1. Primary Care Medicine Dr. Abdul Sattar Khan
MBBS, MPH, MCPS, DCHM, MRCGP (UK), FRIPH (UK)
Assistant Professor
Family Medicine Department

3. Objectives ASK At the end of this course participants will be able to;
Explain the concepts of family medicine
Count the basic features of family medicine
Explain the short history of family medicine
Describe the characteristics of family physician
Explain what is family in family medicine
ASK

4. Definition Primary Health Care is the first level of
contact with the health system to
promote health, prevent illness, care for
common illnesses, and manage ongoing
health problems.
WHO:
ASK

5. Declaration of Alma-Ata-WHO International Conference on Primary Health Care, Alma-Ata, USSR, September 1978
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self-determination.
ASK

6. Concept of Primary care medicine
Primary Health Care includes:
Primary Care (physicians, midwives, nurses, social workers etc);
Health promotion, illness prevention;
Health maintenance & home support;
Community rehabilitation;
Pre-hospital emergency medical services; &
Coordination and referral to other areas of health care.
ASK

7. Different for different community?
Primary Health Care is different in each community depending upon:
Needs of the residents;
Availability of health care providers;
The communities geographic location; &
Proximity to other health care services in the area.
ASK

8. Concept in nutshell ASK
An association of two or more individuals, companies, organizations or governments
ASK

9. Primary Health Care Reform
Medical model Primary Health Care
 Treatment  Health promotion
 Illness  Health
 Cure  Prevention, care, cure
 Episodic care  Continuous care
 Specific problems  Comprehensive care
 Individual practitioners  Teams of practitioners
 Health sector alone  Intersectoral collaboration
 Professional dominance  Community participation
 Passive reception  Joint responsibility
ASK
Barbara Starfield, Johns Hopkins University

10. Primary Health Care in Turkey
Late Ottoman Period…
1827 First modern medical school
1871 Memleket Tabibi (Country physicians): First primary care tasks...
ASK

11. Primary Health Care in Turkey
Act# 224 (May 1961) Prof. Dr. Nusret Fişek
Primary care based health services
17 years before Alma-Ata
ASK

12. New Patient-Centered Medical Home (PCMH)
ASK

13. Patient-Centered Medical Home (PCMH)
ASK

14. Primary Care
ASK

15. History of Family Medicine
For thousands of years, physicians were true “generalists,” providing care for men and women, children and adults through the entire spectrum of life.
ASK

16. History of Family Medicine (FM)
1823 the term of general practitioners mentioned by lancet .
The American Academy of General Practice (AAGP) was established in 1947
1960 ,specialty of family medicine started in USA
1969, American Board of Family Medicine was
Founded.
ASK

17. History of Family Medicine in Turkey
1983 Regulation basis completed...
1985 Training began in 9 teaching hospitals
Turkish Association of Family Physicians established in 1990
Departments in Universities (1993)
1st National Congress of Family Medicine (İstanbul, 1993)
ASK

18. What Is Family Medicine?
According to American Academy of Family Physicians
AAFP(USA), Family Medicine is defined as the medical
speciality which provides continuing and comprehensive
health care for individuals and family. It is the speciality which integrate the biological, clinical and behavioural sciences.
The scope of family practice includes (all ages, both sexes, all organs , all systems and all diseases.
ASK
FAME

19. What Is Family Medicine?
According to the World Organization of Family Doctors (Wonca), the aim of family medicine is to provide personal, comprehensive and continuing care for the individual in the context of the family and the community.
ASK

20. Family Practice
Family Practice: is used to indicate the services part of the specialty ( practical more than the academic aspect).
Family physician :is the specialist trained to practice in the front line of the health care system and to take initial and continuing care for healthy & ill persons.
ASK
FAME

21. 7 - principles of Family Medicine?
Continuity of care.
Comprehensive care.
Coordinated care.
Community & family based care.
Central Patient doctor relationship.
Care as Evidence based.
Care for ALL.
ASK
FAME

22. Competencies of Family Physician
Ability to:
manage acute health problems.
manage chronic health problems.
provide health promotion services.
provide emergency services.
provide counselling services.
provide home care services.
provide preventive care services.
provide terminal and palliative care
ASK

23. Where to practice Family Medicine?
OPD/Clinics .
PHCC.
Family Practice Centres.
Hospitals.
ASK

24. Characteristics of Competent Family Physician (FP)
Competency in (Dx ,Rx )of common health problems.
Improving quality of care.
Rationalized utilization of health facilities.
Motivation of community to practice healthy
behaviours.
Identify the needs of community .
Working within health team as member and leader
ASK

25. Characteristics of Competent FP
Ability to:
communicate efficiently.
carry out studies and research.
plan and implement action plan.
educate and train his/her colleagues .
refer patients when it is needed.
activate community participation.
coordinate with other sectors.
update himself regularly
ASK

26. How does Family Physicians differ from other physicians ?
The first contact and gate of health care system.
Provide continuity of care.
Provides comprehensive care.
Use holistic approach.
Shared care.
Patient centred approach
ASK
FAME

27. KHAN’s 7-star doctor ASK Communi- cator Learner Motivator Community
leader
Care
provider
Communi-
cator
Decision
maker
KHAN’s
7-star doctor
Manager
Learner
Motivator
ASK
4/23/2017
Dr. Khan

28. Family ( functions & structures)
Family is defined as the structural & functional unit of the community.
Two related persons live together for> 6 months.
Nuclear family= parents +- children.
Extended family= couples + parents + children.
ASK
FAME

29. Family in Family Practice
Family is the unit of health care in FP.
Family could be source of health.
Family could be the source of illnesses.
ASK
FAME

30. Wake up call What is Declaration of Alma-Ata-WHO?
Define Family Medicine?
Tell me 7-prinicples of Family Medicine.
How does Family Physicians differ from other physicians ?
ASK
FAME

31. Are you ready to fly with us as Family Physician?31 31