Indus College of Family Medicine and Public Health, Indus Hospital and Health Network, Pakistan.
Faculty of Medical Sciences, University College London, London, UK.
Educ Prim Care. 2023 Sep-Nov;34(5-6):240-243. doi: 10.1080/14739879.2023.2204340. Epub 2023 May 9.
A high-performing, integrated, primary healthcare system is essential to achieve universal health coverage (UHC) goals and improve health indicators. There is enough evidence that healthcare is cost-effective with significantly better outcomes in countries where primary care is delivered through trained family physicians. The concept of "Family Practice approach" is relatively new in developing countries like Pakistan, where majority of basic healthcare is provided by doctors without a formal postgraduate training. The intention to adopt this approach in primary care has increased in recent years in an effort to attain UHC, yet implementation requires a paradigm shift with intervention at multiple levels. There is an opportunity to learn from better developed primary care models for example in UK and Australia to develop a pragmatic and collaborative approach to develop the specialty of family medicine in primary care. This calls for academic interventions at multiple levels, such as mandating family medicine inclusion in undergraduate medical curricula, and ensuring quality of postgraduate training by investment in developing primary care sites for training, curricula, assessment, and quality assurance structures. Encouraging medical students and general practitioners to pursue a post graduate qualification in family medicine would also require promoting family medicine as a worthwhile career and developing a higher esteem for qualified family physicians than the conventional GPs in public and private sector healthcare institutions. These interventions would help evolution of locally grounded solutions to improve the quality of primary care, hence the health outcomes of the larger population of Pakistan.
一个表现出色、综合、基本医疗体系是实现全民健康覆盖（UHC）目标和改善健康指标的关键。有足够的证据表明，在通过经过培训的家庭医生提供初级保健的国家，医疗保健具有成本效益，并且在结果方面显著更好。“家庭实践方法”的概念在像巴基斯坦这样的发展中国家相对较新，在这些国家，大多数基本医疗保健是由没有接受过正规研究生培训的医生提供的。近年来，人们越来越倾向于在初级保健中采用这种方法，以实现全民健康覆盖，但实施需要在多个层面上进行范式转变。我们有机会从英国和澳大利亚等发展较好的初级保健模式中学习，以务实和协作的方式发展初级保健中的家庭医学专业。这需要在多个层面上进行学术干预，例如要求在本科医学课程中纳入家庭医学，以及通过投资于培训、课程、评估和质量保证结构的初级保健站点来确保研究生培训的质量。鼓励医学生和全科医生攻读家庭医学研究生资格，也需要将家庭医学作为一项有价值的职业来推广，并在公共和私营部门医疗机构中对合格的家庭医生给予比传统全科医生更高的尊重。这些干预措施将有助于制定出适合当地的解决方案，以提高初级保健的质量，从而改善巴基斯坦更多民众的健康结果。
