ME02 - Principles of Family Medicine and Biopsychosocial Approach Flashcards
[History] Stated that there should be a specialty board, certification examination and diplomate status for physicians highly qualified in comprehensive care.
1966- Millis Commission Report and Willard Report
[History]
Its objective is to improve the quality of life of people of the world through fostering and maintaining high standards of care in family medicine.
1972- WONCA was formally inaugurated.
- WONCA- World Organization of National Colleges, Academies and Academic Associations of Family Physicians, other wise known as World Organization of Family Doctors.
•1979- WONCA arrived at a definition of Family Medicine.
Important dates to remember in Philippine History for Family Medicine
1961- Philippine Academy of General Practitioners was organized and Dr. Ramon Angeles was the founding president.
•1970- Recognition as a Specialty Society by Philippine Medical Association (PMA)
•1972- changed the name to Philippine Academy of Family Physicians (PAFP)
•1974- First three year residency training program was established at UP-PGH
•1979- First Specialty Board qualifying examination was given and DOH recognition as a specialty
1986- Establishment of accredited three year residency training program at UST- hospital.
•1990- Recognition of Family Medicine as a specialty by Medicare
•1997- Recognition by PMA as the mother specialty society in the field of Family and Community Medicine.
Discipline of Medicine with distinct core of knowledge and characteristics of care, which refers to individuals, family and community, and functions within economic, cultural and social environments and resources.
FAMILY MEDICINE
•Centered on the Family as a basic social unit
•Not only disease-oriented but health- oriented which emphasizes on the importance of disease prevention, health maintence and curative medicine.
What are the characteristics of Care
Primary- first contact care
•Continuing- chronologically, geographically, interdisciplinary, and interpersonal
•Comprehensive
•Aspects of Care: Prevention, Curative, Rehabilitative
What are the Principles of Medicine
Principles of family medicine
- The person, not the problem
- The patient’s context
- The preventive attitude
- The population at risk
- Community resources
- Integrating life
- Integrating work
- Subjective aspects of Medicine
- Resource management
•Family physicians are committed to the person rather than to a particular body of knowledge, group of diseases, or special technique.
The person, not the problem
•The commitment is open-ended in two reasons:
- First, it is not limited by the type of health problem.
- Second, the commitment has no defined end point. It is not terminated by cure of an illness, the end of a course of treatment, or the incurability of an illness.
- The family physician seeks to understand the context of the illness.
- “To understand a thing rightly, we need to see it both out of its environment and in it, and to have acquaintance with the whole range of its variations” wrote William James.
- Why did the patient come?; Why did the patient come at this time?; What does the patient think is wrong?; How does the patient illness fit with his life situation and stage of development?
The Patient’s Context
- The family physician sees every contact with his patients as an opportunity for prevention or health education.
- What are this patient’s risk?; What can I do at this visit to promote his health or prevent disease?
The Preventive Attitude
- The family physician views his practice as a “population at risk”.
- Clinicians think normally in terms of single patients rather than population groups. Family physicians have to think in terms of both.
- It implies a commitment to maintain health whether or not they happen to be attending the office/ clinic.
The Population At Risk
•The family physician sees himself as part of a community-wide network of supportive and health care agencies.
Community Resources
- Ideally, the family physician should share the same habitat as his patients.
- The Love Canal disaster in Niagara Falls provides a vivid illustration of what can happen when physicians are remote from the environment of their patients.
- E.g. Community immersions
Integrating Life
- The family physician sees patients in their homes.
- Knowing the home gave us a tacit understanding of the context or ecology of illness . Ecology, derived from the two Greek words oikos (home) and logos, means literally “study of the home”.
- The rise of the modern hospital removed much of this experience from the home. There were technical advantages and gains in efficiency, but the price was some impoverishment of the experience of family practice.
- Home Care
Integrating Work
Benefits of Home Visits/ Home Care:
- It teach us how much background information can be obtained from patient and his family.
- It can show how many illness can be satisfactorily diagnosed and managed at home using very simple methods.
- It helps us in decision making with regards to hospital admission and help monitor recovery after discharge.
Resource Management
- The family physician is a manager of resources.
- As generalists and first-contact physicians, they have control of large resources and are able to control admission to hospital, use of investigations, prescription of treatment, and referral to specialists.
