OVERVIEW ON

FAMILY MEDICINE

DR. ALI ABDULRIDHA ABUTIHEEN

F.I.B.M.S
Consultant Family Physician
Family Medicine Defined

Family medicine is the medical specialty

which provides continuing, comprehensive
health care for the individual and family. It is
a specialty in breadth that integrates the
biological, clinical and behavioral sciences.
The scope of family medicine encompasses
all ages, both sexes, each organ system and
every disease entity.
 General Practice
 Family Practice
 Family Medicine
 Why the Family ?
&
Why the Family Doctor
Family can be defined broadly to
include people who are related by
blood, marriage, or strong emotional
commitment.
Family members have almost similar
risk factor for many diseases or
unhealthy conditions.
Genetics, social , Environmental,
food, habits , etc.
 also

Family members usually visit the

same doctor
Family members influence the
patient choice of physician,
expectation about care, evaluation of
the diagnosis, and adherence to
prescribed treatment.
A large literature exists on the influence of
family on survival and disease progression.
Strong family supports are protective and
promote healing in acute disease circumstances.
Studies of disease outcomes in myocardial
infarction and stroke reveal striking supportive
effects of family supports even when other
variables are controlled for.
Other diseases also.
Understanding of family influences on
health and disease is essential for effective
practice as a family physician.
Understanding allows not only
appropriate interventions in acute disease
but also anticipatory guidance in the
prevention of morbidity and future illness,
and the promotion of health and well-
being.
Family factors could have protective
influence or can adversely influence on
health.
Protective: closeness and connectedness;
coping skills; clear organization and
direct communication.
Harmful: intrafamily hostility, criticism,
and blame; perfectionism, rigidity; lack
of support systems; and the presence of
chronic psychopathology
Family effects on health & illness
include:
1. Genetics and disease susceptibility.
2. Prenatal and perinatal transmission of
disease.
3. Child rearing and nurturing.
4. Nutrition and lifestyle
5. Access to and quality of care.
6. Spread of infectious disease.
7. Outcomes in acute and chronic illness.
General Practitioner
A physician whose practice consists of
providing ongoing care covering a variety
of medical problems in patients of all
ages, often including referral to
appropriate specialists.
Also called family doctor
A general practitioner (GP) or family physician
(FP) is a physician/ medical doctor who
provides primary care. A GP/FP treats acute
and chronic illnesses, provides preventive
care and health education for all ages and
both sexes.
Some also care for hospitalized patients, do
minor surgery and/or obstetrics.
The term general practitioner is common in the
United Kingdom and some other
Commonwealth countries, where the word
"physician" is only used for certain
specialists and not for GPs.
Quality healthcare in family medicine
is the achievement of optimal
physical and mental health through
accessible, safe, cost-effective care
that is based on best evidence,
responsive to the needs and
preferences of patients and
populations, and respectful of
patients’ families, personal values,
and beliefs.
The family physician provides
continuing, comprehensive care in a
personalized manner to patients of all
ages, regardless of the presence of
disease or the nature of the
presenting complaint
The rewards in family medicine
come largely from knowing
patients intimately over time
and sharing their trust, respect,
and friendship.
Family medicine is the natural evolution of
historical medical practice.
At first physicians were generalists. For
thousands of years, generalists provided all of
the medical care available.
 They diagnosed and treated illnesses,
performed surgery, and delivered babies.
As medical knowledge expanded and
technology advanced, many physicians chose
to limit their practices to specific, defined
areas of medicine. With World War II, the age
of specialization began to flourish.
Primary care is the provision of
continuing, comprehensive care to a
population undifferentiated by gender,
disease, or organ system.
The most challenging diagnoses are
those for diseases or disorders in their
early, undifferentiated stage, when there
are often only subtle differences
between serious disease and minor
ailments.
The family physician is the
conductor, orchestrating the skills of
a variety of health professionals that
may be involved in the care of a
seriously ill patient.
The most cost-effective health care
systems depend on a strong primary care
base.
The United States has the most
expensive health care system in the
world but ranks among the worst in
overall quality of care because of its
weak primary care base.
The greater the number of primary care
physicians in a country, the lower is the
mortality rate and the lower the cost.
“The primary health care-strategy
underestimated the power of hospitals in the
health care system, of the pharmaceutical
industry, and failed, to a large extent, to take
the clinicians on board”.
 The Emergence of the 5-Star Doctor

The optimal (best) model of health service

delivery may be one that contributes to the
meeting of different inputs towards the
satisfaction of the values of relevance,
quality, cost-effectiveness and equity in
health.
 The Family Doctor
To fulfill this responsibility the family doctor
must be highly competent(skilled) in patient
care and must integrate individual and
community health care
In 1995 the World Health Assembly, the principal
governing body of the WHO, adopting
“Reorientation of medical education and
medical practice for health for all”,
urged WHO and its Member States to undertake
coordinated alteration in health care and in health
professions practice and education.
 The Family Doctor

It also called for a “Coordination of

worldwide efforts to reform medical
practice and medical education in line with
the principles of health for all and more
relevant to people’s needs by cosponsoring
consultative meetings to put forward
appropriate policies, strategies and
guidelines".
 Five-star Doctor
The term ‘five-star doctor’ has been
promoted to represent the model
physician for today's society, who
should be able to respond to the needs
of both individual patients (persons)
and their community.
 Five-star Doctor
The Five-Star Doctor is one who
improves the quality of care by
responding to the patient’s total health
needs with integrated preventive,
curative and rehabilitative services
while considering the patient as an
integral part of a family and a
community.
 Five-star Doctor

The Five-Star Doctor makes optimal

use of new but cost-effective
technologies, bearing in mind ethical
and financial considerations and the
final benefits as well as costs to the
patient and society.
 Five-star Doctor

The Five-Star Doctor promotes healthy

lifestyles by effectively
communicating with individuals and
groups and empowering them for their
own health protection and well-being.
The five-star doctor
* Care provider
* Communicator
* Community leader & Health
educator
* Decision-maker,
* Manager & team member
• Researcher
• Ethical\ Professional
5-Star Physician
Am I an Epitome?
Health Care Provider /
ROJoson’s Self-assessment Healer / Counselor

Decision-maker (Ethical
and Cost-effective)

Communicator /
Counselor / Social
Advocate

Community Leader /
Social Advocate

Manager / Team
Member / Social
Advocate

Researcher / Life-long
Learner

Teacher / Educator
I ACCOMPLISH AND PRACTICE
!THESE
Care provider
Besides giving individual treatment “five-star
doctors” must take into account the total
(physical, mental and social) needs of the
patient.
They must ensure that a full range of
treatment - curative, preventive or
rehabilitative - will be dispensed in ways
that are complementary, integrated and
continuous. And they must ensure that the
treatment is of the highest quality
Decision-maker
In a climate of transparency “five-star doctors”
will have to take decisions that can be
justified in terms of efficacy and cost.
From all the possible ways of treating a given
health condition, the one that seems most
appropriate in the given situation must be
chosen.
As regards expenditure, the limited resources
available for health must be shared out fairly
to the benefit of every individual in the
community
 Communicator
Lifestyle aspects such as a balanced diet, safety
measures at work, type of leisure pursuits, respect
for the environment and so on all have a
determining influence on health. The involvement
of the individual in protecting and restoring his or
her own health is therefore vital, since exposure to a
health risk is largely determined by one’s behaviour.
The doctors of tomorrow must be excellent
communicators in order to persuade individuals,
families and the communities in their charge to
adopt healthy lifestyles and become partners in the
health effort
Community leader , & educator
The needs and problems of the whole
community - in a suburb or a district - must not
be forgotten. By understanding the
determinants of health inherent in the physical
and social environment and by appreciating the
breadth of each problem
or health risk “five-star doctors” will not simply
be treating individuals who seek help but will
also take a positive interest in community
health activities which will benefit large
numbers of people.
 Manager & team member
To carry out all these functions, it will be essential
for “five-star doctors” to acquire managerial skills.
This will enable them to initiate exchanges of
information in order to make better decisions, and
to work within a multidisciplinary team in close
association with other partners for health and
social development.
Both old and new methods of dispensing care will
have to be integrated with the totality of health
and social services, whether destined for the
individual or for the community.
Although the five attributes described above
may equally apply to any health professional,
family doctors come close to fulfilling the
concept of the “five-star doctor”, and it is fair
to say that they are seen as playing important
roles as primary care providers who can bring
together quality and cost-effectiveness in
care.
 Characteristics of a
Family Practice Model
Care provided within a community context
Comprehensive Care
Person-centered
Whole-person orientation
Team approach
Elimination of barriers to access
Advanced information systems
Emphasis on quality and safety
Commitment to provide family medicine’s basket
of services
36
Continuity of care
Relationship
Acute & chronic
Promotion
Universal access (Universal
Health Coverage UHC)
 THANK YOU

DR. ALI ABDUL RIDHA ABU

TIHEEN
F.I.B.M.S
Consultant Family Physician