What’s Going on in Turkey?What’s Going on in Turkey?

Current Developments in Family PracticeCurrent Developments in Family Practice

Nezih Dagdeviren, Zekeriya Akturk,Nezih Dagdeviren, Zekeriya Akturk, Suleyman GorpeliogluSuleyman Gorpelioglu

• This is the story of a country trying to This is the story of a country trying to

redefine its way to high quality health redefine its way to high quality health

care, found and lost fifty years ago.care, found and lost fifty years ago.

Some FiguresSome Figures

• Population: 65 millionPopulation: 65 million

• Total number of physicians: 70 thousandTotal number of physicians: 70 thousand

• Primary care:Primary care:– Untrained practitioners: 15 thousandUntrained practitioners: 15 thousand– Family physicians: 1700Family physicians: 1700

BackgroundBackground

• 1947 First residency on General Practice1947 First residency on General Practice

• 1949 Cancellation of the program 1949 Cancellation of the program (residents distributed into different (residents distributed into different specialties)specialties)

• 1985 Family practice residency positions1985 Family practice residency positions

• 1993 Academic departments at the 1993 Academic departments at the universitiesuniversities

• 2003 Primary care health reform2003 Primary care health reform

AimAim

• Presentation of the achievements and Presentation of the achievements and

plans of the Turkish Association of Family plans of the Turkish Association of Family

Physicians (TAHUD) regarding the Physicians (TAHUD) regarding the

changes in primary care so farchanges in primary care so far

AchievementsAchievements

• TTwo workshops wo workshops

– Update of the corporate Update of the corporate policiespolicies on primary care on primary care

– Transitional training of untrained practitionersTransitional training of untrained practitioners

• Coordination and cooperation with the Coordination and cooperation with the

ministry of health in accordance with the ministry of health in accordance with the

TAHUD policy papers.TAHUD policy papers.

AchievementsAchievements

• FFamily practice advisory board meetingsamily practice advisory board meetings

– Four meetings Four meetings

– MMany subgroup meetings.any subgroup meetings.

• A two-phase transitional education was A two-phase transitional education was

decided for the untrained practitionersdecided for the untrained practitioners

AchievementsAchievements

• CCurriculum and teaching materials for the urriculum and teaching materials for the

transitional phase transitional phase prepared prepared

• Core educators course was doneCore educators course was done

• Training the trainers courses were startedTraining the trainers courses were started

• Planning of the second phase education Planning of the second phase education

startedstarted

AchievementsAchievements

• Family practice residency positions Family practice residency positions

increased about ten fold: around 600 increased about ten fold: around 600

residency positions were released at April residency positions were released at April

20042004

• Active support from WONCA-EUROPEActive support from WONCA-EUROPE

PlansPlans

• First level of the vocational training will First level of the vocational training will

be completedbe completed by the end of 2004 by the end of 2004

• FFamily practice resident positions will be amily practice resident positions will be

increasedincreased

• New residency education centers will be New residency education centers will be

establishedestablished

PlansPlans

• Part time residency educationPart time residency education

• Second Second phasephase training training will start by 2005 will start by 2005

• Regulations obliging residency education Regulations obliging residency education

in order to practice medicinein order to practice medicine

PlansPlans

• The new health system The new health system will start will start in pilot in pilot

citiescities

• A new contract for primary care will be A new contract for primary care will be

implemented implemented

ConclusionConclusion

• Some Some lessons lessons cancan be taken from the be taken from the

current changes in Turkey, current changes in Turkey,

• OurOur expect expectation:ation: Turkey will have a great Turkey will have a great

acceleration in family practice in the near acceleration in family practice in the near

future, provided that, the developments future, provided that, the developments

have continuity in the academic, political have continuity in the academic, political

as well as practice levelsas well as practice levels..