What is Primary Care?

Recent public debates about health care reform have shed new light upon the importance of the generalist or primary care physician.  The generalist physician is seen as one who not only is able to diagnose and manage a broad array of common medical problems but can also counsel patients effectively in areas of health screening and prevention.  The generalist or primary care physician is also seen as one who develops a strong rapport with the patient and his/her family and who can orchestrate the patient’s health care from managing acute and chronic conditions to making appropriate referrals to subspecialty consultants and to other health care professionals.

With rising health care costs, hospitalization is increasingly reserved for critically ill patients and for those patients who cannot be managed safely at home.  Emphasis on reducing the length of hospital stays has meant that patients are discharged earlier, often, before they have fully recovered from their illnesses, to follow-up with their primary physicians for further management.  Advances in medical therapeutics and expanded ancillary support services have facilitated the outpatient management of many medical problems.  Diagnostic work-ups are now performed whenever possible in the outpatient setting.  Thus, the management of the ambulatory patient has become more complex and challenging.

In the Primary Care Clerkship, students will learn how to care for patients in the ambulatory setting.  They will learn how to recognize and treat a broad array of common medical problems; how to manage chronic medical conditions; how to foster health promotion and practice preventive medicine; how to form “therapeutic alliances” with patients and to “develop” treatment plans; how to place illness in the context of the whole patient.

This manual outlines the goals and objectives of the clerkship and reviews the requirements for students, site coordinators and preceptors.  Each clinical site selected for the teaching of this clerkship offers students unique clinical opportunities for learning the principles of the practice of primary care.