Primary Care Medicine
description
Transcript of Primary Care Medicine
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Primary Care MedicineDr. Abdul Sattar Khan
MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)Assistant Professor
Family Medicine [email protected]
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ObjectivesAt the end of this course participants will be able to;• Explain the concepts of family medicine• Count the basic features of family medicine• Explain the short history of family medicine• Describe the characteristics of family physician• Explain what is family in family medicine
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Definition
Primary Health Care is the first level ofcontact with the health system topromote health, prevent illness, care forcommon illnesses, and manage ongoinghealth problems. WHO: www.who.int
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Declaration of Alma-Ata-WHOInternational Conference on Primary Health Care, Alma-Ata, USSR,
6-12 September 1978
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through
their full participation and at a cost that the community and country can afford to maintain at
every stage of their development in the spirit of self reliance and self-determination.
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Concept of Primary care medicine
• Primary Health Care includes: – Primary Care (physicians, midwives, nurses, social workers
etc);– Health promotion, illness prevention;– Health maintenance & home support;– Community rehabilitation; – Pre-hospital emergency medical services; &– Coordination and referral to other areas of health care.
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Different for different community?
• Primary Health Care is different in each community depending upon: – Needs of the residents;– Availability of health care providers; – The communities geographic location; &– Proximity to other health care services in the area.
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Concept in nutshell
An association of two or more individuals,
companies, organizations or governments
An association of two or more individuals,
companies, organizations or governments
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Primary Health Care ReformMedical model Primary Health Care
Illness Health
Cure Prevention, care, cure
Treatment Health promotion
Episodic care Continuous care
Specific problems Comprehensive care
Individual practitioners Teams of practitioners
Health sector alone Intersectoral collaboration
Professional dominance Community participation
Passive reception Joint responsibilityBarbara Starfield, Johns Hopkins University
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Primary Health Care in Turkey
Late Ottoman Period…• 1827 First modern medical school• 1871 Memleket Tabibi (Country physicians):
First primary care tasks...
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Primary Health Care in Turkey
• Act# 224 (May 1961)Prof. Dr. Nusret Fişek
• Primary care based health services
• 17 years before Alma-Ata
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New Patient-Centered Medical Home (PCMH)
www.aafp.org
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Patient-Centered Medical Home (PCMH)
www.aafp.org
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Primary Care
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History of Family Medicine
For thousands of years, physicians were true
“generalists,” providing care for men and women, children and
adults through the entire spectrum of life.
www.aafpfoundation.org
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History of Family Medicine (FM)• 1823 the term of general practitioners
mentioned by lancet .• The American Academy of General Practice
(AAGP) was established in 1947• 1960 ,specialty of family medicine started in USA • 1969, American Board of Family Medicine was Founded.
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History of Family Medicine in Turkey
• 1983 Regulation basis completed...• 1985 Training began in 9 teaching hospitals• Turkish Association of Family Physicians
established in 1990• Departments in Universities (1993)• 1st National Congress of Family Medicine
(İstanbul, 1993)
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What Is Family Medicine?
According to American Academy of Family Physicians AAFP(USA), Family Medicine is defined as the medical speciality which provides continuing and comprehensive health care for individuals and family. It is the speciality
which integrate the biological, clinical and behavioural sciences.
The scope of family practice includes (all ages, both sexes, all organs , all systems and all diseases.
FAME18
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What Is Family Medicine?
According to the World Organization of Family Doctors (Wonca), the aim
of family medicine is to provide personal, comprehensive and
continuing care for the individual in the context of the family and the
community.
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Family Practice
• Family Practice: is used to indicate the services part of the specialty ( practical more than the academic aspect).
• Family physician :is the specialist trained to practice in the front line of the health care system and to take initial and continuing care for healthy & ill persons.
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7 - principles of Family Medicine?• Continuity of care.• Comprehensive care.• Coordinated care.• Community & family based care.• Central Patient doctor relationship.• Care as Evidence based.• Care for ALL.
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Competencies of Family Physician
Ability to: • manage acute health problems.• manage chronic health problems.• provide health promotion services.• provide emergency services.• provide counselling services.• provide home care services.• provide preventive care services.• provide terminal and palliative care
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Where to practice Family Medicine?
• OPD/Clinics .• PHCC.• Family Practice Centres.• Hospitals.
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Characteristics of Competent Family Physician (FP)
• Competency in (Dx ,Rx )of common health problems.• Improving quality of care.• Rationalized utilization of health facilities.• Motivation of community to practice healthy behaviours.• Identify the needs of community .• Working within health team as member and leader
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Characteristics of Competent FP
Ability to: • communicate efficiently.• carry out studies and research.• plan and implement action plan.• educate and train his/her colleagues .• refer patients when it is needed.• activate community participation.• coordinate with other sectors.• update himself regularly
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How does Family Physicians differ from other physicians ?
• The first contact and gate of health care system.
• Provide continuity of care.• Provides comprehensive care.• Use holistic approach.• Shared care.• Patient centred approach
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KHAN’s 7-star doctor
Community
leaderCare
provider
Decision
maker
Learner Motivator
Manager
Communi-cator
04/21/23 27Dr. Khan
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Family ( functions & structures)
• Family is defined as the structural & functional unit of the community.
• Two related persons live together for> 6 months.
• Nuclear family= parents +- children.• Extended family= couples + parents + children.
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Family in Family Practice• Family is the unit of health care in FP.
• Family could be source of health.
• Family could be the source of illnesses.
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Wake up call• What is Declaration of Alma-Ata-WHO?• Define Family Medicine?• Tell me 7-prinicples of Family Medicine.• How does Family Physicians differ from other
physicians ?
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Are you ready to fly with us as
Family Physician?