Healthcare System in Ireland Overview

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Questions and Answers

What is the primary goal of primary care?

To manage chronic diseases exclusively

To provide emergency medical services

To promote health and prevent disease (correct)

To provide specialized surgical interventions

Which of the following best describes general practice?

A synonym for secondary care

Care focused solely on hospital settings

A type of emergency medicine practice

First-level contact care for patients (correct)

How does the Department of General Practice contribute to medical education?

By eliminating patient interaction in the curriculum

By focusing exclusively on surgical techniques

By prioritizing advanced technology in patient care

By integrating practical experience with theoretical knowledge (correct)

What is Early Patient Contact in medical education?

An initiative to involve students with patients early in their training Signup and view all the answers

What is the expected role of students in Healthcare Symposia?

To actively engage and contribute to discussions Signup and view all the answers

Which strategy is not considered effective in a team setting?

Avoiding conflicts Signup and view all the answers

What aspect of health does the Global Burden of Disease study focus on?

Global morbidity and mortality trends Signup and view all the answers

Which model serves as a framework for communication in healthcare?

The Calgary Cambridge Model Signup and view all the answers

Which of the following constructs is related to Personal and Professional Identity?

Professionalism Signup and view all the answers

What do social determinants of health refer to?

Economic and social conditions influencing health Signup and view all the answers

Which process is crucial for understanding disease pathology?

Biochemical processes Signup and view all the answers

Which characteristic is essential for understanding medically important microbiological organisms?

Their pathogenesis Signup and view all the answers

What principle is key to microbiological diagnostic investigation?

Microbial identification Signup and view all the answers

What is the primary role of a healthcare assistant in a primary care team?

Provide support and assistance to healthcare professionals Signup and view all the answers

Which group of patients is eligible for free GP care and can apply for a medical card?

Individuals aged 8-69 who meet means testing Signup and view all the answers

What is the expected impact on the number of GPs in Ireland in the near future?

A decrease due to retirements Signup and view all the answers

What do GP visit cards provide under the specific eligibility category?

Free GP care for specific age and care groups Signup and view all the answers

Under the Drug Payment Scheme, what is the maximum amount a family pays for medications in a month?

€80 Signup and view all the answers

Which healthcare role is responsible for offering psychological support and therapy?

Psychologist/therapist Signup and view all the answers

Which option best describes the primary method of access to healthcare for private patients?

Paying for GP visits and other services Signup and view all the answers

Which professional is most likely to provide advice on foot health?

Podiatrist Signup and view all the answers

What is a key component to successful practice in medicine?

Understanding the patient's experience of illness Signup and view all the answers

What does patient-centered care primarily emphasize?

Effective communication and understanding of illness experience Signup and view all the answers

Which of the following is NOT a responsibility of doctors?

Providing unfiltered personal health opinions Signup and view all the answers

What emotion management practice is important when meeting patients?

Caring for your own health and managing emotions Signup and view all the answers

Which aspect is included in the Calgary Cambridge model?

Understanding the patient's concerns regarding their illness Signup and view all the answers

What defines the concept of 'trust' in the doctor-patient relationship?

Patient's belief in the doctor's skills and intentions Signup and view all the answers

What is a common challenge faced by medical professionals?

Managing uncertainty in clinical situations Signup and view all the answers

What does professionalism in medicine encompass?

Respectful behavior and punctuality Signup and view all the answers

Why is humility important in the practice of medicine?

To acknowledge the potential for harm and the need for reflection Signup and view all the answers

What should be respected during healthcare symposia with patients?

Patient confidentiality and privacy Signup and view all the answers

What is the gender split among general practitioners?

50:50 split between genders Signup and view all the answers

Which feature is NOT identified by Barbara Starfield as a central characteristic of effective primary care?

Specialized care Signup and view all the answers

What type of care is provided by Primary Care Centers in Bahrain?

Laboratory and X-ray services Signup and view all the answers

What is the primary focus of Family Physicians in Bahrain after their training?

Chronic disease management Signup and view all the answers

Which of the following is NOT a preventative service offered by Primary Care in Bahrain?

Oncology Treatments Signup and view all the answers

What is necessary for a General Practitioner to become certified in Bahrain?

A 4-year residency training program Signup and view all the answers

What is the significance of the Alma-Ata and Astana declarations in Bahrain?

To achieve universal health coverage Signup and view all the answers

Where do most general practitioners work?

In group practices or clinics Signup and view all the answers

What aspect of patient interaction is emphasized in the first two years of the medical course?

Communication and examination skills Signup and view all the answers

What is the average number of patients seen in a typical day by a GP?

25-30 patients Signup and view all the answers

Which patient type does NOT belong to the common presentations in a GP's clinic?

Post-operative follow-up Signup and view all the answers

What is the role of the General Practitioner in chronic illness cases?

Management and follow-up of chronic illnesses Signup and view all the answers

What type of services is included in the pharmaceutical services provided at Primary Care Centers?

Chronic disease medications Signup and view all the answers

What is a key aspect of early patient contact in medical training?

Direct interaction with patients Signup and view all the answers

What is a primary responsibility of primary care services?

Providing first level contact for health issues Signup and view all the answers

Which of the following best illustrates the role of general practice within primary care?

Promoting overall health and wellness in communities Signup and view all the answers

How does primary care contribute to disease management?

It offers screening, assessment, and treatment options Signup and view all the answers

What distinguishes primary care from secondary and tertiary care?

Primary care is the first contact point for patients Signup and view all the answers

What is a key feature of the Department of General Practice in medical education?

It emphasizes communication and examination skills Signup and view all the answers

What percentage of the population in Ireland is eligible for free GP care with a medical card?

35% Signup and view all the answers

Which of the following groups is NOT eligible for GP Visit Cards under specific eligibility criteria?

Individuals with chronic illness Signup and view all the answers

What is the maximum monthly charge a family pays for medications under the Drug Payment Scheme?

€80 Signup and view all the answers

How many GPs are approximately expected to retire in the next five years in Ireland?

700 Signup and view all the answers

Which healthcare role typically does NOT provide free medications?

Private patients Signup and view all the answers

What percentage of the population can expect to pay for physiotherapy services?

55% Signup and view all the answers

Which of the following best describes the structure of primary care teams in Ireland?

Includes administrative support staff Signup and view all the answers

Who qualifies as a general practice trainee in Ireland?

Individuals who have completed their medical degree Signup and view all the answers

What is one of the essential frameworks utilized in healthcare communication?

The Calgary Cambridge Model Signup and view all the answers

Which of the following best describes the importance of social determinants in health?

They contribute to health inequalities and outcomes. Signup and view all the answers

In the context of the Global Burden of Disease study, which aspect is primarily analyzed?

Trends in morbidity and mortality Signup and view all the answers

Which characteristic is crucial for understanding bacterial infections?

Pathogenesis of microbiological organisms Signup and view all the answers

What concept is integral for managing self and engaging with others in a professional setting?

Personal and Professional Identity Signup and view all the answers

Which statement best describes the principles of pharmacology?

They encompass the study of biological and chemical bases of life. Signup and view all the answers

Which of the following methods is commonly utilized in microbiological diagnostic investigation?

Culturing specimens Signup and view all the answers

What is a critical factor for the development of health resilience in patients?

Access to psychological support Signup and view all the answers

What is a key element in understanding a patient's experience of illness?

Acknowledging the social impact of illness Signup and view all the answers

What does professionalism in medical practice primarily involve?

Maintaining punctuality and confidentiality Signup and view all the answers

Which of the following best supports the patient-doctor relationship?

Effective communication and respect Signup and view all the answers

What is an essential aspect of patient-centered care?

Listening to and addressing patient expectations Signup and view all the answers

How should medical students approach their own emotions during early patient contact?

Reflect on their emotions while remaining professional Signup and view all the answers

What role does listening play in the patient-doctor relationship?

It is critical in understanding the patient's experience Signup and view all the answers

What does the Calgary Cambridge model focus on?

Effective communication with patients Signup and view all the answers

Which element is NOT a good practice during healthcare symposia?

Recording the session for personal use Signup and view all the answers

What emotion should a doctor maintain while interacting with patients?

Confidence in their abilities Signup and view all the answers

Why is reflection important in the practice of medicine?

It allows for continuous personal and professional growth Signup and view all the answers

What is the first point of contact for patients within the healthcare system in Bahrain?

General Practice Signup and view all the answers

Which of the following features identifies an effective primary care system according to Barbara Starfield?

Comprehensive Care Signup and view all the answers

What number of patients does a typical GP see in a day?

25-30 patients Signup and view all the answers

Which component is NOT part of the preventative services provided at Primary Care Centers in Bahrain?

Invasive Surgical Procedures Signup and view all the answers

Which statement accurately describes the training pathway for Family Physicians in Bahrain?

1-year internship followed by 4 years of residency Signup and view all the answers

What is a primary characteristic of the training provided in the first two years of the medical course?

Communication skills Signup and view all the answers

Which service is included in the management provided by Primary Care Centers?

Routine laboratory testing Signup and view all the answers

What aspect of patient care is addressed through the Calgary Cambridge model?

Communication during consultations Signup and view all the answers

Which of the following is an important service provided by a GP for chronic illness management?

Management of multiple chronic ailments Signup and view all the answers

What is a benefit of the Universal Declaration of the Alma-Ata adopted by Bahrain?

Achievement of universal health coverage Signup and view all the answers

Which type of practice location is more common for GPs?

Group practices in health centers Signup and view all the answers

Which of the following is NOT a typical patient presentation in a GP's clinic?

Setting up a complex surgery Signup and view all the answers

What is the primary focus of pharmaceutical services at Primary Care Centers?

Providing prescriptions and medications Signup and view all the answers

Which service is considered a primary level of care and aims to keep people well through various health promotion activities?

Primary Care Signup and view all the answers

What is the primary distinction between primary care and secondary care?

Primary care serves as the first point of contact, while secondary care provides more specialized services. Signup and view all the answers

How does the approach to health care in general practice facilitate community health improvement?

By emphasizing accessibility and community engagement in health services. Signup and view all the answers

Which aspect of primary care is not typically included in the traditional understanding of its function?

Advanced surgical interventions Signup and view all the answers

What role does early patient contact play in medical education?

It facilitates the development of practical communication and examination skills. Signup and view all the answers

Which of the following best describes a key strategy for effective teamwork in healthcare?

Utilizing collaborative interventions to achieve common goals Signup and view all the answers

What is a significant implication of understanding the global trends in morbidity and mortality?

It helps identify regions disproportionately affected by specific diseases. Signup and view all the answers

Which component is critical for effective communication according to the Calgary Cambridge Model?

Nonverbal cues and active listening skills Signup and view all the answers

What aspect of Personal and Professional Identity is essential for engaging with patients?

Demonstrating humility and resilience in practice Signup and view all the answers

What is a primary focus when describing the social determinants of health?

The impact of environmental factors on health outcomes Signup and view all the answers

Which process is crucial for understanding the immunological responses to diseases?

Examining the pathogenic mechanisms of specific infections Signup and view all the answers

In microbiological diagnostics, what principle is fundamental for accurate identification of pathogens?

Employing culture techniques to isolate microorganisms Signup and view all the answers

What psychological principle is essential for maintaining health in a healthcare setting?

Incorporating behavioral changes through patient education Signup and view all the answers

What percentage of individuals in Ireland is eligible for free GP care under the means-tested medical card scheme?

35% Signup and view all the answers

Which healthcare professional typically provides advice on foot care within a primary care team?

Podiatrist Signup and view all the answers

Which of the following groups can specifically apply for GP Visit Cards to receive free GP care?

Children under 8 Signup and view all the answers

What is the approximate maximum monthly cost a family in Ireland might incur for medications under the Drug Payment Scheme?

€80 Signup and view all the answers

Which of the following groups represents private patients regarding GP care in Ireland?

Require payment for all services Signup and view all the answers

Which healthcare role typically helps patients in managing their chronic illnesses within a primary care setting?

General Practitioner Signup and view all the answers

Approximately how many GP trainees qualify each year in Ireland?

200 Signup and view all the answers

What is the expected trend regarding the number of GPs in Ireland over the next five years?

Decrease by 700 Signup and view all the answers

Why is humility considered important in the practice of medicine?

It helps maintain the privilege and responsibility of the profession. Signup and view all the answers

What is a key learning outcome of early patient contact in medical education?

Understand the importance of empathy and compassion towards patients. Signup and view all the answers

What role does self-awareness play in the doctor-patient relationship?

It supports the development of trust and ensures effective communication. Signup and view all the answers

Which of the following best describes the concept of patient-centered care?

Focusing on good communication to enhance understanding of the patient's illness. Signup and view all the answers

What is the significance of the Calgary Cambridge model in healthcare?

It provides a framework for effective communication and understanding patient experiences. Signup and view all the answers

Which of the following reflects a key challenge faced by medical professionals when interacting with patients?

Balancing their own emotions while managing patient relationships. Signup and view all the answers

What requirement is emphasized regarding patient confidentiality in healthcare symposia?

Any shared patient information must be kept strictly confidential. Signup and view all the answers

How does the patient-doctor relationship impact the effectiveness of treatment plans?

Good rapport can lead to better adherence to treatment recommendations. Signup and view all the answers

Which of the following describes the primary focus of professionalism in medicine?

Balancing technical skills with respect, behavior, and patient interactions. Signup and view all the answers

What aspect of patient experiences is crucial for medical practitioners to understand?

The effects of illness on patients' lives should be acknowledged as subjective. Signup and view all the answers

What are the four central features identified by Barbara Starfield as essential for effective primary care?

First Contact, Continuous care, Comprehensiveness, Coordination Signup and view all the answers

How does the primary healthcare system in Bahrain aim to achieve universal health coverage?

Adoption of the Alma-Ata and Astana declarations Signup and view all the answers

Which type of patient complaint would likely not be managed directly by a GP in a primary care setting based on the presented information?

Emergency surgical procedure Signup and view all the answers

What is the average duration for a patient consultation in a GP's clinic?

10-15 minutes Signup and view all the answers

In the context of early patient contact, what core element is emphasized in the medical curriculum?

Communication and examination skills Signup and view all the answers

Which of the following services is classified as a preventative service offered by Primary Care Centers in Bahrain?

Periodic child screening Signup and view all the answers

What is a characteristic feature of GP clinics typically found in Bahrain?

Often part of health centers or primary care centers Signup and view all the answers

Which option is not a known presentation a GP might deal with during a typical morning clinic?

Emergency appendectomy Signup and view all the answers

What distinguishes the Family Physicians in Bahrain after completing their training program?

Provision of comprehensive general medicine services Signup and view all the answers

What is the primary goal of the GP department during the first two years of medical training?

Developing communication and clinical skills Signup and view all the answers

What type of care does primary healthcare in Bahrain primarily emphasize based on the information provided?

Preventative and primary care services Signup and view all the answers

Which of the following statements is true regarding the gender split among general practitioners?

Roughly 50:50 gender split Signup and view all the answers

Which of the following best reflects the role of continuity of care in primary care settings?

Involves long-term relationships with patients Signup and view all the answers

Study Notes

Structure of the Healthcare System in Ireland

The Irish healthcare system is organized into three levels: secondary and tertiary care, primary care, and self-care.
Primary care is the first point of contact for patients and includes various services, including health promotion, disease screening, assessment, diagnosis, treatment, and rehabilitation.
Primary care teams are multidisciplinary and may include GPs, nurses, midwives, healthcare assistants, community pharmacists, and other healthcare professionals.
Secondary and tertiary care refers to hospitals and specialized services that address more complex health issues.

Access to Healthcare in Ireland

Eligibility for healthcare services in Ireland is based on a three-tier system:
- Medical Card: For individuals with low income or specific medical needs, providing free GP care, primary care services, and medications with a small fee.
- GP Visit Card: For individuals aged 8-69 with low incomes, providing free GP care but requiring payment for other primary care services and medications.
- Private Patients: Individuals who do not qualify for a Medical Card or GP Visit Card need to pay for GP care, primary care services, and medications.
Drug Payment Scheme: Limits the cost of medications to a maximum of €80 per month per family.

General Practice in Ireland

There are approximately 4000 GPs in Ireland, with a roughly 50:50 gender split.
Most GPs work in group practices located in health centers, primary care centers, and purpose-built buildings.
Barbara Starfield identified four key features of effective primary care:
- First Contact: GPs serve as the initial point of contact for patients' healthcare needs.
- Continuity: Patients are encouraged to build a long-term relationship with their GP for consistent care.
- Comprehensiveness: GPs address a wide range of health issues for their patients.
- Coordination: GPs take responsibility for coordinating care across different healthcare providers.

General Practice in Bahrain

Family Medicine is a major component of the Bahraini healthcare system, with approximately 28 primary care centers offering free services to all citizens.
Access to primary care is crucial for achieving health for all and is considered the cornerstone of the Bahraini healthcare system.
Family Physicians undergo a rigorous training program, including a 1-year internship, a 4-year residency program, and a 2-year clinical masters program.

Access to General Practice in Bahrain

Primary care centers provide first contact for all citizens, offering services for acute illnesses, chronic disease management, urgent care, lab and X-ray services, pharmaceutical services, social services, physiotherapy, dental services, referral services, and preventative services such as antenatal care, immunizations, and family planning.

RCSI Department of General Practice

The RCSI Department of General Practice plays a significant role in the medical course, offering teaching and assessment in various areas:
- Communication Skills: Emphasizing the Calgary Cambridge model of consultation.
- Examination Skills: Focus on practical skills essential for patient assessment.
- Professionalism: Fostering a strong professional foundation for future physicians.
- Early Patient Contact (EPC): Providing students with real-world experience interacting with patients early in their training through Healthcare Symposia sessions.

Early Patient Contact

EPC aims to bridge the gap between theoretical learning and practical experience, allowing students to:
- Understand the patient's experience of illness.
- Develop empathy and compassion.
- Improve listening skills.
- Appreciate professional responsibilities and ethical considerations.
- Foster patient-centered care.
- Start developing their professional identity.
- Manage their own emotions and stress in challenging situations.
EPC focuses on topics like:
- The patient's experience of illness, including their ideas, concerns, expectations, and the illness's effects.
- The importance of building a strong patient-doctor relationship based on trust, compassion, respect, and continuity of care.
- The concept of patient-centered care, emphasizing effective communication, accurate diagnosis, and personalized treatment plans.
- The significance of professionalism, punctuality, confidentiality, and respectful behavior in patient interactions.

Healthcare System Structure

Primary care provides first level contact, is easily accessible, and focuses on community well-being.
Primary care encompasses a range of services including health promotion, screening, assessment, diagnosis, treatment, rehabilitation, and personal social services.
Primary care is often synonymous with general practice (GP) or family medicine, but includes other services.
Secondary and tertiary care are beyond the scope of primary care.
Self care is the first level of care, where individuals take responsibility for their own health.

Primary Care Teams

Primary care teams consist of various health professionals, including GPs, nurses, midwives, healthcare assistants, community welfare officers, home helps, physiotherapists, occupational therapists, social workers, dietitians, receptionists, clerical assistants, administrators, dentists, podiatrists, community pharmacists, psychologists/therapists, and speech & language therapists.

Access to Healthcare in Ireland

Eligibility for healthcare in Ireland is divided into three categories: medical card patients, GP visit card patients, and private patients.
Medical cards are "means tested"—individuals must meet certain income and asset requirements to qualify.
Medical card holders receive free GP care, free primary care services (with potential waiting lists or service limitations), and free medications with a small prescription charge.
General GP visit cards are also means tested and available to individuals aged 8 to 69.
These cards provide free GP care, but require payment for other primary care services like physiotherapy, and include a drug payment scheme that caps monthly medication expenses.
Specific GP visit cards are available to individuals under 8, over 70, and carers, with expanding eligibility criteria.
Private patients pay for all healthcare services, including GP visits and medications.
The drug payment scheme caps monthly medication expenses for families to a maximum of €80.

General Practice in Ireland

Ireland has approximately 4000 GPs, with roughly 200 trainees qualifying each year.
Despite this, approximately 700 GPs are expected to retire within the next 5 years.
The gender split in Irish general practice is roughly 50:50.
Most Irish GPs work in group practices located in health centers, primary care centers, purpose-built buildings, or converted houses.

Characteristics of General Practice

Barbara Starfield identified four central features of effective primary care: first contact, continuous care, comprehensiveness, and coordination.
First contact means that the GP is the initial point of contact for all healthcare needs.
Continuity of care refers to the GP providing ongoing care for the same patients over time.
Comprehensiveness implies that GPs provide care for all common health needs.
Coordination ensures that care is coordinated for all patients, regardless of their presenting problems.

General Practice in Bahrain

General practice in Bahrain is known as family medicine or primary care.
Family physicians/consultant family physicians are responsible for providing care.
Following a 1-year internship, family physicians undergo a 4-year residency training program leading to Arab Board certification.
An additional 2-year clinical masters program is available in collaboration with the Arab Gulf University (AGU).
The gender ratio in Bahraini family medicine is skewed towards females.
Primary care centers are located throughout Bahrain, with nine operating 24/7.
Private family physicians and GPs also practice in Bahrain.

Primary Healthcare in Bahrain

Primary healthcare is a cornerstone of the Bahraini healthcare system.
The Kingdom of Bahrain has adopted the Universal Declaration of the Alma-Ata (1978) and the Astana Declaration (2018) to achieve universal health coverage.
Access to primary care is crucial for global health strategy and achieving health for all.

Access to GP in the Kingdom of Bahrain

Primary care serves as the initial point of contact for individuals in Bahrain.
Access is free for all citizens.
Services include management of acute and chronic illnesses, urgent care, laboratory and x-ray investigations, pharmaceutical services, social services, physiotherapy, dental services, referral services to secondary care hospitals, and preventative services such as antenatal care, child screening, immunization, post-natal/post-miscarriage care, family planning, women’s screening services, pre-marital services, and ultrasound screening for pregnant women.

RCSI Department of GP and the Medical Course

The RCSI Department of GP plays a significant role in the medical curriculum.

GP Department Teaching in Year 1 & 2

The GP department teaches communication skills, examination skills, professionalism, an introduction to prescribing and clinical decision-making, and Early Patient Contact (EPC).

GP Department in Later Years

Year 3 of the medical course involves a student-selected component.
Year 4 features a GP module with a 6-week rotation.

Communication Skills in Year 1

Communication skills are taught through lectures covering the Calgary Cambridge consultation model and small group tutorials focusing on formal history taking structures.
Resources include systems folders and patient scenarios.

Examination Skills in Year 1

Examination skills are taught through lectures and small group tutorials.
Topics include basic medical examinations (e.g., knee and peripheral nervous system exams), cardiovascular system exams, respiratory system exams, and task lists.
Resources include systems folders and task lists.

Assessment in Year 1

Year 1 assessment includes knowledge checks, clinical skills evaluations (including OSCEs), Progress Tests, and attendance.
Clinical skills evaluations focus on clinical skills and professional, personal, and identity development (PPID) competencies.
OSCEs assess clinical skills, while PPID focuses on professionalism and ethical considerations.

Early Patient Contact

EPC aims to help students understand the "difference" between studying medicine and experiencing it firsthand.
It emphasizes the importance of considering the patient's experience of illness.
Students are encouraged to put themselves in the patient's shoes, developing compassion and empathy.
EPC highlights the power of listening to patients and the importance of the patient-doctor relationship and patient-centered care.
Students learn about their own professional identity, ethical responsibilities, and the importance of managing their own emotions and thoughts.

EPC: The Illness Experience

Understanding the patient's experience of illness is crucial for successful medical practice.
The Calgary Cambridge model provides a framework for effective patient communication, focusing on their ideas, concerns, expectations, and the effects of their illness on their lives.

EPC: Doctor-Patient Relationship

Continuity, respect, hope, compassion, trust, self-awareness, and healing are key aspects of a successful doctor-patient relationship.
The concepts of transference and countertransference are also considered.

EPC: Patient-Centered Care

Effective patient-centered care hinges on good communication, rapport, accurate diagnosis, understanding of the illness experience, and a treatment plan that addresses the patient's needs and preferences.

EPC: Professionalism

Professionalism in EPC involves punctuality, confidentiality, and respectful conduct.
Students are expected to arrive on time, maintain patient confidentiality, and treat patients with respect and undivided attention.

Healthcare Symposia (HCS)

HCS provide opportunities for students to engage with patients living with chronic conditions.
Students learn about the patient's experience of the healthcare system and how illness impacts their lives.
Respecting patient confidentiality is paramount.
Video or audio recording of sessions is prohibited.
HCS are not recorded on Moodle.

The Health Service in Ireland

Healthcare services in Ireland are divided into three levels: Primary care, Secondary care, and Tertiary care.
Primary care provides first-level contact and aims to keep people well through a variety of services.
Primary care services include promotion of health, screening for diseases, assessment, diagnosis, treatment, rehabilitation, and personal social services.
The term 'primary care' is often used interchangeably with 'general practice' (GP) or 'family medicine', but also includes other services.
Primary care teams consist of a range of healthcare professionals including GPs, nurses, midwives, healthcare assistants, home help workers, community welfare officers, physiotherapists, occupational therapists, social workers, dentists, dietitians, receptionists, clerical assistants, administrators, psychologists/therapists, speech and language therapists and community pharmacists.
Access to healthcare in Ireland is dependent on eligibility criteria for different categories of patients:
- Medical card holders: ‘means tested’ with free GP care, free primary care services (but waiting lists and some services not available), free medications (with a small fee).
- GP visit card holders (general): ‘means tested’ for ages 8 to 69 with free GP care (including out of hours), pay for other primary care services, and pay for medications (with a maximum €80/month per family under the Drug payment scheme).
- GP visit card holders (specific): available for under 8, over 70, and carers.
- Private patients: pay for GP care (€55 per consultation), pay for primary care services, and pay for medications (with a maximum €80/month per family under the Drug payment scheme).

General Practice in Ireland

There are approximately 4000 GPs in Ireland.
Roughly 200 GP trainees qualify each year with about a 50:50 gender split.
Approximately 700 GPs are expected to retire in the next 5 years.
Most GPs work in group practices with GP clinics located in health centres, primary care centres, purpose-built buildings, or converted houses.
Barbara Starfield identified four central features of effective primary care:
- First Contact: Primary care acts as the point of first contact for all care needs.
- Continuity of Care: Focus on person-centered care rather than disease-focused care.
- Comprehensiveness: Provide care for all common needs.
- Coordination of Care: Coordinate care for all patients.

General Practice in Bahrain

General practice, family medicine, and primary care are used interchangeably in Bahrain.
Family physicians and Consultant Family Physicians are key providers within the system.
Family medicine in Bahrain involves a 1-year internship followed by a 4-year residency training program leading to Arab Board certification.
A 2-year ‘clinical masters’ program (with AGU) is also available.
There is a higher proportion of female (F) family physicians compared to male (M).
Public sector primary care services are provided in Primary Care Centers (approx. 28 in total, with nine 24/7 primary care centers).
Private sector services are provided by family physicians and GPs.
Primary healthcare is considered a cornerstone of healthcare in Bahrain.
Bahrain has adopted the Universal Declaration of the Alma-Ata (1978) and the Astana Declaration (2018) to achieve universal health coverage, acknowledging the importance of primary care in achieving health for all.

Access to GP in the Kingdom of Bahrain

Primary care is the first point of contact for individuals in Bahrain.
Access to primary care is free for all citizens.
Services include management of acute illnesses, management and follow-up of chronic illnesses, urgent care, laboratory and X-ray services, pharmaceutical services, social services, physiotherapy, and dental services.
Referral services to secondary care hospitals are available if necessary.
Preventative services include Antenatal services, periodic child screening, immunisation, post-natal and post-miscarriage services, family planning services, periodic women’s screening services, pre-marital services, and ultrasound screening for pregnant women.

RCSI Department of GP and the Medical Course

The GP department teaches communication skills, examination skills, professionalism, introduction to prescribing and clinical decision making, early patient contact, clinical skills evaluation, clinical skills OSCE, and progress tests.
In Year 1 & 2, the GP department provides lectures, small group tutorials, and early patient contact.
In Year 3, students contribute to a selected component.
In Year 4, students undertake a 6-week GP module rotation.

Communication Skills in Year 1

The Calgary Cambridge consultation model is taught through lectures and small group tutorials.
Students are provided with systems folders and patient scenarios to practice their skills.

Examination Skills in Year 1

Lectures cover BMF - Knee and PNS Exams, CVS Exam, and RESP Exam.
Small group tutorials are conducted using task lists.

Assessment in Year 1

Assessment is based on knowledge checks, clinical skills evaluations, clinical skills OSCEs, progress tests, and attendance.
Clinical skills OSCEs are only for examination skills.

Early Patient Contact

Early patient contact provides students with an opportunity to experience medicine firsthand.
It emphasizes the importance of:
- Understanding the patient's experience of illness.
- Developing empathy, compassion, and active listening.
- Managing one's own emotions and thoughts.
- Building a strong patient-doctor relationship.
- Understanding the patient's ideas, concerns, expectations, and effects of their illness.
- Practicing professionalism, punctuality, confidentiality, respect, and behavior.

Healthcare Symposia

Symposia provide students with a chance to interact with patients living with chronic conditions.
They help students understand patients' experiences with the healthcare system and the impact of illness on their lives and families.
Students are encouraged to ask questions and learn more about these patients, while respecting patient confidentiality and avoiding recording video or audio of the sessions.

EPC: The Illness Experience

Understanding the patient's experience of illness is crucial for successful medical practice.
The Calgary Cambridge model can be used to communicate with patients.
The four key aspects of the model include:
- Ideas: Patient's own thoughts on the cause of their illness.
- Concerns: Patient's worries about their health.
- Expectations: What the patient hopes to gain from the doctor's help.
- Effects: How the illness impacts the patient's life.

EPC: Doctor Patient Relationship

The patient-doctor relationship is an integral part of healthcare.
Key aspects of the relationship include:
- Continuity: Consistent and ongoing care.
- Respect: Acknowledging and valuing the patient's perspective.
- Compassion: Empathy and understanding of the patient's situation.
- Hope: Offering optimism and envisioning positive outcomes.
- Trust: Building a bond based on confidence and honesty.
- Physician Self-Awareness: Understanding one's own biases, emotions, and perspectives to provide objective care.
- Healing: Striving to improve the patient's physical, emotional, and spiritual well-being.
- Transference and Counter Transference: Understanding and managing unconscious feelings and behaviors that may arise within the relationship.

EPC: Patient-Centered Care

Patient-centered care focuses on the individual patient's needs, preferences, and values.
Key elements include:
- Good patient-doctor communication: Clear, open, and respectful interactions.
- Accurate diagnosis: Understanding the patient's presenting conditions and history.
- Understanding of illness experience: Recognizing the patient's perspective and their unique journey with the illness.
- Effective treatment plan: Collaborating with patients to develop a plan that caters to their individual needs.
- Good adherence: Ensuring patients understand and follow the recommended treatment plan.

EPC: Professionalism

Professionalism is essential for successful healthcare practice.
Key components during early patient contact:
- Punctuality: Arriving on time for appointments.
- Confidentiality: Keeping all patient information strictly confidential.
- Respect and behavior: Providing patients with your undivided attention and treating them with courtesy.

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Description

This quiz explores the structure of the healthcare system in Ireland, including its three levels: primary care, secondary, and tertiary care. It also covers eligibility criteria for accessing healthcare services, such as the Medical Card and GP Visit Card. Test your knowledge about how healthcare is organized and accessed in Ireland.