Not Otherwise Specified Misunderstandings
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Oct 29, 2025 In a thought-provoking discussion, family physician Kurt Stange shares patient-centered stories that highlight the essential elements of primary care, focusing on the importance of relationships. Cultural anthropologist Rebecca Etz critiques the limitations of one-size-fits-all guidelines, emphasizing the social dimensions of health. Elizabeth Bradley discusses how social determinants, not just medical care, affect population outcomes, warning against offloading social needs onto primary care. Together, they explore the fragility of the primary care system and the urgent need for a more integrated approach.
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When Relationships Get Replaced By Call Centers
- Kurt Stange described calling his own longtime practice and being diverted to a call center with no access to his doctor.
- He found appointments pushed toward any available clinician or location rather than preserving longitudinal relationships.
Systems Treat Primary Care As A Gateway
- Lisa Rosenbaum argued systems treat primary care as access points to lucrative specialties rather than places for longitudinal, holistic care.
- That mismatch undermines primary care's capacity to integrate social and medical needs.
Definitions Don't Drive Policy Investment
- NASEM defines primary care by sustained partnerships, broad needs coverage, and community context, but definitions can feel abstract and unpersuasive.
- Clear definitions alone haven't persuaded policymakers to invest in primary care.
