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Component 1: Introduction to Health Care and Public Health in the U.S.


Title: Introduction to Health Care and Public Health in the U.S. Author: Vishnu Mohan MD Last modified by: ITG Created Date: 6/26/2010 4:19:45 PM Document ... – PowerPoint PPT presentation

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Title: Component 1: Introduction to Health Care and Public Health in the U.S.

Component 1 Introduction to Health Care and
Public Health in the U.S.
  • Unit 3 Delivering Healthcare (Part 2)
  • Lecture 2

This material was developed by Oregon Health
Science University, funded by the Department of
Health and Human Services, Office of the National
Coordinator for Health Information Technology
under Award Number IU24OC000015.
Where Is Primary Care Delivered?
  • Primary care clinic
  • Point of delivery
  • A medical facility
  • Usually, the conditions seen at a primary care
    clinic are not serious or life threatening
  • Gateway to healthcare services

Primary Care Medical Specialties
  • Family Practice
  • General Internal Medicine
  • Pediatrics
  • Obstetrics and Gynecology (OB/GYN)

Family Practice
  • Family Practice (also known as Family medicine) 
  • Provides health care for the individual and
  • Integrates biological, clinical and behavioral
  • The scope of family medicine is broad
  • encompasses all ages, both sexes, each organ
    system and every disease entity

General Internal Medicine
  • Doctors of internal medicine also known as
  • Focus on adult medicine
  • Special study and training focusing on the
    prevention and treatment of adult diseases.

  • Pediatrics is the branch of medicine that deals
    with the medical care of infants, children, and
  • The science of child careincludes planned
    preventive and curative care of children

Obstetrics and Gynecology
  • Obstetrics care of women during pregnancy and
    immediately after childbirth
  • Gynecology care of women who have problems of
    the female reproductive system
  • Womens health and GYN preventive care is an
    important facet of primary care
  • Often the same clinician provides both OB and GYN

Specialty Care
  • A specialty is a branch of medicine
  • After completing medical school, physicians train
    in a specific field (their specialty)
  • Some physicians undergo additional training
    (fellowships) after initial training in a more
    general field

Examples of Specialties
  • Dermatology
  • Pathology
  • Radiology
  • Nuclear Medicine
  • Psychiatry
  • Emergency Medicine
  • Preventive Medicine

Specialty clinics
  • Medical specialties
  • Examples
  • Cardiology
  • Immunology
  • Gastroenterology
  • Surgical specialties
  • Examples
  • Orthopedic surgery
  • Neurosurgery
  • Plastic surgery

Delivery of Specialty Care
  • Many surgical specialists see patients in
    outpatient clinics
  • They perform surgeries in hospitals
  • They may perform surgeries in outpatient surgical

Outpatient Surgical Centers
  • Many surgeries or procedures are done in the
  • Some surgeries or procedures are done in
    outpatient (or ambulatory) surgical centers
  • Surgery or procedures are performed in a
    non-hospital location
  • Patients typically go home after a brief period
    of recovery (few hours) after the procedure

Primary Care In Crisis?
  • Increasing number of older patients with complex
    medical issues
  • Imperfect coverage of preventive care services
  • Emphasis on documentation
  • Complex billing and compensation system

Primary Care In Crisis?
  • Decreasing number of physicians practicing
    primary care
  • Supply-demand imbalance
  • Greater dependence on after-hours care
  • Increased cost of health care delivery

Why is Primary Care In Crisis?
  • Few U.S. graduates enter family medicine
  • Only a minority of first year internal medicine
    residents pursue careers in primary care
  • More than 80 percent of graduating medical
    students carry educational debt
  • Specialists are better compensated than primary
    care physicians

Why Dont Physicians Want To Go Into Primary Care?
  • A 2007 survey of graduating US medical students
    -- only 2 planned a career in general internal
  • Debt not as much a negative factor as the
    challenge of treating elderly and chronically ill
    patients with complex medical issues
  • Practice environment and lifestyle also played a

Solving The Primary Care Crisis
  • Health reform and federal stimulus funds
  • Training
  • Grants for training and educational innovation
  • Recruitment
  • Loan forgiveness and other financial inducements
  • International Medical Graduates