1. Family Medicine Dr Paul T Francis, MD Community Medicine
College of Medicine, Zawia

2. Contents History of Family Medicine Importance of Family Medicine
Principles of Family Medicine
Approach to patients
Genogram

3. History
In olden days when somebody became sick he would first take ‘medical’ help from family, then other experienced people and finally from physicians
Number of Physicians were very few

4. 19th century Medical practice was mainly ‘Family medicine’
The doctor treated all medical problems – Medicine, Surgery, Gynecology, Pediatrics etc. of a family

5. 20th Century There was rapid rise in specialization
Physicians became specialists in different branches of medicine
The Family doctor became General Practitioner whose role became less important compared to the specialists

6. Need for Family Medicine
Specialists treated the disease
There was no ‘doctor’ to take care of the patient
There was a demand to have a good general physicians who would take care of the basic needs of a patient
This led to the development of a new branch – Family Medicine

7. What do Family Physicians do?
Family physicians provide comprehensive and continuous primary care health care to:
individuals and families
women and men regardless of age or disease
infants, children and adolescents regardless of disease

8. Family Physicians provide
Prevention & management of acute injuries and illnesses
Health promotion
Hospital care for acute medical illnesses
Chronic disease management

9. Family Physicians provide
Maternity care
Well-child care and child development
Primary mental health care
Rehabilitation
Supportive and end-of-life care

10. Important characteristics of Family Medicine
Deep understanding of the whole person
Act as a partner to patients over many years
Ability to ‘humanize’ health care
Ability to manage complex medical problems in the family setting

11. Practice of Family Medicine
Considers all influences on a person’s health
Knows and understands patient’s limitations, problems and personal beliefs when deciding on a treatment
Proposes therapies and interventions taking into light the above knowledge

12. Influence of Family Physician over the patient
Serves as a partner with patients to maintain well-being over time
Empowers patient with information and guidance that are needed to maintain health over time
Provides care that includes long-term behavioral change interventions that lead to better health

13. Type of cases seen by a Family Physician

14. Approach of Family Physician
Family Physician deals with all age groups from infant to elderly
The approach to the patient will depend on the age of the patient
Family physician also deals with the whole patient and not just the medical problem for which the patient comes

15. Some important roles of Family Physician for patients - 0-19 years
Observe parenting for poor limits or overprotection
Focus on the whole family when making recommendations
Give gentle guidance over multiple visits

16. 2-3 years
Help parents appreciate progress and accepts setbacks in growth and development
E.g. Toilet training
Encourage and support the parents

17. 2-5 years
Help parents if they are uncomfortable dealing with the sexual concerns of children

18. 6-12 years Reinforce the variations of normal development
Set a model for parents by addressing children as independent, intelligent people even at a very young age

19. 13-19 years
Distinguish sometimes normal development and aberrant behavior
Remind parents of their considerable (if unappreciated) influence; adolescents still need parenting
Always listen and try to understand

20. Genogram Genogram is a graphic representation of the family structure
It also represents some of the medical conditions afflicting the patient
The genogram is constructed around a person called the “index” family member
A small arrow is placed near the symbol of the person to indicate ‘index’ member

21. Genogram Horizontal lines to connect married couples and siblings
Draw vertical lines to indicate different generation
The symbol of person is darkened to indicate death
Write the name, important dates and medical conditions near the symbol of the person
A circle can be drawn to include persons living together

22. Genogram - symbols Male Female Marriage Index member Pregnancy Divorce
Dead

23. Genogram of a female patient

24. Summary
Family Medicine has an important role in providing basic health care to all family members
Family physician treats the patient and not merely the disease as it happens in big hospitals
Family medicine takes into account the whole family when diagnosing and treating medical conditions