.  

Best of all, he isn't greedy and "looking for work", so he doesn't overcharge for his services.  I'm happy with my GP and am glad to know there's someone to call, just in case.  I wouldn't want to start with a stranger if I'm ill.

Autopsy?  Won't matter to me, of course, but I agree with Gamina on that one.

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