What are the top 15 most common complaints in primary care?

Top 15 Most Common Complaints in Primary Care

The most common complaints in primary care include upper respiratory tract infections, hypertension, routine health maintenance, arthritis, diabetes, depression/anxiety, back pain, cough, abdominal symptoms, and headache, which collectively account for a significant portion of all primary care visits. 1

Primary Care Complaint Patterns

Clinician-Reported Common Complaints

1. Upper respiratory tract infections
2. Hypertension
3. Routine health maintenance/preventive care
4. Arthritis
5. Diabetes
6. Depression or anxiety
7. Pneumonia
8. Acute otitis media
9. Back pain
10. Dermatitis
11. Headache
12. Fatigue
13. Abdominal pain
14. Cardiovascular concerns
15. Urinary tract infections

Patient-Reported Common Complaints

• Cough
• Back pain
• Abdominal symptoms
• Pharyngitis
• Dermatitis
• Fever
• Headache
• Leg symptoms
• Respiratory concerns
• Fatigue

Regional Variations in Primary Care Complaints

There are notable differences in common complaints between developed and developing countries 1:

• Developed countries: After upper respiratory infections and hypertension, depression/anxiety and back pain are most common
• Developing countries: After upper respiratory infections and hypertension, pneumonia and tuberculosis are most common

Characteristics of Primary Care Episodes

Most primary care episodes are brief in nature:

• Approximately half of all episodes for common conditions (except hypertension) involve only a single medical visit 2
• Few episodes require referrals to specialists, sophisticated procedures, repeat testing, or hospitalization 2

Mental Health in Primary Care

Mental health concerns represent a significant portion of primary care visits:

• Depression and anxiety are among the top six most common complaints 1
• There is a bidirectional relationship between depression and cardiovascular disease 3
• Primary care providers play a crucial role in screening for depression, providing counseling, and prescribing medication when appropriate 3

Medically Unexplained Symptoms

An important consideration in primary care is that:

• Fourteen common physical symptoms account for almost half of all primary care visits 4
• Only 10-15% of these symptoms are found to have an organic cause within a one-year period 4
• Increasing number of medically unexplained symptoms correlates with anxiety, depression, and functional impairment 4

Unfocused Complaints

Some common complaints tend to be "unfocused" (not specific to one organ system) 5:

• Musculoskeletal conditions (back pain, knee pain)
• Mental/nervous system conditions (anxiety, headaches, dizziness)
• General symptoms (abnormal pulsations, swollen glands, abdominal pain)

These unfocused complaints highlight the importance of primary care's coordinator-of-care function, particularly for neurologic, rheumatologic, and general complaints 5.

Challenges in Primary Care

Primary care faces several challenges in addressing these common complaints:

• Undervalued and underresourced, accounting for 35% of healthcare visits but only 5% of expenditures 3
• Workforce shortages and high rates of burnout among family medicine clinicians 3
• Limited time during visit encounters 3
• Need for improved coordination of care and partnerships 3

Understanding the most common complaints in primary care is essential for resource allocation, guideline development, and designing appropriate training programs for primary care providers 1.