PCPs, APPs, and the Everything Bagel Problem — Choosing Not to Choose

The weight of preventive care tasks may be threatening the PCP skills critical to managing complex chronic disease. Have we overloaded primary care with worthy goals, causing paralysis?

During her training, Elizabeth Rourke, a Boston primary care physician (PCP), had a patient interaction that left her forever skeptical of the benefits of primary care–led safety screenings. As required, she began by asking the middle-aged man, who lived in a low-income community, whether he felt safe at home. When he said yes, she proceeded to the next item and asked whether there were any guns in his home. “You’re absolutely right,” Rourke recalls him saying. “I need to go get a gun so I can feel safe...