About what he does family doctor, Vesti.Medicine was told by Zhanna Valentinovna Dorosh, Ph.D., Associate Professor of the Department of Therapy and Family Medicine, Russian National Research Medical University named after. N.I. Pirogova, chief physician 2 clinical departments of the Medicine clinic.
Family doctor or doctor general practice provides medical care on an outpatient basis. This is a clinic, the primary link that a person who seeks medical help encounters. The main difference between a family doctor and a therapist is the amount of what he can do with his hands. Manipulation is within his competence.
If the therapist has two weapons - a phonendoscope and a tonometer, then the general practitioner has otoscopy, rhinoscopy, and laryngoscopy. That is, he can look at the ear, throat, nose, and can look at the fundus of the eye. He carries out some diagnostic minimum for narrow specialists. He can register and decipher an electrocardiogram, and, if we are talking about the outback, and not about large cities, he can do initial treatment of the wound and apply a plaster cast.
For a family doctor, there is a basic education - a medical institute or university, where everyone who graduates receives a diploma, it does not matter whether it is a general practitioner or a pediatrician. After this there should be either a residency in internal medicine or internal medicine, or pediatrics, or an internship if the education was received some time ago. Then the doctor can undergo primary retraining in the specialty “General medical practice(Family Medicine).” Another option is to go immediately after completing basic education at the institute to a residency in this specialty.
If we talk about how many family doctors there are in Russia now, this figure will be close to the number of therapists. There is a retraining program under which therapists who provide primary outpatient care in Moscow and surrounding regions are now being retrained and transferred to the positions of general practitioners and family doctors, depending on where they will work. This figure is constantly changing, the number of such specialists is growing.
The area assigned to the general practitioner is somewhat smaller than the area of the general practitioner. Depending on where the family doctor works, this is no more than 1800 attached. If we are talking about Moscow, then here the doctor does not see children, they remain under the supervision of pediatricians, so only adults are assigned to the general practitioner. The observation system remains the same as that of a local therapist. If the doctor is on vacation, then his place is taken by a part-time doctor who, during the vacation of your immediate supervisor, is responsible for what happens in his area.
The duration of leave for a family doctor is the same as for a general practitioner. The system for calling a family doctor to your home is also no different from the system for a local therapist. Home visits are carried out by the doctor on duty, not a therapist or general practitioner, who works on site and, if there is no operational need for this, he may not attend the call. If there is a need to visit a patient at home, then he can go on call during non-working hours after the end of the appointment.
This is a matter of competence of the general practitioner. You should always understand that the higher the level of professionalism of a family doctor, the less he will need consultations from other specialists. And only if highly professional questions arise, the patient will be referred to medical institution which provides specialized assistance.
For example, if a patient arterial hypertension or hypertension, then these nosological units can be treated by both cardiologists and therapists. There are practically no indications for a patient to be referred to a cardiologist with such a diagnosis. Good family doctor can carry out this level of examination and manipulation.
If the patient has, then at some stage when he needs surgery, of course, the general practitioner will send the patient to see a specialist. If the family doctor feels that he is unable to cope clinical situation, the treatment he carries out is ineffective, he can ask for help from a specialist, or send the patient for consultation. This right remains, and general practitioners exercise it.
If a family doctor looks at the fundus of the eye and sees pathology there, he is obliged to send the patient to a specialist. If a doctor sees a pathology during otoscopy, he is obliged to assess how critical it is for the patient. He will leave some patients under his supervision in accordance with his competence, and send some to a specialist.
The level of competence of a general practitioner is prescribed regulatory documents. These documents are in a state of constant development and are being discussed. They are directly related to what a doctor can do with his hands and see with his eyes.
The definition of "general practitioner" has a more common name - he is known as a family doctor. At its core, he is equivalent to a local therapist, who everyone has known since childhood. The difference between a general practitioner and a regular therapist is that he has a greater range of knowledge and capabilities.
A doctor of broad specialization has to deal with representatives of all ages, diagnose and treat all types of diseases: from neurological to surgical. The main task of a general practitioner is to protect the health of those families assigned to him in the service area and to provide primary medical care. This specialist has knowledge in all areas of medicine, including:
During initial appointment The doctor carefully studies the patient’s medical history and conducts a thorough diagnosis. After this, he works to reduce or eliminate the risk of developing pathologies to which the patient is prone. Early detection diseases is known to help many patients avoid more serious problems.
In addition to all kinds of colds and viral diseases A general practitioner is consulted and observed when:
Contact your general practitioner in Moscow if you experience:
May require:
Providing universal care to the population by family doctors has been practiced in Moscow for many centuries in a row. Back in the 18th century, such famous doctors as Yagelsky, Pogoretsky, Zybelin, Samoilovich fought epidemics. In the 19th century, Alexander I surrounded himself educated people and patronized the development of medicine. The capital of Russia in all centuries has been rich in famous medical practitioners and scientists, such as Botkin, Magnitsky, Uvarov and many others.
Global health care reform aims to improve overall service efficiency and ensure greater value for money in the delivery of services. Within the framework of this policy, local therapists are actively retraining as general practitioners. What is the difference between the categories “general practitioner” and traditionally accepted"local therapist"?
Retraining of specialists to provide general outpatient care allowed patients to take a more effective look at the whole issue of using the treatment capabilities of the relevant clinics and other medical institutions.
The key difference between a family doctor or general practitioner and a therapist who has dealt with this issue before is the possibility of behavior certain manipulations. This significantly expands the possibilities medical worker in comparison with those that were with the therapist.
At the therapist for a long time there were only two key tools. This is a phonendoscope and tonometer. Of course, this was up to the standards of more than fifty years ago, since there weren't even many other types of instruments available before.
However, modern medical care and the availability of compact and very powerful devices for a wide variety of testing and examination present completely new challenges. requirements for specialists. General practitioners successfully master rhinoscopy, otoscopy and laryngoscopy in high level. Now there is no need to go directly to the ENT specialist when your throat, ear or nose hurts.
There is no need to wait in two lines at once, first to see a therapist and then to an ENT specialist, since a general practitioner is able to examine these organs, make a decision and offer treatment for simple cases. Among other things, there is also the possibility analyze the fundus.
Of course, we are not talking about any narrow and deep professional research. However, a general practitioner has a diagnostic minimum, focused on identifying key aspects before referral to specialized specialists.
Such a specialist is able to record and decipher electrocardiogram data. In addition, the requirements for specialists who are located far from major cities and regional centers. Now such doctors are able to provide all stages primary processing wounds and even apply plaster.
Of course, such a wide range of capabilities required from a general practitioner also leads to increased demands on his education. There is a certain basic concept, for example ending medical institute or university.
IN in this case there is no particular difference what specialty the doctor received within specialized education. He can be either a therapist or a pediatrician. IN mandatory Afterwards, a residency must be completed in order to familiarize the future doctor with internal diseases and therapy. Pediatrics are also being explored.
If the education was received in the distant past, even an internship is necessary. After this, initial retraining is carried out in accordance with the specialty “general medical practice” or "family medicine". Of course, among specialists there is another option, for example, going to residency in a relevant specialty immediately after completing basic education.
Considering that all therapists who usually provided basic outpatient appointments will be qualified as family general practitioners, the number of new general practitioners in our country will gradually approach total number therapists now.
There is already an extremely extensive retraining program, which will provide the necessary knowledge to specialists so that they can fully implement the operations required of them.
Of course, the key features of a general practitioner lie precisely in his activities. It is worth noting that due to increased demands, reciprocal steps were taken towards doctors. As a result, GP sites are now reduced.
The maximum number of people assigned to a particular site cannot be more than 1800 people. It is worth noting that many systems remain quite familiar and understandable to experienced doctors. For example, the same surveillance system.
In case of vacation, the specialist is replaced by another doctor who works part-time during the absence of the site supervisor; he is responsible for everything that happens at the site. The duration of the vacation remains exactly the same as that of the therapist. In addition, a diagram is provided calling a specialist to your home. Home visits are carried out by a doctor on duty who is neither a therapist nor a general practitioner.
Today, one of the most sought-after professions in medicine is a general practitioner. Almost every rural resident knows who he is. The fact is that it is in villages that doctors of this specialty most often work.
The main difference between doctors of this specialty and others is that they have basic knowledge in each section of medicine. However, they are not required to provide specialized medical care.
They must be able to solve relatively simple health problems and engage in the prevention of therapeutic, surgical and gynecological diseases in both adults and children.
It is in villages that you can most often find such a specialist as a general practitioner. All the villagers know who he is. General practitioners are most widespread in this area due to the economic inefficiency of building full-fledged medical and preventive institutions in each locality and providing work for a large number of doctors there. From this point of view, it would be much more expedient to create small outpatient clinics staffed by a general practitioner (family doctor), nurse and a nurse. Such a recruitment of employees will allow the outpatient clinic to carry out full-fledged medical care residents of the region attached to it.
For those remote from large centers, a general practitioner becomes a real salvation. All residents of agricultural regions know who this is, because it is to him that they go first of all. He is capable of performing the simplest surgical and gynecological manipulations, and is familiar with the therapeutic pathologies of both adults and children.
This specialist After graduating from a higher medical institution, he must undergo an internship at one or more clinics. He needs to gain skills in therapeutic, surgical, pediatric, and gynecological profiles. As a result of such training, he becomes a specialist with general skills in diagnosing and treating diseases of any medical field.
Prevention, diagnosis and treatment - all these are the main areas within which it conducts its professional activity GP. His work is based primarily on identifying among the population living in the area under his control the risks of developing certain serious illnesses, as well as systematic activities aimed at counteracting their formation.
The general practitioner's office should be equipped with a number of tools that help to carry out primary diagnosis. We are talking about a phonendoscope, tonometer, glucometer, thermometers, spatulas, laryngoscopes, otoscopes, rhinoscopes, ophthalmological and gynecological equipment. In addition, the general practitioner's outpatient clinic should have the simplest surgical instruments.
Ideally, the outpatient clinic can also be equipped with a mini-laboratory. It greatly simplifies the work of a general practitioner. Those specialists in this field who do not try to equip their outpatient clinics have to constantly refer patients to district medical institutions for carrying out simple laboratory research(complete blood count, general urine test, biochemical analysis blood and others).
The work of this specialist has of great importance for the entire population served. Thanks to him, medical care becomes noticeably closer to people. Simple surgical procedures are performed in outpatient clinics. In addition, all conditions have been created here for injection (including in the form of droppers) administration of drugs. There is always a small bed capacity here that allows patients to be placed in a hospital. That is, the patient can see a doctor and, if he deems it necessary, be treated without going to the hospital.
In large outpatient clinics, in addition to a regular specialist, a general dentist may also work.
If a person becomes very ill and cannot visit a doctor on his own, he has the opportunity to call him to his home. Moreover, most often a specialist of this profile attends such calls after lunch, and the appointment at the outpatient clinic is carried out before lunch.
Such institutions and the position of “general practitioner” (we have already found out who this is) were introduced not only to bring medical care closer to the population of rural areas. The fact is that it is also beneficial from an economic point of view. Firstly, there is no need to refer a therapist, gynecologist, surgeon, ophthalmologist, otorhinolaryngologist and others separately here. With everyone it's relative simple problems A general practitioner can handle it. Those who present more serious complaints, or whose health condition causes concern to this doctor, are sent to higher-level health care institutions.
Currently, a general practitioner (who is this, was described above) is not the most common, but at the same time very the required profession. This specialist is in demand in rural areas. At the same time, such a doctor saves the state significant funds, because in every locality it is not necessary to maintain a large healthcare institution in which he works large number doctors A general practitioner can handle many problems on his own. If the intervention of specialized specialists is required to combat a particular pathology, the patient will be referred to medical center the corresponding profile.
In the future, a general practitioner may be re-registered as a so-called family doctor. This specialist is a doctor who specializes in medical care several families. He knows each of his patients very well. A small number of them allows him to delve into the problems of all his charges as deeply as possible. Family doctors are very effective way preserve the health of the population, however, the activities of such specialists are possible only in conditions of a sufficiently developed economy. The fact is that the salary of such an employee will consist of contributions from his direct patients. So the family doctor, if we talk about the widespread activities of such specialists, remains a prospect for the future. In many European countries, the institute of family doctors has existed for quite a long time and has proven its effectiveness. At the same time, the basis of the activities of such specialists is prevention and early diagnosis any diseases.
In addition, the profession of a general practitioner himself is promising. Mobile complexes are now being created that can significantly expand the capabilities of a given doctor in the field of diagnosing certain diseases. We are talking about so-called specialized general practitioner cars. This complex includes a small laboratory, as well as a set for conducting the most important instrumental studies.
When visiting a clinic or any other institution, you will first be referred to a general family specialist.
This type of specialization is somewhat different from therapeutic. General practitioner examining development of diseases in more detail, and is able to independently diagnose and treat the patient.
Quite often, clients self-diagnose themselves, and when visiting the establishment, they already know the voucher to see which specialist they need to get. However, in most cases the client cannot accurately determine the pathology.
The point here is not only the lack of medical education, but also the lack of real practice. Disease – serious phenomenon, there’s no point in delaying it. Therefore, in order to correctly determine the initial diagnosis and choose the right specialist, you will still have to visit a family doctor.
During his student years, the future doctor researches general development all kinds of diseases. A specialist can conduct a consultation regardless of the gender and age of the person applying, which is why it is called family consultation.
Speaking about the functions of work, they contain different approach. The doctor can examine and conduct a course of therapy independently, or may refer you to more specialized specialists. Despite the fact that his duties include comprehensive inspection, treatment is carried out only for a certain number of disorders.
Referred to a family specialist during a medical examination. In this case, the examination only includes weighing, examination, and questions about the presence of certain ailments.
Despite the fact that a physician is trained in all types of pathologies, it is not always necessary to contact him. For example, if in case of bruises, fractures and other types of injuries, you should immediately visit a traumatologist without wasting time.
Although a specialist is considered general, his range of practice is not so wide. Let's consider first main obligations medic:
If we talk about when it is worth visiting a specialist, there are almost no exceptions. Many doctors advise you to be more attentive to the processes of your own body. It is inattention and irresponsibility that aggravates the situation.
When a patient consults a doctor because he can no longer tolerate headaches or pain internal organs, the problem needs to be solved already urgently. Unfortunately, the vast majority of clients are confident that in this way they save the family budget, but an advanced disease is much more expensive and difficult to eliminate.
You should contact a doctor when the occurrence of pain in any areas of the body, not excluding headaches, which are already considered normal. You should visit a doctor if you feel frequent, causeless fatigue or internal heaviness.
In addition, you should pay attention to memory problems, the occurrence of absent-mindedness, or the rapid onset of fatigue.
There are also other reasons to visit patient:
