National health system steps in Turkey: concerns of family physician residents in Turkey regarding the proposed national family physician system.
ABSTRACT Many countries are currently struggling with the public desire for improved health care and provision of basic services on the one hand, and the rising costs of health care on the other. Turkey is acutely experiencing this problem because of its relatively advanced level of economic development and its relatively low level of health status compared to Organization for Economic Cooperation and Development and European Union countries. Since 1990, there has been vigorous debate in the Turkish society regarding the best way to improve public health through improved primary health care. The current government is pursuing a proposal that has been mentioned before, but in a more serious effort than has been previously made. This is an approach to primary care based on systems such as those in the United Kingdom and in Germany, and the basic components are family physicians who have a particular list of patients whom they provide care for. Financing of the system is to be provided with a new general health insurance scheme. In this study, 38 family practice residents at the 3 major training hospitals for this specialty completed an investigator-designed questionnaire for the purpose of characterizing their concerns regarding this proposed system of primary health care delivery. The participants' responses indicated that the new system, which is known as the Family Physician System, will contribute importantly toward raising the overall level of health in Turkey. Specific expected benefits include closer patient-physician relationships, increased job satisfaction on the part of family physicians, and an overall increase in income for the physicians working in the system.
- SourceAvailable from: Fusun Yaris[Show abstract] [Hide abstract]
ABSTRACT: To determine the factors affecting medical students' choice of the specialty of family medicine. The study was conducted in the period from 2004-2006 and comprised 770 first-year medical students from Ondokuz Mayis, Karadeniz Technical, Kocaeli, and Adnan Menderes Universities, Turkey. The questionnaire included questions on demographic data and 6 "yes/no" or open-ended questions on students' career aspirations and the specialty of family medicine. The response rate was 93.1% (n=717, 54.7% male). Nearly all students (n=714, 99.6%) showed an intention to specialize after receiving the medical doctor degree. A total of 187 students (26.2%) showed an intention to work in primary care without specialization "for a temporary period" to "gain some experience." Family medicine was the least preferred specialty (n=7, 0.9%). The most important reasons for the choice of specialty were "better financial opportunities" and "prestige" (n=219, 30.5%), followed by "personal development" (n=149, 20.8%), "more benefits for the patient" (n=128, 17.9%), and "wish to work in an urban area" (n=32, 4.5%). The most preferred specialties were cardiology (n=179, 25.0%), pediatrics (n=121, 16.9%), ophthalmology (n=47, 6.6%), physical therapy and rehabilitation (n=34, 4.7%), and obstetrics and gynecology (n=32, 4.5%). Prestige, money, and personal development are important factors in career decision-making among medical students in Turkey. This should be taken into consideration when conducting reforms at the primary level.Croatian Medical Journal 07/2008; 49(3):415-20. · 1.25 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The health care systems in many countries are focused on specialist care. In those countries that have recently changed to a primary care-based system, some doctors and patients were dissatisfied with the change. To explore the opinions of the general public and the doctors on the change to a family medicine (FM)-based health care system. Qualitative study with focus groups of doctors working in different practice settings. Quantitative study with questionnaires sent to all doctors registered in Hong Kong and a telephone survey targeting the general public aged ≥18. Doctors in the focus groups generally supported a FM-based health care system. They were concerned that there were not enough family doctors for such a system and the patients' current free choice of any doctor for primary care would impede its success. Thousand six hundred and forty-seven adults took part in the telephone survey (response rate 67.6%) and 2310 doctors (22.8%) responded to the questionnaire. Nearly 95% of the general public respondents agreed to the FM system though only 66.3% of them had ever heard of the term family doctor. About 65% of the doctors supported this system but only 33% agreed that the system would work. The specialist-doctors were less supportive of mandatory referral than the non-specialists, while the public was equally divided on this issue. The public accepts the FM-based system but needs education on the benefits of primary health care. Direct access to the specialist would be the greatest barrier. Government involvements are essential for the reform.Family Practice 02/2011; 28(1):49-55. · 1.83 Impact Factor