Family Medicine Necessity but Still A Neglected Medical Specialty in Pakistan
Keywords:
Primary care, Family medicine, Importance, Quality health care, PakistanAbstract
Family Medicine is the primary care medical specialty concerned with provision of widespread health care to the person and the family irrespective of sex, age or kind of problem. It is the specialty of extensiveness that integrates the natural, medical and behavioral sciences. It is emerging as a frame of knowledge that is being constantly developed , explored and qualified as an integrative entity. In our country, this specialty was announced in late eighties. The number of qualified family medicine specialists is still alarmingly low in our society. There is also a lack of understanding in majority of our population regarding the existence as well as importance of Family Medicine. Rotation of students in family medicine facility as part of undergraduate medical curriculum may help in fostering an interest among medical students in this newly emerging subspecialty which could have profound effect on delivery of quality health care in Pakistan
References
Weisz G. The Emergence of Medical Specialization in the Nineteenth Century. Bull Hist Med 2003; 77 (3): 536–74 doi:10.1353/bhm.0150.PMID 14523260.
Ramanayake J. Historical Evolution and Present Status of Family Medicine in Sri Lanka Family Med Prim Care. 2013 Apr-Jun; 2(2): 131–4
McWhinney IA. Text book of Family Medicine. In: The origin of family medicine. Boorstin DJ, Flexner A, editors. 1st edition. New York. Oxford University Press; 1989. p. 9–10
Henderson E, Berlin A, Fuller J. Attitude of medical students towards general practice and general practitioners. Br J Gen Pract. 2002; 52(478):359–63
Tandeter H, Granek-Catarivas M. Choosing primary care? Influences of medical school curricula on career pathways. Isr Med Assoc J. 2001;3(12):969–72
Right B, Brenneis F, Brett-MacLean P, McCaffrey L. Why would I choose a career in family medicine? Reflections of medical students at 3 universities. Can Fam Physician. 2007;53(11):1956–7
US Department of Health and Human Services;1980. annual report
The Joint Committee on Postgraduate Training for General Practice. Training for general practice,1983
Phillips WR1, Haynes DG .The domain of family practice: scope, role, and function. Fam med. 2001 Apr;33(4):273-7
Aloysius DJ. The general practitioner in Sri Lanka. Sri Lankan Family Physician. 1985;24:119
Shah N , Ashraf H , Anwar F , Khan A , Akhtar H, Abro MA .Status of Postgraduate Training and Continuing Medical Education of Family Physicians in Pakistan. Pak J Med Sci January - March 2012; 28( 1): 4-8
Zuberi, R. W. Family medicine: a brief review of its history and concepts and its relevance to Pakistan. Journal of Pakistan Medical Association, 1993; 43(5): 102-6
Phillips RL, Starfield B. Editorial: Why does a U.S. primary care physician workforce crisis matter? American Family Physician 2003;15;68(8):1494-1500. Reprinted: American Family Physician 2004; 70(3): 440-6
Bindman AB, Grumbach K, Osmond D, Vranizan K, Stewart AL. Primary care and receipt of preventive services. J Gen Intern Med 1996;11:269-76.
Dietrich AJ, Goldberg H. Preventive content of adult primary care: do generalists and subspecialists differ? Am J Public Health 1984;74:223-7.
Bindman AB, Grumbach K, Osmond D, Komaromy M, Vranizan K, Luri N, et al. Preventable hospitalizations and access to health care. JAMA 1995; 274:305-11.
Wasson JH, Sauvigne AE, Mogielnicki RP, Frey WG, Sox CH, Gaudette C, et al. Continuity of outpatient medical care in elderly men. A randomized trial. JAMA 1984;252:2413-7.
Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970-1998. Health Serv Res 2003;38:831-65.
Ferrante JM, Gonzales EC, Pal N, Roetzheim RG. Effects of physician supply on early detection of breast cancer. J Am Board Fam Pract 2000;13:408-14.
Campbell RJ, Ramirez AM, Perez K, Roetzheim RG. Cervical cancer rates and the supply of primary care physicians in Florida. Fam Med 2003;35: 60-4.
Roetzheim RG, Gonzalez EC, Ramirez A, Campbell R, van Durme DJ. Primary care physician supply and colorectal cancer. J Fam Pract 2001;50:1027-31.
Greenfield S, Nelson EC, Zubkoff M, Manning W, Rogers W, Kravits RL, et al. Variations in resource utilization among medical specialties and systems of care. Results from the medical outcomes study. JAMA 1992;267:1624-30.
Shi L, Starfield B, Politzer R, Regan J. Primary care, self-rated health, and reductions in social disparities in health. Health Serv Res 2002;37:529-50.
Lohr KN, Brook RH, Kamberg CJ, Goldberg GA, Leibowitz A, Keesey J, et al. Use of medical care in the Rand Health Insurance Experiment. Diagnosis- and service-specific analyses in a randomized controlled trial. Med Care 1986;24(suppl 9):S1-87.
Shi L, Starfield B. The effect of primary care physician supply and income inequality on mortality among blacks and whites in U.S. metropolitan areas. Am J Public Health 2001;91:1246-50.
Forrest CB, Starfield B. The effect of first-contact care with primary care clinicians on ambulatory health care expenditures. J FamPract. 1996 Jul;43(1):40-8..
Rosser WW, Approach to diagnosis by primary care clinicians and specialists: is there a difference?. Fam Pract. 1996; 42(2):139-44
Green LA, Fryer GEJ, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med 2001; 344:2021-5
Shahid M, Razzak J, Jamali S, Ali SS, Ayubi TK. Initial diagnostic categories of patients presenting to four major emergency departments in Karachi. J Coll Physicians Surg Pak 2006; 16:680 -1.
Starfield B. Primary Care: Balancing Health Needs, Services and Technology. Rev. ed. New York, NY: Oxford University Press; 1998.
Karunarathna LA. General practice as a specialty in Sri Lanka. Sri Lankan Fam Physician. 1986;9:19–25
Broemeling A, Watson D, Prebtani F: Population patterns of chronic health conditions, co-morbidity and healthcare use in Canada: implication for policy and practices.HealthcareQuaterly 2008;11:70-6.
Starfield B, Lemke KW, Bernhardt T, Foldes SS, Forrest CB, Weiner JP: Comorbidity: implications for the importance of primary care in ‘case’ management. Ann Fam Med 2003; 1(1):8-14.
Bindman AB, Grumbach K, Osmond D, Komaromy M, Vranizan K, Luri N, et al. Preventable hospitalizations and access to health care. JAMA 1995; 274:305-11.
Dikici MF, Yaris F, Topsever P, Filiz TM, Gurel S, Cubuku M, etal. Factors affecting choice of specialty among first year medicalstudents of four universities in different regions of Turkey. Croat Med J 2008;49:415–20.
Mariolis A, Mihas C, Alevizos A, Gizlis V, Mariolis T, Marayiannis K, et al. General practice as a career choice among undergraduate medical students in Greece. BMC Medical Education 2007;7:15
Pugno PA, Schmittling GT, McGaha AL, Kahn NB. Jr. Entry of US medical school graduates into family medicine residencies: 2005–2006 and 3-year summary. Fam Med. 2006;38(9):626–36.
Huda N, Yousuf S. Career preference of final year medical students of Ziauddin Medical University. Educ Health (Abingdon) 2006; 19: 345-53.
Khader Y, Al-Zoubi D, Amarin Z, Alkafagei A, Khasawneh M, Burgan S, et al. Factors affecting medical students in formulating their specialty preferences in Jordan. BMC Med Educ2008;8:32.
Syed EU, Siddiqi MN, Dogar I, Hamrani MM, Yousafzai AW, Zuberi S. Attitudes of Pakistani medical students towards psychiatry as a prospective career: a survey. Acad Psychiatry 2008; 32: 160-4.
Apker J, Eggly S. Communicating professional identity in medical socialization: considering the ideological discourse of morning report. Qual Health Res 2004; 14: 411-29.
Bickel J, Ruffin A. Gender-associated differences in matriculating and graduating medical students. Acad Med 1995; 70: 552–9
Bowman M, Haynes RA, Rivo ML, Killian CD, Davis H. Characteristics of medical students by level of interest in primary care. Fam Med 1996; 28: 713–9.
Xu G, Veloski JJ, Barzansky B. Comparisons between older and usual-aged medical school graduates on the factors influencing their choices of primary care specialties. Acad Med 1997; 72:1003–7.
Kassebaum DG, Szenas PL, Schuchert MK. Determinants of the generalist career intentions of 1995 graduating medical students. Acad Med 1996; 71: 197–209.
Senf JH, Campos-Outcalt D, Watkins AJ, Bastacky S, Killian C. A systematic analysis of how medical school characteristics relate to graduates’ choices of primary care specialties. Acad Med1997; 72: 524–74
Grayson MS, Newton DA, Whitley TW. First-year medical students’ knowledge of and attitudes toward primary care careers. Fam Med 1996; 28: 337–42.
Colquitt WL, Zeh MC, Killian CD, Cultice JM. Effect of debt on U. S. medical school graduates’ preferences for family medicine, general internal medicine, and general pediatrics. Acad Med1996; 71: 399–411.
Schafer S, Shore W, French L, Tovar J, Hughes S, Hearst N. Rejecting family practice: why medical students switch to other specialties. Fam Med 2000; 32: 320–5.
Xu G, Hojat M, Brigham TP, Veloski JJ. Factors associated with changing levels of interest in primary care during medical school. Acad Med 1999; 74: 1011–5.
Bowman M, Haynes RA, Rivo ML, Killian CD, Davis H. Characteristics of medical students by level of interest in primary care. Fam Med 1996; 28: 713–9
Campos-Outcalt D, Senf J. A longitudinal, national study of the effect of implementing a required third-year family practice clerkship or a department of family medicine on the selection of family medicine by medical students. Acad Med 1999; 74: 1016–20.
Bauer RL, Venkatachalam HM, Forrester RH, Harris GD, Diehl AK The effect of an ambulatory internal medicine rotation on students’ career choices. Acad Med 1997; 72: 147–9.
Xu G, Hojat M, Brigham TP, Veloski JJ. Factors associated with changing levels of interest in primary care during medical school. Acad Med 1999; 74: 1011–5.
Saima P. Iqbal. Family medicine in undergraduate medical curriculum: a cost-effective approach to health care in Pakistan. J Ayub Med Coll Abbottabad 2010;22(4):207-9
Jafarey NA. Changing role of medical college teachers. J Pak Med Assoc 2006;56:297–8.
Biggs J. Postgraduate Medical Training in Pakistan: Observations and recommendations. J Coll Physicians Surg Pak 2008;18(1):58–63.
Number of doctors/Dental surgeons Available from URL:http://www.pmdc.org.pk/Statistics/tabid/103/Default.aspx Accessed Nov 28th 2010.
Jafar TH, Jessani S, Jafary FH, Ishaq M, Orakzai R, Orakzai S, etal. General practitioners’ approach to hypertension in Pakistan: disturbing trend in practice. Circulation 2005;111:1278–83
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Farheen Navaid, Tahira Zamir
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0