Primary-Care Physicians

Primary-care physicians generally serve as the first point of contact to the healthcare system for nearly all of a patient's medical and healthcare needs, including the treatment and diagnosis of health conditions and the provision of preventive and continuing care. Under the managed-care model, the primary-care physician also acts as a gatekeeper who controls access to specialists or costly procedures as a mechanism to control healthcare costs. Primary-care physicians may follow patients in a variety of healthcare settings, including outpatient clinics, offices, hospitals, long-term care facilities, and the patient's home.

Physicians trained in family medicine, general internal medicine, and general pediatrics typically are considered to be primary-care physicians. Additionally, health insurance plans may differ in regard to whether pediatricians and obstetricians/gynecologists, who specialize in the care of women, are considered primary-care physicians. Family physicians generally provide comprehensive care to patients from infancy till the end of life. Pediatricians [Page 962]are considered primary-care physicians for children, adolescents, teenagers, and young adults, while internists, who are practitioners of general internal medicine, provide care to adults.

Because of the aging of the nation's population, greater focus on prevention efforts and lifestyle changes, and the prevalence of acute and chronic diseases, the need for primary-care physicians has grown substantially. In recent years however, the number of primary-care physicians in the United States and other developed nations has been declining, as most physicians tend to specialize in an area of practice. A survey conducted by the University of Missouri-Columbia and the U.S. Department of Health and Human Services (HHS) predicts that by the year 2025, there will be a national shortage of 35,000 to 44,000 primary-care physicians. As a result, the current and future shortage of primary-care physicians is of concern among policymakers and healthcare planners.