Intended for healthcare professionals

Bmj Usa Editorial

Primary care needs a new model of office practice

BMJ 2005; 330 doi: (Published 09 June 2005) Cite this as: BMJ 2005;330:E358
  1. Joseph E Scherger, clinical professor (
  1. Department of Family and Preventive Medicine University of California, San Diego

Fewer in-person visits, more patient contacts

Primary care medical practice is well known for a brief office visit model of practice. However, this model no longer meets the needs and expectations of patients. Tools and methods are now available to revolutionize how primary care is delivered. New care models have the promise to be of higher quality, more efficient, and more satisfying for both patients and physicians. Now is the time to radically change how primary care is delivered throughout the world.

Until the last three decades, people generally went to their primary physicians only when they got sick. Respiratory infections, gastrointestinal maladies, and other common health problems were efficiently diagnosed and treated. Productivity in primary care has been defined by how many patients can be seen each day, and how many patients in a community the primary care physician can manage. While many primary care physicians do an amazing job seeing lots of patients every day, poor overall quality of care has been the dirty secret that has recently come to light.13

Today, primary care physicians are expected to provide comprehensive and continuing care to patients and families, including modern preventive care and chronic illness management. They must adhere to the latest clinical …

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