Is the traditional family doctor an anachronism?

Wong, Geoff; Bentzen, Niels; Lie-jun, Wang

doi:10.1080/17571472.2008.11493219

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Experience from developed countries (especially the U.S. and the UK) where primary care is provided mainly by family doctors or general practitioners with standardized postgraduate training is encouraging [ 17 , 18 , 19 , 20 ]. For people with regular family doctors, primary care is most effective in gate-keeping secondary care [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Zhao

Lin

Qiu

et al. 2017

IJERPH

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This study aims to examine whether the urban elderly in the Zhejiang Province of China signed contracts with their general practitioner (GP) based on their health service needs, and to further identify the determinants of their demand and signing decisions. A community-based cross-sectional study was conducted in 16 community health service (CHS) institutions in Zhejiang Province, China. The urban elderly over 60 years of age were enrolled when visiting the sampled CHS. Baseline characteristics were compared between participants using Chi-Square tests for categorical variables. Univariate and multivariable logistic regression analyses were used to identify determinants of the GP contract service demand and signing decisions, respectively. Among the 1440 urban elderly, 56.67% had signed contracts with their GP, and 55.35% had a demand of the GP contract service. The influencing factors of demand were a history of diabetes or cardiovascular disease (OR = 1.33, 95% CI, 1.05–1.68); urban resident basic medical insurance (URBMI) vs. urban employee basic medical insurance (UEBMI) (OR = 1.96, 95% CI, 1.46–2.61); and middle-income vs. low-income (OR = 0.67, 95% CI, 0.50–0.90 for RMB 1001–3000; OR = 0.59, 95% CI, 0.39–0.90 for RMB 3001–5000). Having a demand for the GP contract service was the strongest determinant of signing decisions (OR = 13.20, 95% CI, 10.09–17.27). Other factors also contributed to these decisions, including gender, caregiver, and income. The urban elderly who had signed contracts with GPs were mainly based on their health care needs. Elderly people with a history of diabetes or cardiovascular disease, as well as those with URBMI, were found to have stronger needs of a GP contract service. It is believed that the high-income elderly should be given equal priority to those of low-income.

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Section: Discussionmentioning

confidence: 99%

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Zhao

Lin

Qiu

et al. 2017

IJERPH

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“…In the healthcare system, when a family physician coordinates medical services and controls a patient's referral to specialists as required, costs of healthcare are reduced [4][5][6]. Studies demonstrate that continuous medical supervision with family physicians reduces usage of expensive medical services, and, particularly, the need for in-patient treatment is reduced by 35%, and the need for emergency services is reduced by 50% [7].…”

Section: Introductionmentioning

confidence: 99%

The Gatekeeper Model: patient’s view on the role of the family physician

ვერულავა¹,

Dangadze²,

Jorbenadze³

et al. 2020

fmpcr

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Background. An adequate primary healthcare system substantially determines the quality of health of the population and effective spending of healthcare resources. The family physician, serving as a 'gatekeeper', can make judicious decisions about the appropriate use of medical services. Objectives. The goal of this study was to find out patients' characteristics, preferences and behaviour in regard to the role of the family physician as a gatekeeper in the Republic of Georgia. Material and methods. As part of a cross-sectional quantitative study, respondents were interviewed using a structured questionnaire. Results. A majority of the respondents (53.7%, n = 245) had a permanent family physician, but were not satisfied with the level of the family physician's professionalism (56.6%, n = 258) and preferred self-referral to specialists (55%, n = 253). Only 19.5% (n = 89) referred to specialists upon the family physician's advice, who would coordinate all services, and 23% (n = 103) have used both family physicians and self-referral. Private health insurance companies were more interested in implementing cost reducing mechanisms rather than the Social Service Agency (which is responsible for the Universal Health Care Programme). Conclusions. It is appropriate to share private health insurance experiences for developing the model of a gatekeeper in the UHCP. In order to improve a family physician institute and increase confidence in it, it is recommended to raise the level of family physicians' skills in their relations with patients, as this has a significant effect on patient preferences. It is advisable to develop a flexible and voluntary gatekeeper model which will better suit the needs of both patients and physicians.

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Mental health literacy as a barrier and facilitator for service use: Qualitative inquiry among Palestinian Bedouins in Israel

Abo-Rass,

Abu-Kaf,

Nakash

et al. 2024

Int J Soc Psychiatry

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Background: Mental health literacy (MHL) has been related to health behaviors and outcomes. However, studies examining MHL as a barrier and facilitator to service use are limited, especially among minority groups. Aims: This study examined MHL as a barrier and facilitator to mental health service use among the Palestinian Bedouin minority in Israel. Methods: Twenty-five Bedouins (15 women) from southern Israel participated in semi-structured, in-depth interviews. The participants were recruited by publishing an ad on social media about the study, then through a snowball technique. The data were analyzed thematically using ATLAS.ti.9, and the intercoder reliability was 92%. Results: We identified four major themes in the interviews: (1) MHL as a barrier to service use, due to lack of knowledge about professionals in the field, mental health services, or reasons and risk factors for mental health problems; (2) traditional attitudes that acted as barriers to service use, including a preference for informal treatment, a lack of faith in mental health treatment, aversion to discussing private feelings, and the perception that mental health is a luxury; (3) MHL as a facilitator to service use by enabling accurate identification of mental distress and suggesting practical avenues for seeking help; and (4) ways to improve MHL that should be culturally sensitive and under the government agencies’ responsibility. Conclusions: Interventions aimed at increasing the use of mental health services among Bedouins and reducing racial/ethnic disparities should increase knowledge in culturally adapted ways, especially regarding professionals and services, and change negative attitudes such as mental health treatment as ineffective or bonus.

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Is the traditional family doctor an anachronism?

Cited by 3 publications

References 31 publications

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

Demand and Signing of General Practitioner Contract Service among the Urban Elderly: A Population-Based Analysis in Zhejiang Province, China

The Gatekeeper Model: patient’s view on the role of the family physician

Mental health literacy as a barrier and facilitator for service use: Qualitative inquiry among Palestinian Bedouins in Israel

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