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Asia Pacific Family Medicine
Published in: Asia Pacific Family Medicine 1/2014

Open Access 01-12-2014 | Commentary

Need to teach family medicine concepts even before establishing such practice in a country

Author: Rasnayaka M Mudiyanse

Published in: Asia Pacific Family Medicine | Issue 1/2014

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Abstract

Background

The practice of family medicine is not well established in many developing countries including Sri Lanka. The Sri Lankan Government funds and runs the health facilities which cater to the health needs of a majority of the population. Services of a first contact doctor delivered by full time, vocationally trained, Family Physicians is generally overshadowed by outpatient departments of the government hospitals and after hours private practice by the government sector doctors and specialists. This process has changed the concept of the provision of comprehensive primary and continuing care for entire families, which in an ideal situation, should addresses psychosocial problems as well and deliver coordinated health care services in a society. Therefore there is a compelling need to teach Family Medicine concepts to undergraduates in all medical faculties.

Discussion

A similar situation prevails in many countries in the region. Faculty of Medicine Peradeniya embarked on teaching family medicine concepts even before a department of Family Medicine was established. The faculty has recognized CanMed Family Medicine concepts as the guiding principles where being an expert, communicator, collaborator, advocate, manager and professional is considered as core competencies of a doctor. These concepts created the basis to evaluate the existing family medicine curriculum , and the adequacy of teaching knowledge and skills, related to family medicine has been confirmed. However inadequacies of teaching related to communication, collaboration, management, advocacy and professionalism were recognized. Importance of inculcating patient centred attitudes and empathy in patient care was highlighted. Adopting evaluation tools like Patient Practitioner Orientation Scale and Jefferson’s Scale of Empathy was established. Consensus has been developed among all the departments to improve their teaching programmes in order to establish a system of teaching family medicine concepts among students which would lead them to be good Family Physicians in the future.

Summary

Teaching Family Medicine concepts could be initiated even before establishing departments of family medicine in medical faculties and establishing the practice of family medicine in society. Family medicine competencies could be inculcated among graduates while promoting the establishment of the proper practice of Family Medicine in the society.
Literature
1.
Murtagh JE: Paradigms of family medicine: bridging traditions with new concepts; meeting the challenge of being the good doctor from 2011. Asia Pac Fam Med 2011, 10: 9. 10.1186/1447-056X-10-9PubMedCentralCrossRefPubMed
2.
3.
Lewis M, Smith S, Paudel R, Bhattarai M: General Practice (Family Medicine): meeting the health care needs of Nepal and enriching the medical education of undergraduates. Kathmandu Univ Med J (KUMJ) 2005,Vol. 3, No. 2(Issue 10):194–198.
4.
Krupat E, Fleming MZ, Freeman P: Patient Centeredness and its correlates among first year medical students. Int J Psychiatry Med 1999,29(3):347–358. 10.2190/DVCQ-4LC8-NT7H-KE0LCrossRefPubMed
5.
Tai Pong LAM: Editorial, What is ‘Family Medicine’ in the Asia Pacific region? Asia Pac Fam Med 2003, 2: 1. 10.1046/j.1444-1683.2003.00056.xCrossRef
6.
7.
Silva NRNR, Perera KKYW, Gunatunge RS, Tantrigoda DA: How many doctors should Sri Lanka have? CMJ 2008,53(3):94–98.
8.
9.
10.
11.
Hodges BD, Albert M, Arweiler D, Akseer S, Bandiera G, Byrne N, Charlin B, Karazivan P, Kuper A, Maniate J, Millette B, Noyeau E, Parker S, Reeves S: The future of medical education: a Canadian environmental scan. Med Educ 2011, 45: 95–106. 10.1111/j.1365-2923.2010.03737.xCrossRefPubMed
12.
Jones R, Oswald N: A continuous curriculum for general practice? Proposals for undergraduate– postgraduate collaboration. Br J Gen Pract 2001, 51: 135–138.PubMedCentralPubMed
13.
14.
Kurtz S, Silverman J, Draper J: Teaching and Learning Communication Skills in Medicine. 2nd edition. Oxford, San Francisco: Radcliffe Publishing Ltd; 2008. E book loc 329–332
15.
Stewart MA, McWhinney IR, Buck CW: The doctor-patient relationship and its effect upon outcome. J R Coll Gen Pract 1979, 29: 77–82.PubMedCentralPubMed
16.
Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting Patient’s agenda: have we improved? JAMA 1999, 281: 283–287. 10.1001/jama.281.3.283CrossRefPubMed
17.
Kurtz SM, Silverman JD: The Calgary-Cambridge referenced observation guides: an aid to defining the curriculum and organizing the teaching in communication training programmes. Med Educ 1996,30(2):83–89. 10.1111/j.1365-2923.1996.tb00724.xCrossRefPubMed
18.
Murakami M, Kawabata H, Maezawa M: The perception of the hidden curriculum on medical education: an exploratory study. Asia Pac Fam Med 2009, 8: 9. doi:10.1186/1447–056X-8–9 10.1186/1447-056X-8-9PubMedCentralCrossRefPubMed
19.
Markides M: Impact of good communication between patient and health professionals. J Pediatr Hematol Oncol 2011, 33: S123-S125.CrossRefPubMed
20.
Charon R: Narrative medicine, a model for empathy, reflection, profession, and trust. JAMA 2001, 286: 1897–1902. 10.1001/jama.286.15.1897CrossRefPubMed
21.
Shilling V, Jenkins V, Fallowfield L: Factors affecting patient and clinician satisfaction with clinical consultation: can communication skills training for clinicians improve satisfaction Psycho. Oncology 2003, 12: 599–611.
22.
Levinson W, Gorawara-Bhat R, Lamb J: A study of patient clues and physicians response in primary care and surgical setting. JAMA 2000, 284: 1021–1027. 10.1001/jama.284.8.1021CrossRefPubMed
23.
Dowell J, Jones A, Snadden D: Exploring medication use to seek concordance with ‘non-adherent’ patients: a qualitative study. Br J Gen Pract 2002, 52: 24–32.PubMedCentralPubMed
24.
Orth JE, Stiles WB, Scherwitz L, Hennrikus D, Vallbona C: Patient exposition and provider explanation in routine interviews and hypertensive patients blood pressure control. Health Psychol 1987, 6: 29–42.CrossRefPubMed
25.
Cowie MR: Person-centred care: more than just improving patient satisfaction. Eur Heart Journal 2012, 33: 1037–1039. 10.1093/eurheartj/ehr354CrossRef
26.
Ahrens T, Yancey V, Kollef M: Improving family communication at the end of life: implications for length of stay in intensive-care unit and resource use. Am J Crit Care 2003, 12: 317–323.PubMed
27.
Hojat M, Joseph SG, Thomas JN, Salvatore M, Michael V, Mechael M: Physician empathy: definition, components, measurement, and relationship to gender and specialty. Am J Psychiatry 2002, 159: 1563–1569. 10.1176/appi.ajp.159.9.1563CrossRefPubMed
28.
Hudon C, Fortin M, Haggerty JL, Lambert M, Poitras ME: Measuring Patients’ perceptions of patient-centered care: a systematic review of tools for family medicine. Ann Fam Med 2011, 9: 155–164. 10.1370/afm.1226PubMedCentralCrossRefPubMed
29.
Krupat E, Bell RA, Kravitz RL, Thom D: When physicians and patients think alike: patient-centered beliefs and their impact on satisfaction and trust. J Fam Pract 2001, 50: 1057–1062.PubMed
30.
Chen D, Lew R, Hershman W, Orlander J: A cross-sectional measurement of medical student empathy. J Gen Intern Med 2007,22(10):1434–1438. 10.1007/s11606-007-0298-xPubMedCentralCrossRefPubMed
31.
Hojat M: Empathy in Patient Care: Antecedents, Development, Measurement, and Outcomes. Springer.com; 2007. ISBN 13: 978–0-387–33608–4
32.
Chnadratilaka MN: Professionalism: the indicator of a civilized and exemplary medical profession. Ceylon Dent J 2012,57(2):57–60.
33.
William T, Branch JR, David K: Teaching the human dimensions of care in clinical settings. JAMA 2001, 286: 1067–1074. 10.1001/jama.286.9.1067CrossRef
34.
35.
Beaulieu MD: What does it mean to be a family physician? Exploratory study with family medicine residents from 3 countries. Can Fam Physician 2009, 55: 14–20.
36.
Lee A, Siu S, Lam A, Tsang C, Kung K, Li PK: The concepts of family doctor and factors affecting choice of family doctors among Hong Kong people. Hong Kong Med J 2010, 16: 106–115.PubMed
Metadata
Title
Need to teach family medicine concepts even before establishing such practice in a country
Author
Rasnayaka M Mudiyanse
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Asia Pacific Family Medicine / Issue 1/2014
Electronic ISSN: 1447-056X
DOI
https://doi.org/10.1186/1447-056X-13-1

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