in the name of god
DESCRIPTION
In The Name of God. Family practice. Family Medicine (Important and It’s Future) R.Askari Ph.D. Student in Health Services Management Email: [email protected]. Your Future is Family Medicine. Information, facts and answers to frequently asked questions about family medicine. - PowerPoint PPT PresentationTRANSCRIPT
1
2
Family Medicine (Important and It’s Future)
R.AskariPh.D. Student in Health Services ManagementEmail: [email protected]
3
Your Future is Family Your Future is Family MedicineMedicine
Information, facts and answers to frequently asked questions about
family medicine
4
Why is primary care Why is primary care important?important?
longer life spans and fewer deaths due to heart and lung disease
fewer cases and deaths due to colon and cervical cancer
better detection of breast cancer less hospital use better preventive care reduced health disparities
5
What do family physicians What do family physicians do?do?
Family physicians provide comprehensive and continuous primary care health care to:
individuals and families
women and men regardless of age or disease
infants, children and adolescents regardless of disease
6
Family physicians Family physicians provideprovide Prevention & management of acute
injuries and illnesses Health promotion Hospital care for acute medical
illnesses Chronic disease management Maternity care Well-child care and child development Primary mental health care Rehabilitation Supportive and end-of-life care
7
What FP attributes are What FP attributes are valued?valued?
Deep understanding of the whole person
Act as a partner to patients over many years
Talent for humanizing health care
A command of complexitySource: Source: Martin JC, Avant RF, Bowman MA, et al. The Future of Family Medicine: A Martin JC, Avant RF, Bowman MA, et al. The Future of Family Medicine: A collaborative project of the family medicine community. Ann Fam Med. 2004 collaborative project of the family medicine community. Ann Fam Med. 2004 Mar-Apri; 2 Suppl 1:53-32Mar-Apri; 2 Suppl 1:53-32 8
Family physicians’ whole-person Family physicians’ whole-person orientation and training ensures orientation and training ensures that FPs…that FPs…
Consider all of the influences on a person’s health
Know and understand peoples’ limitations, problems and personal beliefs when deciding on a treatment
Are appropriate and efficient in proposing therapies and interventions
Develop rewarding relationships with patients
9
Family physicians have a Family physicians have a unique influence on unique influence on patients’ livespatients’ lives
Serving as partner with patients to maintain well-being over time
Empowering with information and guidance that are needed to maintain health over time
Providing care that includes long-term behavioral change interventions that lead to better health
Developing ongoing communication between patient and physician 10
Family physicians are Family physicians are relationship-oriented, which relationship-oriented, which ensures… ensures…
Good relationships with other physicians and health care providers.
Better patient understanding of complex medical issues and improved participation in the care process.
Less expensive and better healthcare experience for patient.
11
Family physicians have a Family physicians have a natural command of natural command of complexity andcomplexity and Thrive on managing complex
medical problems
Integrate all of the medical and personal issues facing an individual
Break down medical terms and
complex medical issues to make it easier for patients to understand
12
How are family physicians How are family physicians trained?trained?
3 years More than 400 family medicine residencies Community-based Medical school-based Military Inner-city Urban Suburban Rural Innovative Training Models
Family medicine residencyFamily medicine residency clinical clinical curriculum curriculum
Adult medicine Critical care medicine
Maternity care Gynecologic care
General surgery Orthopedics
Emergency care Care of children
Skin care Human behavior
Women’s health Newborn care
Continuity Patient Care – all 3 years
14
What are the primary care What are the primary care specialties?specialties?
Source: DA, Cherry DK. National Ambulatory Medical Care Survey: 2005 Summary. Advance Data from Vital and Health Statistics; No. 346, Hyattsville, Maryland: National Center for Health Statistics. 2004. http://www.cdc.gov/nchs/about/major/ahcd/officevisitcharts.htm .
216
168129
573
390
0
100
200
300
400
500
600
Millions
FamilyMedicine
InternalMedicine
Pediatrics All PrimaryCare
OtherSpecialists
The Primary Care Physician Number of Office Visits to Primary Care Physicians vs. Other Specialists
15
What distinguishes family What distinguishes family physicians from general physicians from general internists?internists?
Visits by men to primary care physicians -2006
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Under 18 18-44 years 45-64 years 65 year andover
Family Medicine
Internal Medicine
Ages and gender of patients seen by family physicians and general internists
Source:
National Center for Health Statistics: Chart book on Trends in the health of Americans: 2006
Visits by women to primary care physicians - 2006
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Under 18 18-44years
45-64years
65 yearand over
Family Medicine
Internal Medicine
16
What’s a typical week in What’s a typical week in primary care?primary care?
Source: National Ambulatory Medical Care Survey: 2004 Summary. National Center for Health Statistics
Major Reasons for Visits to Primary Care Specialists
11.5
34.7
32.6
87
0 20 40 60 80 100
Injury Related
Chronic Condition
Acute Condition
Preventive
Rea
son
s fo
r V
isit
s
Percentage
17
People rely on primary care People rely on primary care physicians to care for complex physicians to care for complex diseasedisease
Source: 2002 National Health Interview Survey
Condition Saw a PC physician in the last year
Asthma 80%
Congestive Heart Failure 88%
Coronary Heart Disease 88%
Depression/Anxiety 81%
Diabetes 88%
Hypertension 88%
Multiple Sclerosis 77%
Parkinson’s 90%
18
What’s a typical week in family What’s a typical week in family medicine?medicine?
Reasons for visits to Family Physicians
2
18.1
7.3
9.3
30.2
33.1
0 5 10 15 20 25 30 35
Not Reported
Non-Illness (preventive)
Pre or post surgeryfollow up
Chronic flare-up
Chronic routine problem
Acute problem
Re
as
on
s
Percentage
Source: National Ambulatory Medical Care Survey: 2005 Summary. National Center for Health Statistics
19
Lifestyle of Family Lifestyle of Family Physicians?Physicians? 39.7 hours per week in direct patient
care1 50 hours per week in patient related
activities Avg. wks worked – 46.9 weeks 1
5 weeks for vacation/CME 1
Avg. Income for 2006: $161,000 2
1 1 AAFP Facts About Family Medicine. 2006 http://www.aafp.org/facts.xmlAAFP Facts About Family Medicine. 2006 http://www.aafp.org/facts.xml22 Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Incentives. Oct 2007. Incentives. Oct 2007.
20
Are family physicians in Are family physicians in demand?demand?
The Number One most recruited specialty in 2006
The primary care specialty most in demand
35% increase in recruitment of family physicians in 2004
11 Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Incentives. Oct 2007Incentives. Oct 2007 2 2 Hawkins, J. Encouraging news about family physician recruitment. Hawkins, J. Encouraging news about family physician recruitment. Family Practice Management. 2005 Apr; 12(4); 56-8.Family Practice Management. 2005 Apr; 12(4); 56-8.
21
The WHO framework The WHO framework statementstatement
General Continuous Comprehensive Coordinated Collaborative Family orientated Community orientated
22
The principles of the The principles of the discipline as suggested by discipline as suggested by GayGay• Patient centered approach • Orientation on family and
community context • Field of activities determined by
patient needs and requests • Unselected and complex health
problems • Low incidence of serious diseases • Diseases at early stage • Continuing management • Coordinated care • Efficiency
23
The WONCA 1991 statement The WONCA 1991 statement includes the followingincludes the following
Comprehensive care Orientation to the patient Family focus Doctor/patient relationship Co-ordination with other
services Advocacy Accessibility resource management.
24
25
26
27
28
29
30
31
32
What’s the future of family What’s the future of family medicine?medicine?
Electronic health record (EHR)
Online appointments
Web-based patient education
E-visits
33
Innovations in family Innovations in family medicinemedicine
Group visits
Team approach to care
Systematic approach to care
Chronic disease management
34
Future of family Future of family medicinemedicine Market research
Six task forces
Family medicine’s new model of care
Personal medical home
Continuous relationship
Basket of services
35
36