INTRODUCTION TO FAMILY MEDICINE

DR PATRICIA ESEIGBE MBBS, MPH(LIVERPOOL), FWACP

​

LECTURER/CONSULTANT

DEPARTMENT OF FAMILY MEDICINE

BINGHAM UNIVERSITY/ BINGHAM UNIVERSITY TEACHING HOSPITAL, JOS.

JULY, 2023.

​

OUTLINE

• OBJECTIVES
• INTRODUCTION
• HISTORY OF FAMILY MEDICINE
• DOMAINS OF CARE
• CORE PRINCIPLES
• FAMILY PRACTICE
• CONCLUSION
• REFERENCES

OBJECTIVES

• Acquisition of the basic knowledge of Family Medicine (FM)
• Identify the domains of care in FM
• Know the core principles and characteristics of FM
• Identify who a Family Physician is; the attributes, competencies
• Develop the skill to provide care in the context of a family

INTRODUCTION

• Family Medicine is the medical specialty that provides personal, continuing, comprehensive, and coordinated health care for the individual, in a holistic manner within the context of his family and environment.
• It encompasses all ages, both sexes and every disease entity, integrating biological, clinical and behavioral science
• It provides coordinated care with other specialists

Introduction -2

• Family Medicine is the body of medical knowledge required to be transferred to the physician to enable him function as a Family Physician
• Family Practice is the care given.
• Central to the practice of family medicine is the understanding of the concept of what the family is, the dynamics of its processes and the components of its care

​

​

​

HISTORY OF FAMILY MEDICINE

• The specialty of Family Medicine was created in 1969 to fulfil the generalist function in medicine, which suffered with the growth of sub specialization after World War II.
• Since its creation, the specialty has delivered on its promise to reverse the decline of general medicine and provide personal, front-line medical care to people of all socioeconomic strata and in all regions of the world.

​

HISTORY -2

History of Family Medicine in Nigeria

• Andrew Pearson - Father of Family Medicine in Nigeria. He was the CMO at Igbora Hospital, Ilesha in 1952.
• In 1980 the Faculty of General Medical Practice was created among the 14 faculties of the NPGMCN.
• He then became the DOT at the NPGMCN in 1983
• Family Medicine borne from General Medical Practice in March, 2006 – Senate.
• Family Medicine Curriculum was reviewed in 1998

FAMILY CARE

Pre-hospital Emergency Care &

Home Based Care of the Termally ill

HEALTH FACILITY or Hospital Care

PRIMARY CARE

Primary Medical Care

&

Primary Health Care

THE DOMAINS OF CARE IN FAMILY MEDICINE

DOMAINS OF CARE

• The 3 domains are
• Primary care
• Family care
• Hospital care

PRIMARY CARE

• Primary Medical Care
• Primary Health Care

Encompasses both and is core in Family Practice

DOMAINS -2

Primary Medical Care

• Primary medical care is used to refer to all care delivered at the first or primary level in contrast with care delivered in the hospital.

Primary Health Care

• Primary health care is a philosophy or set of values and principles for organizing the health system as a whole. The comprehensive PHC approach is composed of interrelated individual and public health components.

​

DOMAINS -3

FAMILY CARE

• Family is the unit of health care in Family Practice.
• The family as a unit of care
• It could be source of health, illness, stress
• It posses resources for care
• It plays an important role in prevention and promotion of health in the community.
• Family in health and disease

​

​

DOMAINS -4

HOSPITAL CARE

• The practice of frontline medicine
• In the General out-patient clinic (GOPC), Accident & Emergency (A&E), Wards, Theatre

Problem- oriented progress note:

• Plan out notes to address each problem separately using the mnemonic – SOAP
• S – Subjective/patient’s data (i.e. Biodata, HPC, FSH, PMH, Systems Review)
• O – Objective data from examinations & investigations
• A – Assessment/clinical impression or Diagnosis
• P – Plan for further tests, treatment, health education

At follow up use same SOAP pattern.

​

CORE PRINCIPLES

• Person-centered care
• Primary care management
• Holistic modeling
• Comprehensive approach
• Specific problem solving skills
• Community orientation

Family Medicine is defined by the above listed unique principles

FAMILY PRACTICE

Family practice is the care given by a Family Physician using the principles of Family Medicine

FAMILY PHYSICIAN

• The Family Physician is the physician primarily responsible for providing comprehensive health care to every individual seeking medical care in the context of himself, the family and the communities, taking into account their cultural, socio-economic and psychological background (WONCA, 1991).
• The Six-Star Doctor- Clinician, Manager, Teacher, Advocate, Coordinator, and Researcher.
• He is trained in Family Practice, Family Medicine

​

​

FAMILY PRACTICE -2

• Continuing care – from womb to tomb
• Comprehensive care – encompassing all ages, both sexes, each organ, every disease entity
• Integrates the biological, clinical and behavioral sciences
• Coordinated care - care by other specialists are prioritized, facilitated and redirected with patient being explained to
• Compassionate care - patient centered
• Family oriented - open to all family members and viewed in the context of the family

FAMILY PRACTICE -3

• Family physicians deliver a range of acute, chronic and preventive medical care services.
• Family Physicians take professional responsibility for the comprehensive care of unselected patients with undifferentiated problems, committed to the person regardless of age, gender, illness, organ/ system affected, or methods used.
• Effective communication is key

�Therapeutic triangle in Family Practice

patient

Physician

Family

CONCLUSION

• The scope of Family Medicine is dynamic, expanding, and evolutionary.
• It is a discipline that integrates several medical specialties into a new whole.
• It is concerned with the holistic approach to patient care in which the individual is seen in his totality, and in the context of his family and community.

​

REFERENCES

• Rakel R (2016),Textbook of Family Medicine, 9^th Edition, Saunders, Canada
• Mash B (2009), Handbook of Family Medicine, 2^nd Edition, Oxford Southern Africa.
• South-Paul JE, Matheny SC, Lewis EL. (2011) Current Diagnosis and Treatment in Family Medicine, 3^rd ed. Lange, McGraw Hill.

​

​

​

​

​

​

THANK YOU FOR LISTENING

GOD BLESS YOU ! ! !