Michael Goldstein, PhD, from the Fielding School of Public Health at UCLA and Mr. John Weeks, Executive Director of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), address the need for more primary care providers in the March 2013 white paper "Meeting the Nation's Primary Care Needs."
According to the white paper “Meeting the Nation’s Primary Care Needs” from the ACCAHC, there has been a growing public awareness of the need for more primary care providers. Proposed solutions to this issue have included increasing the percentage of medical school graduates who choose primary care specialties, using advanced practice nurses as independent primary care providers, implementing patient-centered medical homes, and increasing training and utilization of physician assistants.
A theme that seems to have emerged is the importance of the non-medical doctor (M.D.) practitioners in primary care. Some studies, reports, and workforce experts suggest that non-M.D.s may even be preferable for delivering primary care more effectively and efficiently. According to Dr. Goldstein and Mr. John Weeks, these health professionals come from four distinct, licensed disciplines: chiropractic (chiropractic medicine), naturopathic medicine, acupuncture and Oriental medicine (AOM), and direct-entry (certified professional) midwifery.
The white paper’s introduction includes a discussion on the definition of Primary Care, as well as on the unique competencies, scope of education, and self-identification as primary care surrounding each of the four disciplines.
These two definitions of Primary Care have been forwarded as the most widely used and around which there is the strongest consensus:
World Health Organization (1978-short version):
“Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology … It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process.”
Institute of Medicine (1978):
“… accessible, comprehensive, coordinated and continual care delivered by accountable providers of personal health services.”
Underlying the various definitions for primary care, a widely agreed upon characteristic of primary care is that the practitioner’s role extends from responding to acute conditions to the management and co-management of chronic problems, referral and engagement of patients in prevention and health promotion.
Despite the widely acknowledged need for non-M.D.s to assume a role in delivering primary care services, potential contributions from roughly 107,500 licensed members of the health professions workforce have rarely been explored by workforce analysts and policy makers.
The ACCAHC has proposed this project to offer health professionals, policy makers, and other interested parties a single document that can provide as much clarity as possible, at this point in time, on the roles these disciplines might have in meeting the nation’s primary care needs. Their goal is to initiate fruitful discussion to help the nation attain the quality and quantity of primary care practitioners that it requires.
Click here to see the full paper on the ACCAHC website.
Editorial citation: Goldstein, MS, Weeks, J (2013). Meeting the Nation’s Primary Care Needs: Current and Prospective Roles of Doctors of Chiropractic and Naturopathic Medicine, Practitioners of Acupuncture and Oriental Medicine, and Direct Entry Midwives [White paper]. Retrieved from http://accahc.org/images/stories/pcp_030713_final.pdf