The proportion of primary care physicians varies in Indonesia. Primary care physicians in Indonesia was conducted by general practice physicians and also delivered by nurse practitioners and physician assistants. Considering all sources of primary care, there is still a lack of primary care providers in many areas of the country, particularly in remote and rural areas.
The concept of primary health care was defined by the World Health Organization in 1978 as both a level of health service delivery and an approach to health care practice. Primary care, as the provision of essential health care, is the basis of a health care system. Seventy-five to eighty-five percent of the population seek primary health care yearly. It provides both the initial and the majority of health care services of a person or population. This is in contrast to secondary health care, which is consultative, short term, and disease oriented for the purpose of assisting the primary care practitioner. Tertiary care is for patients with unusual illness requiring highly specialized services. Primary care clinicians may be physicians, nurses, or various other health workers trained for the purpose.
While there are many definitions of primary care, the principles of accessible, comprehensive, continuous, and coordinated personal care in the context of family and community are consistent. Primary health care should be available to all people without the barriers of geography, cost, language, or culture. In primary care, all types of problems, at all ages and for both genders, are considered, including care for acute self-limited problems or injuries, the care of chronic diseases such as diabetes or AIDS (acquired immunodeficiency syndrome), the provision of preventive care services such as immunizations and family planning, and health education.
Primary health care provides the first point of contact in the health care system. In Indonesia, the main source of primary health care is general practice.
The aim is to provide an easily accessible route to care, whatever the patient’s problem. Primary health care is based on caring for people rather than specific diseases. This means that professionals working in primary care are generalists, dealing with a broad range of physical, psychological and social problems, rather than specialists in any particular disease area.
An important role is acting as the patient’s advocate and co-ordinating the care of the many people who have multiple health problems. Since primary care practitioners often care for people over extended periods of time, the relationship between patient and doctor is particularly important. Primary health care involves providing treatment for common illnesses, the management of long term illnesses such as diabetes and heart disease and the prevention of future ill-health through advice, immunisation and screening programmes.
Because primary health care is broad, it is information rich. Primary care clinicians coordinate care for patients among different service providers and for different patient concerns, responding to the fact that most patients have multiple problems. Continuity of care refers to the ongoing relationship between individual patients and primary care clinicians who are committed to the person, not a specific disease, body of knowledge, or specialized technique, and who recognize that physical, mental, emotional, and social concerns are related. Primary care clinicians, interested in the meaning of illness to the particular person, must negotiate care with that individual. A person’s health is greatly influenced by the individual’s family, culture, and community. Thus, the delivery of primary health care may be different for each individual and in different areas of the world.
The proportion of primary care physicians varies by country—for example, in Great Britain, it is 80 percent; in the United States, it is 32 percent. Primary care physicians in the United States consist of family or general practice physicians, general internists, and general pediatricians. Some primary care may be delivered by specialists, especially obstetrician-gynecologists, but it is not the focus of their practice.
Primary care physician serves as the entry point for substantially all of medical and health care needs. It is an advocate in coordinating the use of the entire health care system to benefit people and takes continuing responsibility for providing care. Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses. By regularly seeing a primary care practitioner, patients can identify and control health risk factors before they become problems. Primary care practitioner encourages us to take charge of our health and is a trusted partner in an environment where we can feel comfortable and known.
All doctors are not alike. Many different health care professionals with different types of education can provide health care. In other countries such as in USA, Adults in our family could see an internist. Children could go to a pediatrician. Or the whole family could see a family medicine doctor. We could have a family medicine doctor and an obstetrician/gynecologist, or an internist and a geriatrician. If it’s right for us, it’s the right choice. Here’s a guide to the five kinds of primary care doctors available at Lehigh Valley Health Network, USA.
References:
- University of Bristol, UK
- Valerie J. Gilchrist. Encyclopedia of Public Health, 2002.
- Lehigh valley health network, USA
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