What is Family Medicine?

Family medicine is the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioural sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity. (American College of Family Physicians 2005)

Scope of Family Medicine

For thousands of years, doctors as generalists, provided all of the medical care available. They diagnosed and treated illnesses, performed surgery, and delivered babies. With the advances in medical science and technology, and an even expending medical knowledge, many physicians chose to limit their practices to specific, defined areas of medicine – specialisation.

After World War, the number of specialists and subspecialists in many Western countries increased at a phenomenal rate, while the number of generalists declined dramatically. There was an increasing public concern about the fragmentation of personalised health care and the shortage of personal physicians who could provide initial, continuing and comprehensive care. This started the development of family medicine or general practice as a specialty in USA, Canada, United Kingdom, Australia and throughout the world. The concept of the generalist was reborn with the establishment of family medicine/general practice as an unique medical specialty.

Family medicine is a three-dimensional specialty, incorporating (1) knowledge, (2) skill and (3) process. Although knowledge and skill may be shared with other specialties, the family medicine process is unique. At the centre of this process is the patient-physician relationship with the patient viewed in the context of the family and their social surrounding. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family medicine from all other specialties which may be restricted by age (eg.geriatrics, paediatrics), sex (eg. Obstetrics & Gynaecology), organ system (eg. cardiology, neurology) or diseases (eg. Infectious disease).

Primary Health Care Coordinator

In the dimension of process, the family physician functions as the patient's means of entry into the health care system and providing navigation within the complex health care system. Family physicians, as the first contact in most situations, are specifically trained to deal with non-specific, undifferentiated symptoms, signs or health concerns. The family physician's care is both personal and comprehensive and covers biological, psychological, behavioural and social aspects. This care is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention (eg. vaccination), health promotion and health maintenance (eg. health screening), counselling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g. office, inpatient, critical care, long-term care, home care, day care, etc)

Family physicians often collaborate with other health professionals and utilize different skills from various health care providers to optimise the health outcome of their patients. When referral is required, the family physician refers the patient to other specialists or caregivers but remains the coordinator of the patient’s health care. This prevents fragmentation of care in both the outpatient and inpatient settings. The family physician serves as the patient’s advocate in dealing with other medical professionals, third party payers (insurer), employers and others. Competent family physician act as a cost-effective coordinator of the patient’s health care needs.

It is important for every individual to have a caring, competent and compassionate family physician whom you can develop a long term, trusting doctor-patient relationship with. You should be able to communicate with your family doctor your physical, psychological, behavioural and social problems.