FACULTY OF MEDICINE & HEALTH

SCIENCES
DEPARTMENT OF COMMUNITY
MEDICINE & PRIMARY HEATH CARE

By

Dr. Ali Al-Fakeeh

CONCEPT
Comprehensive health

care. HOLISTIC approach. Family medicine is the specialty of inclusion.

 Focus in Family Medicine is

on patient and not on the disease. Caring for patient VERSUS caring for a disease. Family medicine acts through its all principles.

Six Principles:
1. Continuity of care.
2. Comprehensiveness.

3. Coordination.
4. Community. 5. Prevention. 6. Family.

1 Continuity of care:
One doctor seeing the patient

(family). It is an important principle. Develops patients trust ..> effective care. Continuity of care for patient and not for a disease. Doctor can use his personality as therapeutic tool.

1st continuity of care practiced?

a. Past history utilization. b. Importance of family

medicine is stressed. c. Plan of management.

d. Goals of management.

e. Doctor-patient

relationship (TRUST). f. Looking in medical record-family health file.

2. Comprehensiveness:
Holistic approach- biological, social and psychological. diagnostic and therapeutic plan. Involve other health providers

 How to evaluate

comprehensiveness? Is there a problem list. Medication list. Medical record accessibility.

 Is it a patient oriented

care? Does patient have a separate agenda? Financial status of patient:Diagnosis Therapy

 Psychological aspects 50-60%

of patients are psychological

disturbed. Can we diagnose depression? Psychosomatic e.g.-chest pain.

 Now (let us exclude

organic before diagnosing psychological) is not more supported. Two diagnoses can be made e.g. cancer and depression.

3. Coordination of Care:
Guidance of patient care.
Identification of other health

providers. Other health provider should satisfy both patient and family doctor.

 Discuss patient care with

involved specialist. Accompany patient consultants visits (occasionally). Visiting patient in hospital.

4. Community:
This affects patient care through knowing the: a. Occupation. b. Culture. c. Environment.

These affect:
Community education.

Community services.
Diagnostic tool.

Therapeutic tool, e.g.

agencies. Adjusting insulin dosage according to patient lifestyle.

5. Prevention:
Recognizing risk factors.
Delaying the complications.

Promoting health (Lifestyle).

Anticipation of problems e.g.

psychological.

 Screening for disease e.g.

PAPsmear. Interfering with lifestyle to prevent IHD & COPD. Preparing patient for normative crisis.

6. Family Aspects:
Patient is a member of

family system. Effect of illness on family and family illness. Patient support system.

 Functional and dysfunctional

family. Family Genogram (Biological description). Family circle (Emotional description). Family history.