A Trial of Increased Access to Primary Care

Abstract

The elderly patients studied by Weinberger and colleagues (May 30 issue)¹ may have had additional access to physicians and nurses during the six-month period after their discharge from the hospital, but the question remains: Did they receive primary care? Too often, what is called primary care lacks the critical component of continuity of care by a physician who is specifically trained and skilled in the comprehensive first contact with and ongoing care of a population.² Table 1 of Weinberger et al. shows that members of the study group were assigned to “primary care physicians,” whom they did not meet until shortly before hospital discharge. This mode of care might better be termed “discontinuity of care.” Physicians who practice primary care would have been caring for their patients throughout the hospital stay and probably for many years before. The mutual knowledge and experience of patient and physician in a continuous relationship is critical.