By Ebrahim Nouri Goushki

Family doctors: the heart of health care 

May 20, 2023 - 16:28

TEHRAN - Family physicians are often considered the heart of a nation's healthcare program for several reasons.

Long-term communication: Family physicians are often the first point of contact for the healthy and sick community seeking health care. 

They provide continuous and comprehensive care to healthy and ill people throughout their lives and build long-term relationships with them. 

This allows doctors to understand the medical history, lifestyle, and social conditions of the community under their care and provide them with personalized care and support.

Holistic approach: Considering the physical health of the covered community, family doctors not only have a holistic approach to health care but also consider the improvement of her emotional, social, and psychological relationships. 
They focus on preventive care, screening, and early detection of diseases to help patients maintain health and prevent chronic diseases.

Care Coordination: Family physicians serve as the central point of coordination for the health care needs of the community. 

They work with other healthcare providers, such as specialists and hospitals, to ensure that people receive the best possible care and avoid duplication of services.

Advocacy and education: Family physicians are advocates for their communities, helping them navigate the health care system and access the resources they need. 

They also educate patients about their health, including how to manage chronic disease conditions, make healthy lifestyle choices, and prevent disease.

Family doctors play an important role in improving the health and well-being of individuals and communities. 

Their dedication, compassion, and expertise make them the heart of healthcare and a trusted source of support for patients and families.

Family doctors have always been the backbone of health care. Family doctors have always been a platform for comprehensive, compassionate, and people-oriented care.

Family doctors have a unique perspective on patients' health challenges and can provide comprehensive care, playing a major role in this axis towards primary health care.

We believe that the focus should be on preventive health care and social care, and better use should be made of existing human resources, especially family doctors, in the field of care and prevention.

The humanization of primary care means that family physicians (they go by many names: general practitioners, family doctors, primary consultants) should be more involved in prevention and health care and not just work as supervisors and gateways to secondary services.

Governments should be responsible for coordinating health care because it is part of the health care infrastructure in their countries. Governments are also well placed to facilitate the necessary cooperation between different interest groups by advocating effective policies. 

There is a clear need for "human-centered" designs across the spectrum of healthcare (including new technologies). This is critical because it can help optimize the patient experience.

Currently, in several countries and regions of the world, sufficient leverage has been provided to move toward these goals. 

Patient communities must guide the discussion around awareness and understanding of the importance of the existing social contract and its potential changes. 

All stakeholders are urged to consistently respect and apply these frameworks for a humane approach to health care, and more than any other group of health care providers, family physicians play a uniquely pivotal role as stewards of the system. 

They have public health care, although there are limitations in the health care system, including the inability to focus on eliminating health disparities and timely provision of financial resources as the main drivers of power in health care.

In any case, family physicians provide primary and continuing care for the entire family in communities, addressing physical, mental, and social problems and coordinating the full range of healthcare services with other professionals.

In Iran, more than 38 years have passed since the successful implementation of the network expansion plan in accordance with the principles of PHC in the villages, which has been the reason for the pride of the health system of the Islamic Republic of Iran in all corners of the world.

Since 2005, by maintaining the same structure, free insurance plans for villagers with family doctor plans and referral systems in rural, nomadic areas and cities with less than 20,000 people, provided the means to improve the health of more villagers.

According to many national and international experts, relying on the same principles by removing the weaknesses of its program on the one hand and the not-so-satisfactory success of the people and service providers in providing the 02 urban version in Fars and Mazandaran which made the fundamental changes in health promotion, our expert team, on the other hand, decided to consider the weaknesses of the existing packages (rural and urban) to implement a model of family medicine program and referral system with a team-oriented approach as it happened in the country's rural networks. Let's implement the whole country, both rural and urban, with almost the same conditions.

The strategic principles that we follow in this model are:

1- Changing the approach from a family-centered caring family doctor to a community-centered caring family medical team, which will perform their comprehensive duties under the responsibility and management of the family physician of the comprehensive health service centers and the neighborhood health care physicians.

2- Maintaining the structure of the existing healthcare networks and the existing forces and creating a new infrastructure similar to the healthcare house (neighborhood care house) in the cities, which will provide services actively with the same model as the village.

3- Using the capacity of private sector doctors as co-workers of family doctors (not family doctors) who will help family doctors in treating patients.

4- Level one to two referral system (general to a specialist) is done freely by any general practitioner anywhere in Iran.

5- The health information technology management system in the family medicine program and the referral system will be flow-oriented, which will facilitate the implementation processes of this model around the electronic health record.

6- The central issue is the integration and comprehensiveness of health processes instead of the central organization.

Happy World Family Doctor Day to all family doctors in the world.