42 nd STFM Annual Spring Conference April 29 – May 1, 2009 Denver, Colorado

“How STFM changed our lives” SOBRAMFA (Brazilian Society of Family Medicine)

Presenting ourselves...

More of us

Where do we come from?

Here is Brazil Population: 190.ooo million 176 medical schools

São Paulo Population: people 4th biggest metropolis of the planet

Celebration! STFM & Ten years of inspiration

WHO ARE WE?

SOBRAMFA  Academic Society founded in 1992 (17 years old) by a group of specialists  To promote the humanistic dimensions of doctoring and establish the proper basis and scientific methodology for family medicine

SOBRAMFA  Something was missing  Brazilian Health Care and medical educational system: - Based in hospital care - Highly fragmented - Focused in specialties and irrational use of technology - Desease centered approach - Impersonal practice  Began teaching humanistic medicine  Bigger mission: To advance Family Medicine in Brazil  First contact with STFM: Orlando, FL  First big step: STFM Annual Meeting 2001 in DENVER, CO Sobramfa group of physicians and students

Objectives of this presentation:  To present and discuss what we (SOBRAMFA) have learnt from the STFM meetings in ten years  To show how SOBRAMFA applied the Family Medicine core values from STFM to the Brazilian scenario  To be an example for the development of family medicine in other countries How STFM changed our lives

What did we learn to foster the development of Family Medicine in Brazil?

What is in fact Primary care  Putting in practice this concept of PC  Trust and respect/ Family Medicine identity  Feed back from population and other doctors  Fostering PC, we are responding to the demand of brazilian health care system

“ I ’ ve always wanted that kind of doctor ”

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of FM 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team work How STFM changed our lives

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of FM 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

Establish Family Medicine as an academic discipline  It ’ s not a reality in Brazil t seems to be why FM is not a well definined specialty  Our “ Quality ” concern

Lack of good generalists

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of FM 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

Family doctors MUST be involved in medical education  Specialized faculty in medical schools to spread its core values  Role model  T The only way to generate life long carreers in Family Medicine  Our experience

Jundiai Medical School

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of Family Medicine 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

We need to establish Departments of Family Medicine in medical schools  I In Brazil, FM is attached to social medicine or public health departments; virtually there ’ s no FM department  No prepared faculty or proper background  Integrated thinking and acting  Power to propose educational changes  Stroger representation in the national educational scenario

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of Family Medicine 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

We need do be close to medical students  Teaching while practicing  Engaging students into family medicine core values  What do we do? - Mini Fellowship in Family Medicne (MF2 program) - Monthly meetings at the SP medical association - Regular invitations

WHAT we should do to empower Family medicine 1. Establish family medicine as an academic discipline 2. Be involved in Medical Education 3. Establish Departments of Family Medicine 4. Keep close to the medical students 5. Build leadership among medical students How STFM changed our lives

We need do build leadership among medical students  “ “ We cannot build something special with second line people. We need the best ones ” Pablo G. Blasco

Step forward Identification, courage & determination Future

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

Patient centered care  Illness is much more than disease  Our mission is to take care of our patients: however and wherever they are (integrity, continuity, Pacient centered)  The needs of the patients require an approach of their various problems within a broad perspective  Action based in the patient ’ s needs  “ Resolutive medical group ”  Our experience

Our experience Integrated Medicine in 3 Community Hospitals in São Paulo Integrated Medicine in 3 Community Hospitals in São Paulo - Inpatient - Inpatient - Outpatient - Outpatient - Home visits - Home visits  Nove de Julho Hospital  São Cristovao Hospital  Cruz Azul Hospital How STFM changed our lives

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

The personal doctor figure  Reminds the old traditional medicine/ Health specialist  In the teaching scenario, we stimulate the student to feel as THE patient ’ s doctor  A powerful role model for medical students  Students experience a chance to make the difference in someone ’ s life

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

Reflective practicing  Who are you ?  What do you want ?  Is what you are doing going to take you where you want to go ?  Actions - values - principles  Instilling in students the permanent habit of reflection Innovative methods in affective education by using humanistic resources

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

LOVE MEDICINE COMPASSION UNDERSTANDING

Humanism  Family physician: a specialist in Humanistic Medicine ? It has in FM a proper field for educating doctors  Be updated with the scientific advances keeping the focus on the patient ’ s feelings  Sobramfa ’ s aim: balance building technical and humanistic skills  Attractive practice for medical students of Brazil  Our annual meetings ’ themes

SOBRAMFA ANNUAL MEETINGS

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

Practical idealism  The pleasure of making our idealism a way of earning life  Medical insurance agencies  Family doctor is required in a variety of settings: - Outpatient service - Inpatient service - Home visits - Nursing homes  New paradigm of care

HOW we apply the FM core values in education 1. Patient centered care 2. The personal doctor figure 3. Reflective practicing 4. Humanism 5. Practical Idealism 6. Team Work How STFM changed our lives

Team work  Sobramfa = family team  Working and living together the dream of turning Family Medicine into a reality in Brazil  Challenges become easier and the victories come earlier  Global family of FM (friends from STFM)

We ’ re still painting our way, but you ’ re more then welcome to share this challange with us!

Thank you!