History and definitions of family medicine


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History and definitions of family medicine

  1. 1. History and Definitions of FM Dr. Faisal Al Hadad Consultant of Family Medicine & Occupational Health
  2. 2. History Centuries ago people tried to take care of themselves before resorting to “healers”
  3. 3. 17th and 18th centuries    Relatively few physicians were available to the general population. Most of them practiced in 3 different settings: – Traveling around the country – In urban centers where they served the growing middle class – As personal attendants to wealthy or aristocratic families. Surgeons trained by apprenticeship and apothecaries who dispensed and sold drugs provided the medical needs to poorer and rural people.
  4. 4. 20th Century  Most physicians were “General Practitioners.”  A growing shift towards specialization took place throughout the 1920s and 1930s.  Between 1931 and 1974, physicians classifying themselves as “General Practitioners” declined from 83% to 18%, and there was a concomitant rise in specialists.
  5. 5. Fragmented Patient Care  Many people felt like the trend toward specialization had fragmented patient care and weakened the patientphysician relationship.  “There are 57 different varieties of specialists to diagnose and treat 57 different varieties of diseases, but no physician to take care of the patient.”  The decline in the number of “general practitioners” and the public concern over fragmented medical care led to the movement to create the “specialty” of Family Medicine.
  6. 6. 1940s  Generalist began to initiate steps to elevate general practice to “specialty” status.  Their goal was the development of a curriculum and creation of a formal certification board.  Generalists were claiming equal training and equal rank.
  7. 7. 1960s WHO (1963) report: "Training of Physicians for Family Practice" which recommended a postgraduate study program specifically designed to meet the needs of the General Practitioner. The Millis Report (1966):  The Millis Report became a forerunner for the development of Family Practice residency programs.  Dr. Millis became known as the “grandfather of Family Practice.”  Conclusion of Millis Report: Family Practice needed to be a Board Certified specialty.
  8. 8. Definitions of FP/GP  American Academy of Family Physicians (AAFP)  American Board of Family Practice (ABFP)  Royal Australian College of General Practitioners (RACGP)  Royal College of General Practitioners (RCGP-UK)  Royal New Zealand College of General Practitioners (RNZCGP)  The World Organization of National Colleges and Academies of General Practice/Family Medicine (WONCA)
  9. 9. American Academy of Family (Physicians (AAFP - 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.
  10. 10. Royal Australian College of General (Practitioners (RACGP General Practice is that component of the health care system which provides initial, continuing, comprehensive and coordinated medical care for all individuals, families and communities and which integrates biomedical, psychological, social and environmental understanding of health.
  11. 11. Royal College of General Practitioners ((RCGP-UK  General practitioners (GPs) are best defined by the unique nature of the doctor-patient relationship. GPs are personal doctors, primarily responsible for the provision of comprehensive and continuing medical care to patients irrespective of age, sex and illness. In negotiating management plans with patients they take account of physical, psychological, social, and cultural factors, using the knowledge and trust engendered by a familiarity with past care.  They also recognise a professional responsibility to their community. GPs exercise their professional role by promoting health, preventing disease and providing cure, care or palliation. This is done either directly, or through the services of others according to health needs and the resources available within the community they serve.
  12. 12. WONCA General practice / family medicine is an academic and scientific discipline, with its own educational content, research, evidence base and clinical activity, and a clinical specialty orientated to primary care.
  13. 13. Thank you