COMMENTARY

Top Reasons for Primary Care Visits

Tom G. Bartol, NP

Disclosures

February 04, 2019

Viewpoint

Understanding the most common reasons for primary care visits can help to guide policy, training, and evaluation resources to help improve primary care.

Not only do these reasons differ among developed and developing countries, but clinicians and patients have different perspectives on the reasons for primary care visits. Clinicians report seeing more patients for chronic illness management, mental health issues, and routine health maintenance. On the other hand, patients are more likely to see their visits to PCPs as being prompted by symptoms.

In this study, patients had less awareness or recollection of visits to PCPs for routine chronic disease management or health maintenance and preventive care. This gives us insight into what patients are looking for when they seek care from a PCP. They want to feel better.

Chronic and preventive care are important and can easily take priority in the clinician's mind, especially with the many quality measures and guidelines that dominate our electronic record systems. It is easy to focus on a number or value or test result that might have little significance to the patient. It's easy to miss what is most important to the patient while we work on what is needed for our guidelines for "patient-centered" care.

The heart of patient-centered care is connection before content. Before focusing on the numbers (A1c, blood pressure, etc.) or the guidelines (screenings, check boxes, etc.), a couple minutes of informal chatting about family, work, and life can help us to hear and understand the perspective of the patient and what is important to the patient on that particular day. Although the appointment may be set up for a routine chronic care visit, the patient may be hoping to address other physical, emotional, and psychosocial issues. The connection that is formed can identify what is important to the patient, align perceptions, and build a therapeutic relationship that results in care and caring.

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