A primary care physician (PCP), or primary care provider, is a health care professional who practices general medicine. PCPs are our first stop for medical care. Most PCPs are doctors, but nurse practitioners and even physician assistants can sometimes also be PCPs. A PCP is the person your child should see for a routine checkup or non-emergency medical care. If your child has a mild fever, cough, or rash, or is short of breath or nauseated, a PCP usually can find the cause and decide what to do about it. Usually, PCPs can treat conditions in their own offices. If they can’t, they can refer you and your child to a trusted specialist. If your child needs ongoing treatment or is admitted to a hospital, the PCP may oversee the care, help you make decisions related to treatment, or refer you to other specialists if needed. One of a PCP’s most important jobs is to help keep kids from getting sick in the first place.

This is called preventive care. Different types of PCPs treat kids and teens. Family practitioners, or family medicine doctors, care for patients of all ages, from infants, kids and teens, to adults and the elderly. Pediatricians care for babies, kids, and teens. Internists, or internal medicine doctors, care for adults, but some see patients who are in their late teens. Adolescent medicine specialists are pediatricians or internists who have additional training in caring for teens. Combined internal medicine and pediatric specialists have training in both pediatrics and internal medicine, allowing them to bridge the gap between treating young patients and adults. Obstetricians and gynecologists specialize in women’s health issues and are sometimes PCPs for girls who have started menstruating. A nurse practitioner or physician assistant sometimes is the main provider a child sees at a doctor’s office. A PCP should be your first option for any medical condition that isn’t an emergency.

When in doubt, call the PCP. Even if the PCP isn’t available, someone else in the office can talk with you and determine whether your child should go to the ER. On weekends and at night, PCPs often have answering services that allow them to get in touch with you if you leave a message. To find a PCP, start by asking yourself what matters to you. For instance, you’ll want the PCP’s office to take your health insurance and, ideally, be close to home. Other things to consider include how helpful and friendly the staff is, how easy it is to get in touch with the PCP, and whether the PCP’s office hours will work with your schedule. Ask for recommendations from friends, neighbors, relatives, and doctors or nurses you already know and trust. Once you have a list of candidates, learn what you can about the PCP. Find out about any extra services: some offices also have specialists, mental health providers, dieticians, lactation consultants, and social workers on the premises. It can be convenient to have all of these services under one roof. Your health insurance plan may have a directory of preferred PCPs, and many practices will let you meet with a potential provider to see if he or she seems like a good fit for your child. And remember, although it’s easier to find and stick with one PCP, if you feel your child isn’t getting the level of care you’re looking for, you can always switch to another PCP.

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This sometimes volatile mix of cultures and ideas is also incredibly productive. The farms of the Driftless are known for some of the best milk, cheese, beef, and vegetables money can buy. The smaller scale means it often doesn’t pay to use the antibiotics and hormones that drive the conventional farming industry, so many farmers lean by default towards rotational grazing and organic methods. The difference in food production has placed the Driftless at the forefront of an organic food and sustainable agriculture movement that is influencing cooking and eating habits across the U.S. Food grown on small farms, according to traditional and organic methods, is healthier for you. And it pays better. Premiums on naturally raised livestock and organic crops keep small farms alive. The uncommon alliances built by the organic food movement have had a much larger social impact in the Driftless, creating what political analysts call the “Upper Mississippi River Valley Anomaly,” a substantial cluster of mostly agricultural, heavily Caucasian “blue” counties. “A distinctive bioregional culture has evolved in this four-state region,” writes Stephen J. Lyons in the introduction to his book, Going Driftless.

“A culture that values all things small and local, including food, music, education, environment, and media.” Lyons then quotes from Ernest Callenbach’s novel, Ecotopia: “The land is well cared for and productive. Food is plentiful, and wholesome, and recognizable. The Driftless region has remained stable in large part due to a socio-economic structure almost lost in the hustle to create modern civilization. This structure is based upon an alliance of progressive ideals, common sense land stewardship, food-based activism, and modern finance. Everywhere it comes into contact with mainstream culture, something special happens. On October 22, 1867, Mathias Brimeyer wrote a letter to his family back in Luxembourg. A few years earlier, he had completed a month-long journey from Paris to New York by ship, then by train from New York to Dubuque. “In America one comes in contact with all kinds of people, known and unknown. At first it was hard but now it all suits me right good. That not many come back to their homeland where there is no freedom is a sign that things are better in America and all have finer living.

Every day is like a parish picnic day back home… Eggs and fish are plentiful. European immigrants poured into the Midwest after the Louisiana Purchase (1803) and the Erie Canal (1825) opened up the frontier to the bursting cities of the East Coast. By then, French trappers had already annihilated the Fox and Sauk tribes who ran the Upper Mississippi Valley trade routes. Most other Native tribes were either on the run or gearing for a last stand. Some, like the Hochunk, helped mine lead out of the hills around Galena and Mineral Point, old world boomtowns turned modern-day tourist destinations and artists’ enclaves. The Kickapoo, who lend their name to many a business and valley in southwestern Wisconsin, picked up stakes and moved to the border with Mexico. What remained were Franco-German and Irish farming communities clustered around churches and sales barns, intermarrying and straying but a few valleys over to trade beef for milk, pork for cheese, hay and corn for vegetables and butter.


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