Entrance Register
Entrance Register

Family medicine

Family medicine  is a complex of scientific and practical measures for organizing family medical practice.

Family medical practice should be considered as one that provides long-term care for the health of a citizen and all members of his family, regardless of the nature of the disease, the state of organs and systems of the body, at all periods of a person's life, under appropriate conditions.

Family medicine includes: preventive medicine and medical and rehabilitation medicine. Preventive medicine identifies the problems of forming, preserving and strengthening the health of a healthy person, family and community. In turn, medical and rehabilitation medicine studies the principles of diagnosing diseases , their treatment, medical and social rehabilitation of patients and secondary prevention. [ 1 ]

Family medicine

General Practitioner Training Centre in Croydon (United Kingdom)

Family medicine practice is based on the principles of evidence-based medicine .

The main principles of family medicine:

  • long-term and continuous observation;
  • multidisciplinary primary care;
  • attitude towards the family as a unit of medical care;
  • prevention as the basis of the family doctor's activities ;
  • cost-effectiveness and feasibility of assistance;
  • coordination of medical care;
  • the responsibility of the patient , his family members and society for maintaining and improving his health. [ 2 ]

Durability and continuity of assistance

The concept of longevity includes, on the one hand, the relationship between the family  - doctor  - nurse system and, on the other hand, the relationship with other specialists working in the field of health care , to whom the family doctor has to turn for help and advice. The family doctor and the family nurse play the role of defenders of the patient's interests, integrators of the medical "service" regardless of the place where this process is carried out - in a medical institution, at home or at work. The longevity of the service is ensured by both the doctor himself and his colleagues - narrow specialists. In the optimal case, the relationship between the family doctor and the patient can be completed in the event that the participants in this process wish to interrupt them. The longevity and continuity of the relationship is most closely related to the quality of medical recommendations. One of the positive factors of continuous service is ensuring constant cooperation between the family doctor and the patient. Continuity of observation significantly improves the indicators of identifying psychological problems of the patient, to some extent reduces the need for unjustified additional services regarding laboratory and instrumental examination methods and, as a result, contributes to reducing the cost of medical services. Family doctors and nurses constantly monitor the health of family members, create passports for each of its members, which indicate risk factors, heredity, living and working conditions, teach how to provide first aid and care for sick family members (introduction of insulin , antibiotics , massage , emergency care , etc.). It should be emphasized that the principles of family medicine contribute to ensuring the continuity of medical care, as they say, from the moment of conception to the last minute of life, when the doctor is obliged, by virtue of his capabilities, to help a person approach the moment of completion of his life journey.

Multidisciplinary

If we proceed from the ideas about the multidimensionality of forms of ill health, we should realize that family medicine is a clinical specialty that considers a person as a whole. The duty of a family doctor is to provide primary medical care to any patient, regardless of his age and gender. A comprehensive approach of a family doctor to a sick patient can often become the basis for conclusions that differ significantly from those obtained with a one-sided, highly specialized medical approach.

Family approach

Providing patients with qualified primary medical and preventive care in outpatient settings and at home is the function of a family doctor . [ 3 ] Providing care to several generations of patients from the same family, a family doctor and a family nurse inevitably become witnesses to the internal problems of the family and are closely confronted with them. The family's attitude to the health of its members, the influence of environmental factors , sports , nutritional characteristics , the importance of bad habits for health , etc. should be constantly monitored by a medical professional who must anticipate both expected and unexpected transitions of each family member to the risk zone. A family medicine specialist has a unique opportunity to apply preventive measures at an early stage of pathological changes.

Preventiveness

Preventive orientation is an important principle of family medicine. Forecasting the risk of developing certain diseases, their preclinical diagnosis, timely informing the patient, and taking preventive measures are the most important components of the daily work of a family doctor and nurse. Only a family doctor has a motivated need to truly engage in prevention in the process of daily work with his patients and their family members. This is explained not only by the fact that a family doctor knows his patients and the circumstances of their lives that are harmful to health better than highly specialized colleagues, but also by the fact that only a family doctor is directly interested in reducing the morbidity of the attached population. A family doctor more often than other specialists should use rational tactics, both from a medical and an economic point of view, justified in relation to the necessary laboratory and instrumental research methods and recommend the need to use specialized treatment technologies. Integrating new knowledge and skills into the ongoing process of providing medical care to a person from birth to the end of their life journey improves the quality of family medical practice. At the same time, patients benefit from a more holistic approach to their health and greater opportunities to receive timely and adequate care at the local level.

Economic efficiency

The ZPSM model reduces costs for

  • remuneration of specialized specialists
  • inpatient care (due to reduction of unnecessary hospitalizations)
  • training of personnel and providing them with housing
  • for emergency care (if a family doctor lives in the service area, there is no need to call an ambulance)

Family medicine department

A general practice area (general practice area - family medicine) is an area in which a family doctor, within the scope of his/her activities, ensures the implementation of a complex of preventive measures to prevent and reduce morbidity, disability and mortality , early detection of diseases, provides qualified primary medical and preventive care to the population attached to the family-territorial principle, carries out their medical examinations and monitors their health status.

In Ukraine, on average, 1,100-1,200 people (including children) live in a ZPSM district in rural areas, and 1,400-1,500 people in cities.

See also

Notes

  1. Zaremba, E. Kh.; Hrytsko, R. Yu.; Kyyak, Yu. G.; Lemishko, B. B.; Zaremba-Fedchyshyn, O. V.; Zaremba, O. V. (2017). The main direction of work of family medicine specialists is prevention . Practitioner . No. 6, No. 4. pp. 5—10. ISSN  2413-550X . Archived from the original on October 24 , 2020. Retrieved October 20, 2020 .
  2.  World Organization of Family Physicians (WONCA) website [1] [ Archived May 26, 2010 at the Wayback Machine .]
  3.  Order of the Ministry of Health of Ukraine dated 07/23/2001 N 303

Sources

  • Family medicine: national textbook for students of the IV year of medical school: In 3 books. Book 2. Symptoms and syndromes in the clinic of internal diseases / L. S. Babinets, O. M. Barna, S. V. Biletsky and others; ed. O. M. Hyrina, L. M. Pasiyeshvili. - Kyiv: Medicine, 2016. - 455 p. - P.449
  • Family medicine: textbook: in 3 books. Book 1: General issues of family medicine / O. M. Girina [and others]; ed.: O. M. Girina, L. M. Pasiyeshvili, G. S. Popik. — Kyiv: Medicine, 2013. — 672 p. ISBN 978-617-505-244-0
  • Antropova, T. O. Nursing in family medicine [Text]: textbook / T. O. Antropova. - 4th ed., revised. - Kyiv: VSV "Medicine", 2015. - 488 p. ISBN 978-617-505-381-2
  • Shkala L.V., Levchenko G.F. Family Medicine. General Provisions: Monograph. – Lugansk: LDMU, 2008. – 200 p. ISBN 966-687-034-7
  • Family medicine: a textbook for students of the III-IV year of medical school / edited by V. B. Goshchynsky, E. M. Starodub. - Ternopil: Ukrmedknyga, 2005. - 810 p.
  • Family medicine: psychological aspects of diagnostics, prevention and treatment of patients: a manual for interns of the IV Medical University of Kyiv. / edited by I. S. Vitenko. - [B. m.]: Ukrmedknyga, 2002. - 187 p. : tab.

Link

Authors: Українка Леся Петрівна, Тарас Шевченко, Admin Ucfm UCFM