DISCUSSION TOPIC:

4Cs of Primary Care: Comprehensiveness

[download]
Barbara Starfield describes comprehensiveness in the following way: “Comprehensiveness means that all problems in the population should be cared for in primary care (with short-term referral as needed), except those that are too unusual (generally a frequency of less than one or two per thousand in the population served) for the primary care practitioner or team to treat competently”. The ability to provide comprehensive care is a key factor that often differentiates primary care physicians from specialists. While specialists may be subject-matter experts on specific body systems and illnesses, the primary care provider must be the subject-matter expert of the patients themselves. The ability of the primary physician to consistently provide comprehensive care strengthens the patient-provider relationship by which trust, and overall satisfaction are likely to increase.  A primary care provider must be able to identify and treat a wide variety of maladies by looking through a wide lens through which the biological and social complexities of the whole person are exposed. In fact, the 1966 Millis Commission Report likened the primary care physician to the president of a company or the quarterback of a football team: the idea being that they are “the epitome of over-all competence” by which they employ the help of specialists when needed while never losing sight of the bigger picture: the overall health of the patient.