Practice Content

Defeating Diabetes

Most Effective Diabetes Treatments

Get Instant Access

Since 1975, the National Ambulatory Medical Care Survey conducted by the National Center for Health Statistics (NCHS) of the U.S. Department of Health and Human Services has annually reported the problems seen by office-based physicians (in all specialties) in the United States. More than 53% of all office visits in the United States were to primary care physicians (Figure 1-5). The 20 most common diagnoses seen by physicians in their office are shown in Table 1-3. Note that arthritis is fourth and diabetes mellitus sixth, reflecting the prominence of chronic diseases in practice. For those who think primary care is little more than caring for acute pharyngitis, note that it is 19 th. When only chronic conditions are listed (Table 1-4), arthritis is second and diabetes fourth.

Primary care physicians manage an average of 1.65 problems per visit. Of visits to primary care physicians, 61% were for a medical examination, compared with 23% for surgical specialists. Although hypertension is the most common problem encountered in offices (see Table 1-3), primary care physicians checked the blood pressure at 60% of the visits, compared with only 20% of surgical specialists and 40% of visits to medical specialists (National Center for Health Statistics, 2002).

Available data concerning primary care indicate that more people use this type of medical service than any other and that, contrary to popular opinion, sophisticated medical technology is not normally either required or overused in basic primary care encounters. Most primary care visits arise

All others

Orthopedic surgery

Ophthalmology

All others

Orthopedic surgery

Ophthalmology

General and family medicine

Internal medicine

Obstetrics and gynecology — Pediatrics

Figure 1-5 Percent distribution of office visits by physician specialty: United States, 2005. (From Cherry DK, Wcodwell DA, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2005 Summary. Advance data from vital and health statistics. No 387. Hyattsville, Md, National Center for Health Statistics, 2007. www.cdc.gov/nchs/ahcd/ officevisitcharts.htmj

General and family medicine

Table 1-4 Rank Order of Chronic Conditions, All Ages

Internal medicine

Obstetrics and gynecology — Pediatrics

Figure 1-5 Percent distribution of office visits by physician specialty: United States, 2005. (From Cherry DK, Wcodwell DA, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2005 Summary. Advance data from vital and health statistics. No 387. Hyattsville, Md, National Center for Health Statistics, 2007. www.cdc.gov/nchs/ahcd/ officevisitcharts.htmj

Table 1-3 Rank Order of Office Visits by Diagnosis

1. Essential hypertension

2. Routine infant or child health check

3. Acute upper respiratory infections, excluding pharyngitis

4. Arthropathies and related disorders

5. Malignant neoplasms

6. Diabetes mellitus

7. Spinal disorders

8. Rheumatism, excluding back

9. General medical examination

10. Follow-up examination

11. Specific procedures and aftercare

12. Normal pregnancy

13. Gynecologic examination

14. Otitis media and eustachian tube disorders

15. Asthma

16. Disorder of lipoid metabolism

17. Chronic sinusitis

18. Heart disease, excluding ischemic

19. Acute pharyngitis

20. Allergic rhinitis

Hypertension

Arthritis

Hyperlipidemia

Diabetes

Depression

Obesity

Cancer

Asthma

Chronic obstructive pulmonary disease Ischemic heart disease Osteoporosis Cerebrovascular disease Congestive heart failure Chronic renal failure internal medicine, osteopathy) and is focused on reducing fragmentation of care and overcoming the reliance on specialty rather than primary care (Berenson et al., 2008; Rogers, 2008).

Primary care was encouraged to expand beyond its restrictive role as a provider of care to one that analyzes the needs of a community and focuses on those at risk of disease. This process was first described in the 1950s by Sydney Karf, who looked at the needs of his community in South Africa, whether or not they were his patients (Kark and Cassel, 1952). The process involves identifying the health problems of a community, such as diabetes or obesity, and developing a program to prevent the disease and care for people in the early stage, then evaluating the effectiveness of the program (Longlett et al., 2001).

Was this article helpful?

0 0
Natural Arthritis Pain Remedies

Natural Arthritis Pain Remedies

It's time for a change. Finally A Way to Get Pain Relief for Your Arthritis Without Possibly Risking Your Health in the Process. You may not be aware of this, but taking prescription drugs to get relief for your Arthritis Pain is not the only solution. There are alternative pain relief treatments available.

Get My Free Ebook


Post a comment