Family Medicine crisis?
International Ambassador Association Health Care Professionals
EURACT Director of Communications
Currently we are experiencing a drive to replace the doctor – patient relationship where the focus is on emphatic values and personalization of care, with a concept that sharing clinical information through informatic instruments could replace the informal and intimate patient – family doctor relationship.
A case in point is the importance given to the technical, standardized and codified elements in our work, which is distracting us from adequately listening to the patient and treating him/her wholistically. It is well known how the International Classification of Diseases (ICD) codification in its various editions is inadequate within the family medicine’s dimension, where we often treat symptoms without actually having a clear diagnosis where frequently time itself is of diagnostic help, during which we prescribe provisional or symptomatic treatments (at times to contain incertainty), or we try to exclude less probable diagnostic possibilities.
It is one matter to hand prescriptions directly to patients who are free to use them as they consider best for them, however it is another matter to transfer such sensitive data to third parties, not related to the therapeutic – assistance relationship. Clearly, consensus by the patient on such data transfer is crucial.
In order to ensure the support of our healthcare systems we will also be shortly experiencing increased pressures to decrease interventions which are not fully supported by scientific evidence. However, interventions supported by studies rarely refer to populations as we meet in the common daily clinic practice since they are conducted in selected groups, free from the co-morbidity’s complexity.
In fact if we read carefully several recent scientific papers, we can see that in the family medicine’s setting, mainly when concerning chronic social pathologies, it is rare to find interventions with convincing evidence on relevant clinic endpoints.
By reducing the access to family medicine and by eliminating the doctor – patient relationship, we will thus be worsening efficiency and increasing beaurocracy leading to a decrease in equity in healthcare provision.