The unique identity of FM/GP

#HealthSystemsCrisis #FM_GP #Unique_Identity World Organization of Family Doctors (WONCA) WONCA Europe

Nerio Enrique Romero González, MD

Health systems face difficult times, even in countries with more significant economic development. The UK, Canada, and Spain are examples of that. Difficulties derived from the need to achieve the objective of universal access to quality primary health care explain a big part of the problem.

Such trouble is currently stimulated by various factors whose importance varies according to the different systems, among which the perennial relative scarcity of resources (human and economic, mainly) stands out. Related to that, we find financial budgets that need to get bigger almost constantly, the aging of the population, the growth of chronic multimorbidity, and the retirement of growing contingents of physicians and other providers of personal health services.

These difficulties have reached a significant presence in the political agendas of these countries and pressure the search for care options in order to facilitate access, or at least, to improve public perception of accessibility to first-line services. Care options that are now being proposed, or will be in the next future, could tend to be based on the fragmentation of care since if it is not possible to give access to all those who feel they need immediate attention from a GP, it is predictable that services be offered for common specific problems that generate that demand (whether it is "real" or "felt"), that these services could be delivered in an episodic base, and even by non-medical professionals or technical personnel.

These possible immediate care options could become socially acceptable, based on the fact of unsatisfied needs and also that it is likely there will be always a part of the population that does not feel the need for a GP, although this is not a desirable situation for those of us who believe in the advantages of achieving universal access to family doctors as a first-line service. Whatever the political and administrative decisions that are made, we believe that an increased tendency to fragmentation of first-line personal and family health care is foreseeable and, as a consequence, also a risk to care continuity and comprehensiveness, so valuable principles for family medicine/general practice movement.

How to protect those principles? Although this is a question whose answer will depend on each country's specific characteristics, problems, and health system, we believe that caring for and strengthening the identity of family medicine/general practice as a discipline will be an essential strategic line in all cases. Among others, care comprehensiveness, and continuity are central and indispensable elements of this unique identity. Nowadays, in times of pressure and change, it‘s about strengthening our discipline (specialty) as the practice model to lead, both in practice and academic realms, the activity of first-line health care.

Our book “Practicing Comprehensive Family Medicine. Fundamentals, Tools and Cases” is designed to contribute to the continuous creation and strengthening of that distinctive identity. In this text teachers, doctors, and students will find, through the interaction between examples of practice and relevant theoretical elements, a practical way of looking at the unique identity of family medicine/general practice and becoming associated with it. We invite you to read and use it as a reference or educational book, confident that you will find it interesting and useful.

How to get it? It is accessible globally through Amazon stores in printed and digital book versions. The latter, being immediately delivered and free of shipping costs, also has a remarkably affordable price. Should you prefer to obtain it in Spanish, you can also order it on Amazon, under the title “Integralidad en Acción. Fundamentos y Herramientas de la Medicina Familiar”:

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