Heart disease and cancer are the leading causes of death in the United States, according to the latest data from the Centers for Disease Control and Prevention. But there's reason for optimism in the fight against chronic diseases like these.
The number of preventable deaths caused by these conditions has fallen since 2010 -- a sign that the efforts of primary care providers to detect and treat these diseases early are working.
Traditionally, primary care physicians played a relatively marginal role in America's biggest public health crises. But with the rise of chronic disease as the chief threat to public health today, primary care docs are now on the front lines in the battle to improve public health.
Take cancer. Every year, about 1.6 million Americans develop some form of cancer. Breast cancer is proving particularly prevalent. One in eight American women can expect to develop it at some point in their lives.
The average cancer patient's main point of contact with the medical system is her primary care provider. Indeed, check-ups are now one of the largest categories of health spending in the country.
There are other vital links in the system, of course. Oncologists deliver specialized treatments and surgeries. Medical researchers develop drugs. Nurses and physician assistants provide vital support services.
But the primary care doctor is the portal to the rest of the medical establishment -- the gatekeeper. Indeed, the typical family physician sees three to four newly diagnosed cancer patients every year.
And primary care doctors are uniquely well positioned to administer treatment. Many families see the same primary care physician for most -- if not all -- their lives. There's an intimate rapport between patient and provider. There's trust. There's a shared history. The doctor is deeply familiar with the specific physical and psychological factors that should inform a cancer patient's course of care.
Primary care doctors also help keep health costs under control. Treating chronic conditions is expensive. But chronic disease is also a massive drag on the economy -- it drives down worker productivity and increases rates of disability and injury. By preventing the progression of disease, primary care doctors reduce these indirect costs. Plus, preventative services often bring about savings elsewhere in the healthcare system.
Several medical schools are working to prepare students for this shifting public-health landscape. Yale Medical School, for instance, offers senior medical students the opportunity to serve as primary care physicians for patients of Yale-New Haven Hospital's Wednesday Evening Clinic. Under the supervision of an attending physician, these students take ownership of their own group of patients for a year or more, helping to manage chronic conditions and maintain patient health over a long-term period.
At the medical school I lead, St. George's University, we've modified our curriculum to specifically prepare primary care physicians for managing chronic illness. Students are taught to identify specific demographic risk factors for certain chronic diseases -- and to tailor treatment appropriately.
Health care is changing. Primary care doctors are now on the front lines in the fight against chronic conditions. The American healthcare system -- and its medical schools -- must evolve in response.
G. Richard Olds, M.D., is President of St. George's University (www.sgu.edu).