component 1: introduction to health care and public health in the u.s

Component 1: Introduction to Component 1: Introduction to Health Care and Public Health Care and Public

Health in the U.S.Health in the U.S. Unit 3: Delivering Healthcare (Part 2)

Focus On Primary Care

Where Is Primary Care Delivered?Where Is Primary Care Delivered?

Primary care clinic:◦Point of delivery◦A medical facility

Usually, the conditions seen at a primary care clinic are not serious or life threatening

“Gateway” to healthcare services

Component 1 / Unit 3Health IT Workforce Curriculum Version 1.0/Fall 2010 2

Primary Care Medical SpecialtiesPrimary Care Medical Specialties

Family PracticeGeneral Internal MedicinePediatricsObstetrics and Gynecology (OB/GYN)


Family PracticeFamily Practice

Family Practice (also known as Family medicine): ◦Provides health care for the individual and family◦Integrates biological, clinical and behavioral sciences◦The scope of family medicine is broad

encompasses all ages, both sexes, each organ system and every disease entity


General Internal MedicineGeneral Internal Medicine

Doctors of internal medicine also known as “internists”

Focus on adult medicineSpecial study and training focusing on the

prevention and treatment of adult diseases.


PediatricsPediatrics

Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents

The science of child care…includes planned preventive and curative care of children


Obstetrics and GynecologyObstetrics and Gynecology

Obstetrics – care of women during pregnancy and immediately after childbirth

Gynecology – care of women who have problems of the female reproductive system

Women’s health and GYN preventive care is an important facet of primary care

Often the same clinician provides both OB and GYN services


Specialty CareSpecialty Care

A specialty is a branch of medicineAfter completing medical school, physicians

train in a specific field (their specialty)Some physicians undergo additional training

(fellowships) after initial training in a more general field


Examples of SpecialtiesExamples of Specialties

DermatologyPathologyRadiologyNuclear MedicinePsychiatryEmergency MedicinePreventive Medicine


Specialty clinicsSpecialty clinics

Medical specialties Examples:

◦Cardiology◦Immunology◦Gastroenterology

Surgical specialties Examples:

◦Orthopedic surgery◦Neurosurgery◦Plastic surgery


Delivery of Specialty CareDelivery of Specialty Care

Many surgical specialists see patients in outpatient clinics

They perform surgeries in hospitalsThey may perform surgeries in outpatient

surgical centers


Outpatient Surgical CentersOutpatient Surgical Centers

Many surgeries or procedures are done in the hospital

Some surgeries or procedures are done in outpatient (or ambulatory) surgical centers◦Surgery or procedures are performed in a non-hospital

location◦Patients typically go home after a brief period of

recovery (few hours) after the procedure /surgery


Primary Care In Crisis?Primary Care In Crisis?

Increasing number of older patients with complex medical issues

Imperfect coverage of preventive care servicesEmphasis on documentationComplex billing and compensation system


Primary Care In Crisis?Primary Care In Crisis?

Decreasing number of physicians practicing primary care

Supply-demand imbalanceGreater dependence on after-hours careIncreased cost of health care delivery


Why is Primary Care In Crisis?Why is Primary Care In Crisis?

Few U.S. graduates enter family medicineOnly a minority of first year internal medicine

residents pursue careers in primary careMore than 80 percent of graduating medical

students carry educational debtSpecialists are better compensated than

primary care physicians


Why Don’t Physicians Want To Why Don’t Physicians Want To Go Into Primary Care?Go Into Primary Care?

A 2007 survey of graduating US medical students -- only 2% planned a career in general internal medicine

Debt not as much a negative factor as the challenge of treating elderly and chronically ill patients with complex medical issues

Practice environment and lifestyle also played a role


Solving The Primary Care Solving The Primary Care CrisisCrisis

Health reform and federal stimulus fundsTrainingGrants for training and educational innovationRecruitmentLoan forgiveness and other financial

inducementsInternational Medical Graduates


component 1: introduction to health care and public health in the u.s

Documents

workforce curriculum

health care

public health

primary care clinic

medical care of infants

gyn preventive care

primary carehealth

specialty carea specialty