Family Medicine 3rd Year PDF

Community 3rd Year BY: dr. doha elshamY 3rd Year Community HEALTH CARE SERVICES Health for all Should be: ❖ Comprehensive ❖ Accessible ❖ Acceptable ❖ Feasible ❖ Provide community-participation Health care systems are often designed to encourage caretaker...

Community 3rd Year BY: dr. doha elshamY 3rd Year Community HEALTH CARE SERVICES Health for all Should be: ❖ Comprehensive ❖ Accessible ❖ Acceptable ❖ Feasible ❖ Provide community-participation Health care systems are often designed to encourage caretakers to seek care first at the primary level and then be referred, if necessary, to a higher level of care. If this reflects actual care-seeking behavior, then health care costs for the caretaker will be minimized. In many countries, however, caretakers often bypass primary care facilities and seek care directly at referral care hospitals for illnesses that could be easily treated at the primary care facility. This can overburden the referral facility, and is often costlier for the caretaker and the health care system. What is primary care? It is the health care provided by a specially trained and skilled physician for comprehensive first contact with persons who had undiagnosed signs, symptoms or any health concerns and continuing their care. Concept of PHC Social equity Wide coverage 1|Pa ge B y : D r. D o h a E l s h a m y 3rd Year Community Self-reliance Intersectoral coordination People involvement in planning Primary care physician is a general Physician who provides definitive care to the persons at first contact and assumes the responsibility for providing the patient’s care by a well-established referral system. What is Family Medicine? Family Medicine is the specialty that provides: ▪ continuous and ▪ comprehensive health care ▪ for individuals and families, ▪ for all ages, ▪ Both genders, ▪ All organ systems and disease entity. What is the role of a family physician? 1- Providing comprehensive medical care and arranging for other health personnel to provide services when needed. Well trained family doctor can diagnose and treat up to 80% of common health problems. 2- He should be clinically competent to provide medical care after taking into considerations the cultural, socioeconomic, and psychological background. 3- He is responsible for continuing care for his patients. 4- He should care for the individual in the context of family, and the family in the context of community. 5- Family Health records 6- Referral Family Health Records (FHR) A health (medical) record is the chronological documentation of medical care delivered to a patient by the members of the health care team. Purposes of the FHR Basis for planning individual patient care as it contains the most important events of sickness and health from birth to death. Provides a mean of communication Provides clinical data for use in each visit without repeating the questions and also for use in research and education. Protects the legal interests of the patient and physician. Serves for analysis, study and evaluation of the quality of care offered. 2|Pa ge B y : D r. D o h a E l s h a m y 3rd Year Community Provides data for community diagnosis to define priority and set suitable health plan. Provides data for third parties concerned with patient other than physician and health center as insurance companies. Referral System: Being a system, examination of a referral system requires consideration of all its parts. Competencies of Family Physicians ▪ Knowledge ▪ Communication Skills ▪ Doctor – patient relationship ▪ Patient viewed in context of the family ▪ Decision making ability ▪ Problem solving ability ▪ Teamwork ▪ Managerial Skills Family medicine ▪ Comprehensive ▪ Competent ▪ Continuity ▪ Referral system 3|Pa ge B y : D r. D o h a E l s h a m y 3rd Year Community When do you consider yourself a good family doctor? When you achieve optimal physical and mental health through accessible, cost effective care, that is based on the best responsiveness to the patient’s needs, and respectful of his families, personal values and beliefs. What is the history of Family Medicine in Egypt? Family practice and family physician present in Egyptian society many decades ago. Family practice was renewed as one of the main activities of community oriented, community based medical education [ in faculty of medicine Suez Canal university FOM. SCU.]. Family practice is the current continuum of General practice as an academic department [in FOM. SCU.]. New concern of Family medicine as a National Policy in the Ministry of Health and Population. We have an Egyptian board of family medicine. Now, We have doctorate and master degrees in Ain shams university. Workplace Based Assessment Competences (WPBA) Competence means having the abilities, knowledge and skills necessary for professional practice. The framework for WPBA is made up of 13 competences: 1. Skills: a. Communication Skills b. Consultation Skills c. Counselling Skills communication with patients, and the use of recognized consultation techniques 2. Practicing holistically – operating in physical, psychological, socioeconomic and cultural dimensions, taking into account feelings as well as thoughts 3. Data gathering and interpretation – for clinical judgement, choice of physical examination and investigations and their interpretation 4. Making a diagnosis and making decisions – a conscious, structured approach to decision making 5. Clinical management – recognition and management of common medical conditions in primary care 6. Managing medical complexity and promoting health – aspects of care beyond managing straightforward problems, including management of co-morbidity, uncertainty, risk and focusing on health rather than just illness 7. Organization, management and leadership - an understanding of the use of computer systems to augment the GP consultation and primary care at individual and systems levels, the management of change, and the development of organisational and clinical leadership skills 4|Pa ge B y : D r. D o h a E l s h a m y 3rd Year Community 8. Working with colleagues and in teams – working effectively with other professionals to ensure good patient care, including sharing information with colleagues 9. Community orientation – management of the health and social care of the practice population and local community 10. Maintaining performance, learning and teaching – maintaining performance and effective CPD for oneself and others 11. Maintaining an ethical approach to practice – practicing ethically, with integrity and a respect for diversity 12. Fitness to practice – the doctor's awareness of when his/her own performance, conduct or health, or that of others, might put patients at risk, and taking action to protect patients 13. Clinical examination and procedural skills – competent physical examination of the patient with accurate interpretation of physical signs and the safe practice of procedural skills 5|Pa ge B y : D r. D o h a E l s h a m y