The Alma-Ata Declaration on Primary Health Care was issued 40 years ago and was considered a watershed in public health. The World Health Organization advocated primary care as the key to achieving the goal of “Health for All” by the year 2000. The direct care model must be effective and accessible to all citizens to implement this goal. The following article explores some of the essential fundamentals of primary health care.
Ethics in primary care
This book examines the ethical challenges faced by physicians in primary care, focusing on the different moral frameworks, habits of thought, and practices that govern health care. Authors Harmon Smith and Larry Churchill argue that the primary care encounter offers a unique perspective on the physician-patient relationship, offering a fresh understanding of medical ethics. Although the book is divided into four main sections, it provides a helpful overview of the subject and will prove invaluable for primary care clinicians and policymakers alike.
First, primary care physician must consider a situation’s context to determine their ethical obligations. A physician can weigh conflicting values and principles based on the Four Principles theory. For example, non-maleficence, beneficence, and justice outweighed Dr. X’s autonomy. While a physician may consider all four principles to determine the best course of action, he must balance each factor with others.
Barriers to accessing primary health care
According to a recent Commonwealth Fund survey, about 90% of adults in the United States experience some type of barrier to accessing primary health care. In particular, they experience difficulties contacting physicians or scheduling an appointment. In addition, almost half of the respondents are unaware of the location of their nearest PHC. In light of this information, it may be necessary to redesign the health care system to reduce barriers and improve access. The results show that one in five adults experience multiple barriers to accessing PC, and an average of 16% experience numerous barriers to PC after reaching the primary care office. While the prevalence of the individual obstacles varied between nations, there were similarities among vulnerable groups. Specifically, people with low income and immigrants were more likely to face multiple barriers than people without a medical condition. In addition, before reaching PC, people with mental health conditions were more likely to experience various obstacles. Finally, age is a protective factor against multiple barriers.
Generalist versus deontological approach to ethics in primary health care
The idealized relationship between the primary health care provider and the patient is under pressure, especially in countries with discontinuous care and a traditional gatekeeping role for specialists. So, should the deontological approach be adopted? Let’s look at two situations where the deontological approach might apply.
The practical approach to medical ethics focuses on the greater good, the most equal and just for the most significant number, and ignores the health of individuals. This approach also overlooks social health inequities, which arise from societal and cultural inequality. Therefore, a deontological approach to ethics in primary health care cannot address such social disparities.
Patient’s rights in primary care
A patient’s rights are essential to receiving high-quality health care. These rights include the right to know the identity of the health care provider and any other personnel who may be involved in their care. Patients are also entitled to privacy, ensuring that their medical records are kept strictly confidential. Moreover, they are entitled to know the consequences of refusing specific treatments. Finally, patients can also ask their doctors for an explanation regarding alternative plans and the prognosis of their condition.
There are several forms of patient rights, including written statements or nonbinding statements. Some of these rights are influenced by a single ethical principle. Others are based on several principles. Some are a result of the law, while others are purely voluntary. For example, the right to privacy can be exercised in various ways, and patients should be given as much choice as possible regarding the medical care they receive.
Community centered family primary care
Community-centered family primary care is one of the most critical aspects of health care. Traditionally, family physicians have been the first line of health care providers that patients turn to for advice about their health. By promoting continuity of care, primary care practitioners build unique relationships with patients. Primary care practitioners who know several family members are often better able to provide care for their entire family. In addition to their expertise in family health, community-centered providers often provide family health discussion groups and promote preventative programs.
In this primary care model, patients are treated by health care professionals within a community rather than a medical center. Primary care providers work at community-level service systems centered around the families who seek them out. The community-level system includes physicians, other health care providers, local schools, public transportation, and social service organizations. Almost all health services are provided in the local community, with some centralized services.
GPs as patient’s advocate
They were identifying the PCC (patient-centered care) model challenges. This study was conducted from a social constructivist/interpretive philosophy perspective. The PCC model includes four interrelated components: a patient’s perspective, GPs’ professional perspectives, and patient-centeredness. These components were identified through the research process.
As a patient advocate, your role is to represent your patients on their behalf outside of the doctor-patient relationship. This includes advocating for patients locally, nationally, and internationally. For example, suppose you are a GP, you could act as a patient advocate in your community by referring patients to appropriate services, writing to local representatives on behalf of your patients, and advising patients on wills and powers of attorney.
