Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world (original) (raw)
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Family medicine, 2018
There is a limited evidentiary base on the development of family medicine in different contexts and countries. The lack of evidence impedes our ability to compare and characterize family medicine models and identify areas of success that have led to the effective provision of care. This paper offers a comparative compilation and analysis of the development of family medicine training programs in seven countries: Brazil, Canada, Ethiopia, Haiti, Indonesia, Kenya, and Mali. Using qualitative case studies, this paper examines the process of developing family medicine programs, including enabling strategies and barriers, and shared lessons. An appreciative inquiry framework and complex adaptive systems thinking inform our qualitative study. Committed partnerships, the contribution of champions, health policy, and adaptability were identified as key enablers in all seven case studies. The case studies further reveal that some enablers were more salient in certain contexts as compared to ...
Canadian family physician Medecin de famille canadien, 2016
To find a common global definition of family medicine. Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. Searching both definition of family medicine and history of family medicine yields a variety of defining features. Visiting family medicine training programs worldwide highlights this discrepancy. It is not an easy task to define family medicine-one of its key attributes is its adaptability to a local context, but this makes aggregation of data challenging. There is a lack of clarity ...
A global picture of family medicine: the view from a WONCA Storybooth
BMC Family Practice
Background: Family Medicine is a novel discipline in many countries, where the motivation for training and value added to communities is not well-described. Our purpose was to understand the reason behind the choice of Family Medicine as a profession, the impact of Family Medicine on communities, and Family Medicine's characterizing qualities, as perceived by family doctors around the world. Methods: One-question video interviews were conducted using an appreciative inquiry approach, with volunteer participants at the 2016 World Organization of Family Doctors conference in Rio de Janeiro. Qualitative data analysis applied the thematic, framework method. Results: 135 family doctors from 55 countries participated in this study. Three overarching themes emerged: 1) key attributes of Family Medicine, 2) core Family Medicine values and 3) shared traits of family doctors. Family Medicine attributes and values were the key expressed motivators to join Family Medicine as a profession and were also among expressed factors that contributed to the impact of Family Medicine globally. Major sub-themes included the principles of comprehensive care, holistic care, continuity of care, patient centeredness, and the patient-provider relationship. Participants emphasized the importance of universal care, human rights, social justice and health equity. Conclusion: Family doctors around the world shared stories about their profession, presenting a heterogeneous picture of global Family Medicine unified by its attributes and values. These stories may inspire and serve as positive examples for Family Medicine programs, prospective students, advocates and other stakeholders.
Family practice development around the world
Family …, 1996
practice development around the world. Family Practice 1996; 13: 351-356. There is a global need for family physicians to serve as cornerstones of comprehensive primary health care systems. In order to meet this need, it is necessary for each country to provide these physicians with a thorough education focused on the relevant health care problems of the population being served. taHng propmna lor bnty phytclam FIGURE 1 Slants of family practice training around the world. Countries with established famify medicine programmes:
Research in Family/General Practice is Essential for Improving Health Globally
The Annals of Family Medicine, 2004
D uring the last decade of the 20 th century, there has been an increased recognition by the World Health Organization of the importance of primary care in improving the health of populations, with the medical literature providing supporting evidence. Under the infl uence of this growing awareness, many developed and developing countries have bolstered the role of primary care in the organization and structure of their health care systems. 1-3 Numerous universities in these countries have increased the primary care focus and content of their educational programs to better address the primary care needs of the populations their graduates will serve. This increasing interest in the provision of primary health care clinical service and education, however, has not been accompanied by investment in research efforts. Primary care research is the missing link in the development of high-quality, evidence-based health care for populations. Awareness of the missed potential to benefi t the health of the world' s population led to the World Organization of Family Doctors (Wonca), supported by a number of other agencies (see sponsors list), to underwrite an invitational conference on the future of primary care research. Under the title Improving Health Globally: The Necessity of Family Medicine Research, 74 primary care experts from 34 countries
2015
OBJECTIVE To provide an overview of the main methodologic challenges to finding definitive evidence of the positive effects of family medicine and family medicine training on a global scale. COMPOSITION OF THE COMMITTEE In 2012, 2013, and 2014, the College of Family Physicians of Canada hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. METHODS We performed a scoping review to determine the methodologic obstacles to understanding the positive effects of family medicine globally. REPORT The main obstacle to evaluating family medicine globally is t...
Ciência & Saúde Coletiva
Since 2012, the Besrour Centre for Global Family Medicine at the College of Family Physician of Canada has brought together its partners from the Americas annually, to reflect on the evolution of Family Medicine on the continent since Alma-Ata, and to look forward to future challenges. Family doctors are but one element of a strong health system. Family Medicine provides key ingredients to respond to population health needs especially as countries move through the epidemiological transition to face larger burdens of chronic disease and multimorbidity. In this paper, we provide a high-level overview of the state of Family Medicine on the continent. We then analyze trends in the education of family physicians to face this changing landscape, including the emphasis on the leader role of future family physicians. Postgraduate programs in Family Medicine in the Americas are placing increasing emphasis on teaching collaborative care in view of creating truly interdisciplinary health teams...
Global Family Medicine: A 'UNIVERSAL' Mnemonic
In this essay, I borrow the idea of universal precautions from infection control and suggest that family physicians use a set of considerations, based on the mnemonic UNIVERSAL, to nurture cultural humility, enter a metaphoric " space-in-between " in cross-cultural encounters, and foster global fluency. These UNIVERSAL considerations I base on my experiences in global family medicine, attending to economically poor and socially marginalized patients in both international and domestic settings. They are informed by readings in transcultural psychiatry, medical anthropology, development studies, and primary care. I invite others involved in global family medicine to reflect on what they have learned along their own professional paths, so as to enhance their therapeutic abilities as global family physicians, wherever they may be. (J Am Board Fam Med 2017;30:104 –108.)