Family medicine ( FM ), formerly family practice ( FP ), is a medical specialty devoted to health care comprehensive for people of all ages; specialist named family doctor or family doctor . In Europe, the discipline is often referred to as common practice and practitioners as general practitioners or GP ; this name emphasizes the holistic nature of this specialization, as well as its roots in the family. Family practice is the division of primary care that provides continuous and comprehensive healthcare for individuals and families of all ages, sexes, diseases, and body parts; Family doctors are often primary care physicians. It is based on patient knowledge in the context of family and community, emphasizing disease prevention and health promotion. According to the World Family Doctors Organization (WONCA), the goal of family medicine is to provide personal, comprehensive, and sustainable care for individuals within the context of family and community. The problem of values ​​underlying this practice is usually known as primary care ethics.
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Family doctors in the United States can have a M.D. or D.O. degree. Doctors who specialize in family medicine should successfully complete an accredited three or four year family medical residency in the United States in addition to their medical degree. They are then eligible to take the board certification exam, which is now required by most hospitals and health plans. The American Board of Family Medicine requires its Diploma to maintain certification through the ongoing process of continuing medical education, medical knowledge review, monitoring of patient care through chart audits, practice-based learning through quality improvement projects and retrieving board certification exams every 7 to 10 years. The American Osteopathic Board of Family Physicians require Diplomates to maintain certification and undergo a recertification process every 8 years.
Doctors certified in family medicine in Canada are certified through the College of Family Physicians of Canada, after two years of additional education. Further education is also a requirement for continued certification.
The term "family medicine" is used in many European and Asian countries, not "general medicine" or "general practice". In Sweden, certification in the field of family medicine requires five years of working with a tutor, after a medical degree. In India, those who wish to specialize in family medicine should complete a three-year family drug residency, after their medical degree (MBBS). They were honored as D.N.B. or M.D. in family medicine. Similar systems exist in other countries.
Family doctors provide a variety of acute, chronic and preventive medical care services. In addition to diagnosing and treating illness, they also provide preventive care, including regular checkups, health risk assessments, immunizations and screening tests, and personalized counseling to maintain a healthy lifestyle. Family physicians also manage chronic diseases, often coordinating treatments provided by other subspecialists. Many American Family Doctors deliver babies and provide prenatal care. In the US, family physicians treat more patients with back pain than other subspecialist doctors, and about as many orthopedists and combined neurosurgeons.
Family doctors and family doctors play a very important role in a country's health care system. In the US, for example, almost one in four of all office visits are made to a family doctor. That's 208 million office visits each year - nearly 83 million more than the next largest medical specialization. Today, family doctors provide more care for underserved and rural American populations than any other medical specialty.
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Family medicine in Canada
In Canada, prospective family doctors are expected to complete residency in family medicine from an accredited university after earning a M.D. they. Although residency usually has a duration of two years, graduates may apply to complete the third year, leading to certification from the College of Family Physicians Canada in disciplines such as emergency medicine, palliative care, and women's health, among many others. In some institutions, such as McGill University in Montreal, graduates of the family medical residency program are eligible to complete a master's degree and Doctor of Philosophy (Ph.D.) in Family Medicine, comprising mostly of research-oriented programs.
Family medicine in the United States
History of family medical practice
Concern for family health and drugs in the United States has been around since the early 1930s and 40s. American public health advocate Bailey Barton Burritt was labeled "the father of the family health movement" by The New York Times in 1944.
After World War II, two major problems formed the emergence of family medicine. First, medical specializations and subspecialties increase in popularity, have a detrimental effect on the number of physicians in general practice. At the same time, many medical advances are made and there are concerns in the "general practitioner" or "general practitioner" population that four years of medical school plus one year of internship is no longer adequate preparation for the breadth of necessary medical knowledge. profession. Many of these doctors want to see the residency program added to their training; this not only gives them additional training, knowledge, and prestige, but will allow board certification, which is increasingly necessary to obtain privileges in the hospital. In February 1969, family medicine (later known as family practice) was recognized as a special specialty in the US. It is the twentieth specialization to be recognized.
Education and training
Family physician completing a bachelor's degree, medical school, and three more years of specialized medical residency training in family medicine. Their residency training includes rotation in internal medicine, pediatrics, gynecology, psychiatry, surgery, emergency medicine, and geriatrics. Residents should also provide care for the continuity patient panel in the "outpatient" model practice for the entire residency period. Privilege focuses on treating all people, recognizing the effects of all external influences, through all stages of life. Family doctors will see anyone with any problem, but experts in general issues. Many family doctors provide babies in addition to caring for patients of all ages.
In order to become board certified, the family physician must complete residency in family medicine, have complete and unlimited medical licenses, and take a written cognitive exam. Between 2003 and 2009, the maintenance process of board certification in family medicine is being changed (as well as all other American Specialty Boards) to a series of annual tests in various fields. The American Board of Family Medicine, as well as other specialist councils, require additional participation in continuous learning and self-assessment to improve clinical knowledge, skills and skills. The council has created a program called "Maintenance of Certification Courses for Family Doctors" (MC-FP) that will require family doctors to continue to demonstrate proficiency in four areas of clinical practice: professionalism, self-assessment/lifelong learning, cognitive skills, and performance in practice. Three hundred hours of continuing medical education in the previous six years must also be eligible for the exam.
Family doctors can pursue scholarships in several fields, including juvenile medicine, geriatric drugs, sports medicine, sleeping pills, and home care and palliative medications. The American Board of Family Medicine and the American Osteopathic Board of Family Medicine both offer an Additional Qualification Certificate (CAQ) in each of these topics. Recently, a new scholarship in International Family Medicine has emerged. The scholarship is designed to train family physicians working in resource-poor settings.
Disadvantages of family doctors
While many sources cite the shortage of family doctors (as well as other primary care providers, ie internists, pediatricians and general practitioners), per capita primary care physician supplies have actually increased by about 1 percent per year since 1998. In addition, recent decline in the number of graduates MD pursuing residency in primary care has been matched by the number of DO graduates and international medical school graduates (IMGs) who enter primary care residencies. However, projections show that by 2020 family physician demand will exceed their supply.
The number of students entering family medical residency training has fallen from a high of 3,293 in 1998 to 1,172 in 2008, according to the National Residency Matching Program. Fifty-five family medical residency programs have been closed since 2000, while only 28 programs have been opened.
In 2006, when the country had 100,431 family doctors, labor reports by the American Academy of Family Physicians showed the United States would need 139,531 family doctors by 2020 to meet the needs of primary medical care. To reach that number 4,439 family doctors must complete their residency every year, but currently the country draws only half of the future family doctor's number will be needed.
The waning interest in family medicine in the US may be caused by several factors, including lower prestige associated with specialization, lower salaries, and an increasingly frustrating work environment. Salaries for family doctors in the United States are honorable, but lower than average for doctors, with an average of $ 225,000. However, when dealing with debts from medical schools, most medical students opt for higher payment specializations. Potential ways to increase the number of medical students entering family practice include providing assistance from medical education debt through a loan-payment program and cost-for-service reimbursement restructuring for health care services. Family doctors are trained to manage an acute and chronic health problem for an individual simultaneously, but their appointment slots may be on average only ten minutes.
Current practice
Most family physicians in the United States practice in small group practice or solo or as hospital employees in practice of the same size that the hospital has. However, this specialization is wide-ranging and allows for a wide range of career options including education, emergency medicine or urgent care, inpatient medicine, international medicine or wilderness, public health, sports medicine, and research. Others choose to practice as consultants to various medical institutions, including insurance companies.
Family Medicine in India
Family Medicine (FM) came to be recognized as a medical specialty in India only in the late 1990s. According to the National Health Policy - 2002, there is an acute shortage of specialists in family medicine. When family physicians play a crucial role in providing affordable and universal health care to people, the Government of India is now promoting the practice of family medicine by introducing post-graduate training through the DNB (National Diplomacy Council) program.
There is a severe shortage of postgraduate training chairs, leading to many struggles, difficulties and career bottlenecks for newly graduated doctors, just graduating from medical school. The Family Drug Training chair should ideally fill this gap and allow more doctors to pursue a Family Medicine career. However, the absorption, awareness, and development of this specialization is slow.
Although family medicine is sometimes called common practice, they are not identical in India. Medical graduates who have successfully completed a Bachelor's degree in Medicine, a Bachelor of Surgery (MBBS) and have been registered with the Indian Medical Council or any state medical board considered a GP. A family doctor, however, is a primary care physician who has completed specialist training in family medicine disciplines.
The Medical Council of India requires a three-year residency for family medicine specialization, leading to the Doctor of Medicine (MD) award in Family Medicine or the Diplomate of National Board (DNB) in Family Medicine.
National Examination Agency conducts a family medical residency program in an accredited education hospital. After successfully completing a three-year residency, the candidate was awarded the Diplomate of National Board (Family Medicine). The DNB (FM) curriculum consists of: (1) medical science and allied science; (2) operation and science of allies; (3) maternal and child health; (4) basic science and public health. During his three-year residency, the candidates receive integrated inpatient and outpatient learning. They also receive field training at community health centers and clinics.
The Indian Medical Council allows accredited medical colleges (medical schools) to undertake similar residency programs in family medicine. After successfully completing a three-year residency, the candidate is awarded a Doctor of Medicine (Family Medicine). Government medical school, Calicut has started this MD (FM) course in 2011. Some AIIMS institutes have also started a course called MD in community and family medicine in recent years. Despite the acute shortage of qualified family physicians in India, further progress is slow.
College of Physicians at the Indian Medicine Association, offers a one-year Diploma in Family Medicine (DFM), a distance education program from the Graduate Medical Institute, Colombo University, Sri Lanka, for doctors with a minimum of five years of experience in general. practice. Because the Medical Council of India requires a three-year residency for family medicine specialization, this diploma is not recognized qualification in India.
Because India's need for primary and secondary health care is huge, medical educators have called for systemic changes to include family medicine in undergraduate medical curricula.
Recently, family-trained family physicians have established the Indian Family Doctors Academy (AFPI). AFPI is a family physician academic association with an official full-time residency training (DNB Family Medicine) in Family Medicine. There are currently about two hundred family medical residency training places accredited by the National Board of Examination of India, which provide about 700 training posts each year. However, there are various issues such as academic acceptance, accreditation, curriculum development, uniform training standards, faculty development, research in primary care, etc. requiring urgent attention to family medicine to develop as an academic specialization in India. The Government of India has declared Family Medicine as the focus area of ​​human resource development in the health sector in National Health Policy 2002 & lt; https://web.archive.org/web/20101104135914/http://mohfw.nic.in/np2002.htm & gt;. There is ongoing discussion to employ multi-skilled doctors with DNB family medical qualifications of specialist posts in NRHM (National Rural Health Mission).
Three possible models of how family physicians will practice their specialty in India may evolve, namely (1) private practice, (2) training in primary care clinics/hospitals, (3) practicing as consultants in secondary/tertiary care hospitals.
Family medicine in Japan
Family treatment was first recognized as a specialization in 2015 and currently has about 500 family doctors certified. The Government of Japan has made a commitment to increase the number of family doctors to improve the cost effectiveness and quality of primary care given the rising cost of health care. Japan Primary Care Association (JPCA) is currently the largest family physician academic association in Japan. The JPCA family family training scheme consists of a three-year program after a two-year internship. In 2012, the average consultation length is 10.2 minutes.
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References
Source of the article : Wikipedia
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