“ Basics in organization of family medicine in Ukraine and Worldwide” - PowerPoint Presentation

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“Basics in organization of family medicine in Ukraine and Worldwide”

ZSMUDepartment of general practice – family medicine

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First term primary health care (PHC) is found in scientific studies of Lord Dowson (1920, UK), Millis, Willard (1960-1969, USA), and M. Lflonde (1974, Canada), which mentioned in their writings about PHC, but none of them gave a definition of this concept.

In

May 1978

at the International Conference on PHC, held in Alma-Ata, the World Health Organization (WHO) first defines the concept of PHC, which indicated the priority PHC and affected the national system of health care around the world.

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2. Charlestown center of a family medicine

1. New London

family medical

center

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3. Family medicine center Hamptons. USA

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Family medicine in the world continues to develop.

Today, the development of a family medicine in the

world has achieved considerable success, especially in Europe.

Switching health care systems in many European countries on the principles of a family medicine has proved its efficiency and economic benefits.

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Were created powerful

international

association of family doctors

WONCA

and

regional

(

European, Asian, South American, North American, and others).

They periodically hold international conferences and congresses where new achievements and successes of family medicine in the world are illuminated.

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World Organization of National Colleges, Academies - Wonca

World Organization of Family Doctors (WONCA) founded in 1972;

consists of national colleges, academies and organizations of general practitioners / family doctors.

Now it counts about 300,000 members representing 126 organizations from 102 countries.

WONCA

President

Prof

Richard

G

Roberts

WONCA

Е

urope

President

Anthony

Mathie

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The main aim of Wonca

is the improvement of living standards by:

raising service standards in family medicine,

promoting intensive exchange of information,

support scientific and clinical research, and

the development of educational standards.

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Workgroups

Education (EURACT)

Research

Environment

Ethical Issues

Informatics

Women and Family Medicine

Mental Health

High-quality and safe care

Rural Practice

WICC (International Classification)

Special Interest Groups

Cancer and Palliative Care

Difficulties in Health

Geriatric help

Medicine of migration and tourism

international health

International Movement of family doctors Vasco

da

Gama includes 32 countries

Purpose:

Holding conferences and exchange programs for young family doctors

Identifying problems of young family doctors and finding their solutions

Participation in the development of measures to improve the quality of education

cooperation with all WONCA

Institutions.

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General practice / family medicine is an academic and scientific discipline with its own purpose, objectives, research methods, evidence base and clinical activity.

Family Medicine

is a separate discipline rather than a set of parts of other disciplines because it requires its own scientific base.

Research

is an integral part of any scientific discipline (they are also part of family medicine).

(

European

Wonca

, 2002, 2005)

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(

European

Wonca

, 200

5

)

Competence of a GP – Family doctor

1.

Management of primary care :

- first contact,

- open and unrestricted access,

help with all the health problems

effective use of resources through the coordination of assistance and cooperation with other primary care professionals,

managing the interface between general and specific help,

take the role of defender of the patient when needed,

ie

, to protect patients from harm that may be inflicted as a result of unnecessary investigation and treatment

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(

European

Wonca

, 200

5

)

Competence of a GP – Family doctor

2.

Patient-centered care:

-

focused on the individual, his / her family,

- establishing a long relationship,

- effective communication,

long continuous assistance

3

. Addressing specific problems :

making specific decisions,

the prevalence of certain accident must cope simultaneously considering individual approach with both acute and chronic health problems with at all stages,

a wide range of complaints and illnesses,

comorbidities

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4. A comprehensive approach:- control disease stage differentiation diagnosis,

- risk management and probabilities, - health promotion and prevention as important as cure,

- care and palliative care

5. Targeting Society:

responsible for public health

6. Holistic approach:

health problems in their biomedical, psychological, social, culture and

existential dimension

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Characteristics of general practice - family medicine:

Available for the entire population primary care, most often - on the line of first contact with the patient's health care system, which solved the problem of the patient, regardless of age, sex and other characteristics;

2. Ensures efficient use of resources

of the entire health system by coordinating the efforts of various specialists, as well as by patients' rights when necessary;

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Characteristics of general practice - family medicine:

3. Provides individual assistance to the patient, but with the characteristics of his family and social environment;

4. Has a unique opportunity consulting all family

members

, regardless of age, examines the state of health of the family in several generations. Based on effective relationship between doctor and family.

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5. Responsible for the consistency and continuity of care, according to the patient's needs;

6. Has its own unique type of clinical thinking and decision-making path, which is determined by statistical and epidemiological indicators of health and illness;

7. Solves the problem of diseases in preclinical often non-differentiable stage;

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8. Solves both the problem of acute and chronic diseases;

9. P

ersonalized counseling on maintaining a healthy lifestyle

;

10. Responsible for the quality and effectiveness of care

provided to the individual as well as to the community;

11. Solve health problems in their physical, psychological, social, cultural and existential definitions;

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Diagnostic techniques include - interviewing the patient to collect information on the present symptoms, - prior medical history and other health details, followed

by a physical examination. Many FDs are trained in basic medical testing:interpreting results of blood or other patient samples,

electrocardiograms, or x-rays

More complex and time-intensive diagnostic procedures are usually obtained by referral to specialists, due to either special training with a technology, or increased experience and patient volume that renders a risky procedure safer for the patient.

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After collecting data, the FD:- arrives at a differential diagnosis and, with the participation of the patient, formulates a plan including components of further testing, specialist referral, medication, therapy, diet or life-style changes patient education, and follow up results of treatment.

FD also counsel and educate patients on safe health behaviors, self-care skills and treatment options, and provide screening tests and immunizations

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Educational program and program of research in general practice / family medicine

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Models of the family doctor practice in the world

Private Practice:

physician and nurses.

2.

Group practice

when several doctors grouped, saving money, organize interchangeably among themselves, to some specialization of medical practice.

3.

Medical centers

(Scandinavian model), which is actually a clinic of a GP, sometimes a hospital for the elder patients.

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USA MEDICINE

The share of GP is nearly 40%

Every year on health care 14% of the gross national product consumed, or almost 3 thousand dollars per 1 inhabitant.

Average salary of a family doctor is from 44 to 60 thousand dollars a year.

At 49.7 - 60-hour weeks (47.4 weeks per year) FD takes about 175-182 patients and makes 27 visits to hospital.

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MEDICINE in CANADA

The relationship between family doctors and narrow specialists is 50:50.

3 of 4 Canadians surveyed prefer to get any medical help from a family doctor in the first place.

In a small town with a population of about 4,000 people there are surgeon, internist and 6 competent GP.

They work as well in a local hospital with capacity of 60-80 beds.

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MEDICINE in CANADA

FD spend their morning in the hospital after 12 pm works with patients in his office, which has laboratory equipment (from elementary to advanced studies), daily intake 25-40 patients who prefer to visit doctor in his office.

When hospitalization is necessary, FD assists with helping a patient during the whole period of staying in the hospital.

Usually FD has 60 or more hours a week, visiting 182 patients.

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MEDICINE in United Kingdom

The share of FD is about 70%

Every citizen registered in the list of specific FD

Each FD usually gives more than 8 000 consultations per year

Approximately 85% of the consultations held in the office of the FD, 5% and 10% home visit, and by phone

The patient usually can not be consulted by a doctor of secondary level (

eg

, hospital), without referring to a FD in a first place.

About 13% of the population each year seek treatment in inpatient institutions, 50% of which require emergency measures.

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France medicine

This system is ranked as

№

1 in the WHO rating

FD number is 65 000

Any medical care, except emergency, performed only after the patient’s visit to FD

It’s only possible to buy medicines prescribed by a FD

Only students with the highest level of success can become narrow specialists, others are FD

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The main problems of family medicine

To create algorithms

, based on scientific data obtained at the

primary stages

To develop research protocols

To conduct research projects that reflect the nature and problems of discipline

.

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