Albert Francis E. Domingo, MD

my flight of ideas

Family Practice

Posted on | June 3, 2006 | No Comments

(Part 3 of Stateside Healthcare: Art, Science, and Commerce?)

As one of the primary care fields, Family Practice (FP) has an important place in the healthcare delivery system. Its versatility of being able to diagnose and treat conditions classifiable under various specialties (seen during the elective rotation were cases falling under orthopedics, psychiatry, gynecology, internal medicine, pediatrics, ophthalmology, and minor surgery) gives it a role that allows patients to receive immediate care and not wait long for a specialist. In the event however that a condition proves to be beyond the training of the family practitioner, an educated referral is made, with the FP physician ordering preliminary diagnostics and administering basic treatment – easing the illness of the patient and the work that the specialist has to do.

There is of course the question of what differentiates a family practitioner from a general practitioner (GP). While a GP in essence has the same scope of patient age (from womb to tomb) with that of FP, the latter lays claim to post-graduate residency training of three years. Typically, the first year includes rotations in major medical disciplines with time for outpatient services; while the second and third years involve rotations in major specialty and subspecialty services and increased outpatient time . This gives FP practitioners familiarity with and experience on management of commonly encountered diseases, equipping them with the knowledge and skills to do primary care to patients of virtually any age. In underserved areas wherein certain specialties cannot be found, FP provides diagnosis and treatment (e.g. emergency appendectomy).

Alternative practices also abound for FP physicians. A 2001 essay in the American Academy of Family Physician (AAFP)’s publication Family Practice Management lists fourteen alternatives to the often construed outpatient practice style of the FP Physician: resort doctor, prison doctor, free-range physician , medical director, locum tenens , legislator, urgent care and emergency medicine, hospitalist , administrator, focused practices , public health and epidemiology, research, private business , and education. Considering individual practitioner variations, FP income on the average ranges from approximately US$ 140,000 to 163,000 (PHP 7.23 to 8.42 million, at US$1 = PHP51.65) per annum.

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