A visionary approach towards Primary Care in Europe

Karen Pisconte, Stefan Morreel, Bjarte Sorensen, Krystyna Kochanowicz, Zuzana Vaneckova, Anna Klimiuk, Florian Stigler, Matthew Baines

Discussion

• Personal Vision of Practice within next 5 years• Vision of ideal Practice

Personal Vision of Practice within next 5 years

• Work as an employed GP• Work in own GP-practice• Become a good GP• Master in Public Health• Engage in Politics

Vision of ideal Practice

• Easily accessible• First point of contact for medical/ psychological / social

problems• Holistic approach to patients care• Preventing somatisation and overdiagnosis• Multidisciplinary• Good link to community-based services• No money issues between patient and GP

The framerwork• 3 levels • Patient/Community• Disease• Politics and Economy

• For each level• Vision• Facilitators• Barriers• Ideas

Patient / Community • Facilitate education with GPs leading • Health-check-ups (if evidence-based)

• barriers• community work is poorly funded• not enough evidence and cost-effectiveness for check-ups• GP training lacks multidisciplinary approach• GP not used to facilitate to networks• In some countries low image of GPs

Patient / Community• Facilitators • GPs have a central role within the community• multidisciplinary approach• High trust from patients

• Ideas• GP-based educational lessons• Research on evidence of screening programs• Increase funding for community work• Health awareness programs

Disease• Barriers• Financial interests of specialists

• Ideas• Better and more comprehensive training• Financial incentives for “regained” patients

Politics / Economy / System• Vision• Focus on PHC• Direct involvement in budget control / prioritization• Transparency

• Facilitators• Economic incentives• Legislation

Politics / Economy / System• Barriers• Legislation• Resistance of specialists• Lack of knowledge concerning PHC benefits• Shortage of workforce

• Ideas• PHC “Branding”• Training in all GP practices• Increasing attractivity of being a GP (salary, working hours, career

opportunities, …)• Increase transparency

Disease• Vision• Common diseases treated by GPs• Rare diseases managed by GPs, treated by specialists• Regaining “lost”patients

• Facilitators• Accessibility• Longterm relationship with patients• Space and equipment available• Approach on multimorbidity

“Be nice but be strong“