Principles of family medicine Flashcards
What influence coping capability?
- Natural disposition
- Course of life
- Social environment micro
- Social environment macro
- Physical and chemical
- Biological
- Unknown factors
What are the key elements of the consultation
1) Building relation 2) Opening of discussion 3) Collection of information 4) Consensus about the problem and Mx plan 5) Conclusions
Advantage of the patient centered consultation
1) Increased satidfaction 2) Better compliance 3) Better outcomes 4) Lower costs 5) Lower risk of medical error
Families share
1) hereditary disease 2) Housing 3) Living conditions 4) Eating habits 5) leisure activities 6) hygienic conditions 7) pollutions ( smoking, water, air)
Families share as a social unit:
- Illness behavior
- Health maintenance behavior
What are the principles of FM?
- Continuity of care
- Comprehensiveness of care (helhet)
- Family oriented care - influence
- Preventive care (a. see risk factors b. delay consequence of chronic disease c. promoting healthy lifestyle)
- Community oriented care (occupation, culture, environment, social habits)
Types of practice
- Single practice
- Group practice
- Health center
Sources of income
- Public
- Private: a. patient b. employer
Payment methods
- Fee for service
- Per case
- Capitation
- Salary
Fee for service, weakness and strength
S: 1) Incentive to provide service 2) easy analysis
W: 1) cost inflation 2) unecessary Tx
Per case, W and S
S: Well balanced remuneration and incentive to minimize resources
W: technical problems w classification, tendency to overuse Dx
Capitation W&S
S: Simple, easy budgeting, incentive to minimize tests
W: Incentive to select pat at low risk, difficult analysis, tendency to limit services
Salary W&S
S: Simplest, easy budgeting
W: no influence on provider behavior, reduced productivity
Payment consequence
- Fee for service: payer have financial risk, increased volume of services from provider
- Per case: shared financial risk, cost reduction behavior
- Capitation: provider have risk, cost reduction behavior
- Salary: no financial risk, decreased number of service from provider
Teamwork composition
- Physician
- Practice nurse
- Practice assistants
- Community nurse
- Physiotherapists
- Managers
Teanwork relationships
- Partnership and leadership
- Share of responsibilities
- Group communication: a. mutual trust b. conflict solution
- Professional development
Time management
- Appointment systems
- Consultation sessions
- Telephone consultations
- Home visits
- Out of hours care
- Administrative work
External public zone
Patient WC, reception/acheives, waitingroom, nurse surgery, store
Internal medical zone
Consultation room, physician surgery, examination, physiotherapy, Dx lab, mini clinics
Personell (social) zone
Social room, library, personell toilets, administrative office
Medical equipment
ECG, basic labs, minor surgery tools, US machine, spirometer, physic equipment
Patient chart
- Readable/ electronic
- Confident
- Basic content: 1) personal data 2) list of problems 3) chronic pharmacotherapy 4) habit 5) allergy 6) lab results 7) consultation data
SOAP system
Subjective (complaint)
Objective ( measurements/ vitals/ findings)
Analysis ( diagnosis)
Plan ( what to do next? labs/referral/procedure/meds)
What is quality assurance?
Continuing, dynamic process aimed at the improvement of all aspects of care
What are the medical AUDITS?
- External: 1) Beurocratic 2) Restrictive 3) Summative
- Internal: 1) Flexible 2) Formative 3) Save
What are the dimensions of improvement? (according to Donnabedian)
Structure, process and outcome
What are the method of QA?
1) Peer review group 2) Guidelines 3) Self-learning 4) Practice visits
What is APGAR in family medicine?
Adaption, Partnership, Growth, Affection and Resolve - assessing the functioning of a family system in health and illness
