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Primary Care in Mental Health Services - Essay Example

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Mental illness was found to be the leading cause of disability in the whole world. According to the World Health Organization (WHO), 20% of people each year experience a diagnosable mental illness. In turn, only 25% of these receive help and most of that help is provided by primary care (USA, National Institute of Mental Health 2002)…
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Primary Care in Mental Health Services
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Download file to see previous pages In what obtains now, primary care is facing a confluence of factors that could spell disaster.
Thomas Bodenheimer (2006) reports of patients becoming increasingly dissatisfied with their care with the difficulty of gaining timely access to a primary care physician. Moreover, many primary care physicians are unhappy with their jobs as they face a seemingly insurmountable task. A study done by Gottschalk and Flocke found that primary care physicians spend nearly one half of their workday on activities outside the examination room, predominantly on follow-up and documentation of care for patients not physically present (Gilchrist, 2005).
Further, Doherty (2006) reports that the quality of primary care is found uneven; reimbursement is inadequate; and fewer and fewer U.S. medical students are choosing to enter the field. That there is decline in primary care is not surprising, according to Kowalczyk (2006), given that primary care doctors work a harried pace with unpredictable hours while earning some of the lowest salaries in medicine. In the United States, primary care doctors earned an average of about $160,000 in 2004, compared with $230,000 for obstetricians/gynecologists and $300,000 for dermatologists, according to a consulting company, the Medical Group Management Association (Kowalczyk, 2006).
In the midst of primary care physicians dwindling, there is a lack of strong primary-care base for the health system with improved care and reduced health care costs. In effect, patients are having a harder time getting timely appointments with their personal physicians, therefore seek expensive emergency room services, adding to the cost (Bodenheimer, 2006). As early as two decades ago, medical literature rued this situation, pointing out the imbalance between oversupplied specialties and the primary care specialties which are undersupplied (Primary Care Physicians, 1989).
From international findings, some of the barriers to provision of primary mental health care include access, culture, recognition and knowledge, time, training, cost, stigma and discrimination, knowledge of, and relationships with, local networks, community organisations, and specialist mental health services (Underlying concepts, 2006). Yet, many doctors blame a national shortage of primary care doctors on limited access (Kowalczyk, 2006).
The reasons for the imbalance, however, seem to be more complex and varied among hospitals. Many internists, especially women, are cutting back their hours to spend more time with their families. At the same time, the aging population and the increasing complexity of medicine mean that each patient requires more time and services, reducing the number of patients some doctors can see. (Kowalczyk, 2006).
To Bodenheimer (2006) however, primary care is dying due to three main factors: 1) Low reimbursement rates for primary care services, 2) The stressful work life of primary care physicians, and 3) The dwindling number of US medical graduates choosing careers in family medicine. Doctors have been warning of a shortage of primary care physicians since early in the decade, with a number of medical students deciding not to practice general internal medicine. Twenty percent chose general internal ...Download file to see next pagesRead More
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