What is Primary Care Management?

Primary care management is a term that can be used in several ways. It can refer to the use of case managers, either that work for insurance companies or for doctors, who help to gather all information required about a patient, and oversee individual patient care, often using information technology. Another definition may be that sometimes primary doctors manage more complex illnesses, either with or without help of a specialist. There are many articles devoted to the issue of how general practitioners and others may manage chronic and complicated conditions like diabetes or depression, for instance. In the second definition, primary care management of conditions may still involve some form of case management by social workers or others.

In primary care settings it isn’t always possible to collect all information abut a patient or communicate with specialists a patient sees. This creates problems on a number of levels. Patients don’t get the best care because doctors don’t have information, and they may get duplicate types of care due to poor communication.

This problem is made more drastic in places like the US because of a growing trend away from practicing family medicine. There may be few doctors in populous areas that must serve extremely large populations. Doctors may work in large practices, never seeing their own designated patients more than once, and failing to form those bonds that used to mark the family doctor relationship with patients. Busy offices create another problem too, in terms of limiting time that doctors spend with each patient.

Creating a primary care management program and hiring a primary care manager in a doctor’s office can work well to offset some of these difficulties. Patients may have someone who occasionally meets them, talks to any specialists, and logs and keeps track of medical information from multiple sources. This person may also watch ages and risk factors to determine when and if patients require additional care like check-ups or screening and remind the doctor and patient of this fact. It’s been shown that such managers can actually help unnecessary or duplicate testing and improve direction of individualized care. They may be particularly useful in making sure the doctor has all information needed to make appropriate decisions, while reminding physicians of the various best practice standards to treat certain illnesses.

Sometimes these care managers work for insurance companies instead, and while they do serve cost reduction, they may also serve patients by helping them find and see specialists, and making sure information is available to any treating physician. Some people have difficulty understanding why a company that wants to reduce costs would offer any form of altruistic help. The simple answer is that primary care management through an insurance company often reduces costs without sacrificing on patient care.

The other way in which primarily care management may be discussed is when doctors treat complex illnesses. In most cases it is ideal for specialists to be involved in treatment of certain conditions. Patients may not want this. For instance, they may not want to see a psychiatrist because of stigma associated with mental illness, and in these cases doctors may decide to manage their conditions. Alternately, patients can’t get specialists they need; limited insurance plans may make it difficult to find a specialist who is near enough to provided needed care.

Essentially, the dual emphases of primary care management of diseases is to catch illnesses early and to treat common but complex illnesses by using identified best practices. When programs like this are implemented, they are often very helpful in keeping the patient population at a primary care facility in better health.