Basics in organization of family medicine in Ukraine and Worldwide

Июль 21, 2022

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Basics in organization of family medicine in Ukraine and Worldwide

Содержание

2. First term primary health care (PHC) is found in scientific studies of Lord Dowson (1920, UK),
3. 2. Charlestown center of a family medicine 1. New London family medical center
4. 3. Family medicine center Hamptons. USA
6. Family medicine in the world continues to develop. Today, the development of a family medicine in
7. Were created powerful international association of family doctors WONCA and regional (European, Asian, South American, North
8. World Organization of National Colleges, Academies - Wonca World Organization of Family Doctors (WONCA) founded in
9. The main aim of Wonca is the improvement of living standards by: raising service standards in
10. Workgroups Education (EURACT) Research Environment Ethical Issues Informatics Women and Family Medicine Mental Health High-quality and
11. General practice / family medicine is an academic and scientific discipline with its own purpose, objectives,
13. (European Wonca, 2005) Competence of a GP – Family doctor 1. Management of primary care :
14. (European Wonca, 2005) Competence of a GP – Family doctor 2. Patient-centered care: - focused on
15. 4. A comprehensive approach: - control disease stage differentiation diagnosis, - risk management and probabilities, -
16. Characteristics of general practice - family medicine: Available for the entire population primary care, most often
17. Characteristics of general practice - family medicine: 3. Provides individual assistance to the patient, but with
18. 5. Responsible for the consistency and continuity of care, according to the patient's needs; 6. Has
19. 8. Solves both the problem of acute and chronic diseases; 9. Personalized counseling on maintaining a
20. Diagnostic techniques include - interviewing the patient to collect information on the present symptoms, - prior
21. After collecting data, the FD: - arrives at a differential diagnosis and, with the participation of
22. Educational program and program of research in general practice / family medicine
23. Models of the family doctor practice in the world Private Practice: physician and nurses. 2. Group
24. USA MEDICINE The share of GP is nearly 40% Every year on health care 14% of
25. MEDICINE in CANADA The relationship between family doctors and narrow specialists is 50:50. 3 of 4
26. MEDICINE in CANADA FD spend their morning in the hospital after 12 pm works with patients
27. MEDICINE in United Kingdom The share of FD is about 70% Every citizen registered in the
28. France medicine This system is ranked as №1 in the WHO rating FD number is 65
29. The main problems of family medicine To create algorithms, based on scientific data obtained at the
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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 Еurope 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, 2005)
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, 2005)
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. Personalized

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.

Basics in organization of family medicine in Ukraine and Worldwide

Содержание

First term primary health care (PHC) is found in scientific studies

2. Charlestown center of a family medicine1. New London family medical

3. Family medicine center Hamptons. USA

Family medicine in the world continues to develop.Today, the development of

Were created powerful international association of family doctors WONCA and regional

World Organization of National Colleges, Academies - Wonca World Organization of

The main aim of Wonca is the improvement of living standards

WorkgroupsEducation (EURACT)ResearchEnvironmentEthical IssuesInformaticsWomen and Family MedicineMental HealthHigh-quality and safe careRural PracticeWICC

General practice / family medicine is an academic and scientific discipline

(European Wonca, 2005) Competence of a GP – Family doctor1. Management

(European Wonca, 2005) Competence of a GP – Family doctor2. Patient-centered

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

Characteristics of general practice - family medicine:Available for the entire population

Characteristics of general practice - family medicine:3. Provides individual assistance to

5. Responsible for the consistency and continuity of care, according to

8. Solves both the problem of acute and chronic diseases;9. Personalized

Diagnostic techniques include - interviewing the patient to collect information on

After collecting data, the FD:- arrives at a differential diagnosis and, with the