general-practitioner relationship for more than 15 years need about �0 per cent less after-hours care or hospital admissions and experience approximately 25 per cent less mortality compared to those who had a regular general practitioner for just one year .
Having access to family medicine provides four ingredients essential to good care� continuity , access , comprehensiveness and co-ordination .
While other specializations concentrate on narrower aspects of medicine , family physicians specialize in comprehensive medicine , and engage with patients directly over time . Family doctors know how to manage a huge range of symptoms and conditions across the span of a lifetime .
In fact , a recent study in the �nited States rated family medicine as the most complex of all medical specialties , requiring the highest degree of �udgement and integrated knowledge .
The work , while challenging , is valuable and makes the rest of the health-care system more e�cient .
Having a person or a team get to know your story over time is incredibly powerful . When I see patients I�ve known for a long time , we can get a lot done quickly . They tell me what�s worrying them , and together we can decide quickly if a familiar issue calls simply for assurance and encouragement , or whether something has changed and needs addressing .
We make these decisions based on symptoms and past medical history — factoring in elements such as stress , family situations , grief and expectations for health . Because patients know and trust me , I can tell them , “ I think �Y� is going on , but if you see these symptoms or changes in the next four weeks , I want to hear about it .”
That trust provides the opportunity to reassure and the chance to separate something benign from something worrisome , which in turn offers incredible e�ciency back to the system . Family physicians aren ’ t sending folks for long lists of unnecessary investigations , because we know our patients� stories .
Benefits for patients and the health system There is a belief in some circles that if we only shared one common medical record , every patient�s story would become available to all , resolving the issue of providing continuity .
But having one person or team look after a patient ’ s primary care and keeping a good history is not the same as having many people looking after that patient and adding to that record in many settings and situations .
Patients without a family doctor must try to access the health-care system by going to an ER or walkin clinic . That often means a long wait , only being able to address one issue at a time and possibly that the treatment they will be offered will resolve the immediate concern , but won�t necessarily address the root of the issue .
Further , those patients likely miss the chance to tell a chapter of their health story to someone who will remember if a similar issue comes up in the future . Family doctors are also experts in prevention . They know how to look for things that could become problematic down the line . Lack of access to family medicine puts people at greater risk of having diseases such as cancer go much longer without being diagnosed or treated .
Finally , as anyone with a loved one dependent on help for the essential activities of daily life can tell you , co-ordinating care is a critical and effective function of family medicine .
Whether it ’ s referring patients to resources or specialized help or orchestrating something as personal and impactful as the choice to die at home , family doctors are experts in translating your health story into plans to assemble and oversee your broader health-care team .
The return on investment in a strong primary care foundation is an increase in the average lifespan , a greater sense of health overall and a reduction in costs in all other parts of the system . The lack of family physicians is a problem worth solving . n
Having access to family medicine provides four ingredients essential to good care : continuity , access , comprehensiveness and co-ordination .
GlobalHealthAsiaPacific . com FEBRUARY-MARCH 2020
69