National family medicine conference was held
According to Fars News Agency’s Salamat reporter, a national family medicine conference hosted by Mazandaran University of Medical Sciences was held on March 10 of this year for two days with an emphasis on three axes of family medicine and health promotion, family medicine and the effectiveness of measures, family medicine and health socialization. became.
The focus of family medicine and health promotion included health education, pregnant mothers, health ambassadors, and healthy children.
The axis of family medicine and the effectiveness of measures also included the sections of diabetes control, blood pressure control, cancer screening and mental health, and the axis of family medicine and health socialization included social factors affecting health, the role of the media in health, health literacy, and the basic principles of ethics. He was a professional in family medicine services and technological ideas in the fields of family medicine.
In this conference, 105 articles were sent to the secretary of the conference, of which 83 were accepted. Out of 83 refereed articles, 3 articles in the poster section and 3 articles in the speech section were selected as the best articles. Out of a total of 83 accepted articles, 31 articles were presented as lectures and 52 articles were presented as posters.
One of these accepted articles titled “Integrated implementation of family medicine in the same way in urban areas, outskirts of cities, rural areas and nomads” based on health area, referral center, disease centers – with in-person, remote and in-person treatment and care Menzel was prepared and presented by Dr. Nouri Ghoshki along with a three-person team consisting of specialized scientific elites in the field of health.
The focus of this study is considering new and up-to-date theories in the field of reforming the health system with the solution of reforming family medicine and the referral system based on the proposed five-button control model, which represent the mechanisms and processes that policymakers should use to design effective reforms. It was designed to be used in healthcare. It should be said that the five keys to controlling health care reform are designed not to work in isolation. Rather than offering prescriptive recommendations, the five control knobs provide a framework for evaluating health systems that guides decision makers’ understanding of the reform process. These five control buttons in the scope of the family medicine reform plan in this study were:
1- Funding: including all mechanisms and activities designed to collect money for the health system.
2- Payment: all the mechanisms and processes through which the healthcare system distributes payments between providers.
3- Organization: it is who are the providers, consumers, competitors and their management and what changes should occur in the organization of the health care system at several levels including the front line and management levels.
4-Regulations: Actions that take place at the levels of parliament, cabinet, ministry of health, insurance organizations, and the medical system organization that change or change the behavior of various actors in the health care system.
5- Actors’ behavior: all the actions of service buyers (insurance organizations), service providers (doctors) and patients (campaigns against restrictions on the choice of family doctors) as well as changing people’s behavior through population-based interventions.
In fact, in providing sustainable medical and care services with the aim of improving people’s health, paying attention to three components: need, desire and demand in the family medicine program created the following requirements in this study, which should be in harmony and compatibility with the facts:
People should not be allowed to get sick so that they need treatment.
There is a need for care and action to prevent the occurrence of diseases or their complications.
In the case of effective care and action, the need for expensive treatments is reduced.
The demands of the people are strongly influenced by the induced demand of doctors and the competitive market.
Expensive diagnostic and therapeutic technologies are expanding rapidly.
Insurance organizations have lacked resources in paying expenses.
Paying out of people’s pockets for medical expenses has increased a lot.
Many people cannot afford health services.
People are resistant to restrictions on visiting a family doctor and will be pushed to pay health expenses freely.
People like to receive the services of experts directly.
There is a significant difference between the income of general practitioners and specialists.
The tenure of general practitioners in the position of general practitioner is short.
The length of stay of doctors in villages and deprived areas is short.
Doctors are reluctant to partner with the public sector.
Doctors do not want to participate in the family medicine program due to the amount of payment and the payment delay of the insurance organizations.
The ability to pay for health services by people in disadvantaged areas is lower than in areas with less benefits.
There is no obligation between the patient and the doctor and the insurance organization.
In this study, in the proposed plan, doctors providing primary care, both in the private and public sector, at level one, play three roles and perform duties:
1- Insurance gatekeeper (trusted insurance doctor): He has the role of monitoring the good behavior of the actors involved, from the insured to the members of the health team.
2- The gatekeeper of treatment (family doctor): people will refer to specialist doctors only through the family doctor. Remote visit and electronic prescription entry, patient or individual appointment and referral to the emergency center, neighborhood doctor, etc. are performed by this role of the doctor.
3- Neighborhood doctor: Family doctors can cover one or more health areas. Visiting all referred cases from the health team, visiting referred cases from the family doctor, any action that requires the approval of the family doctor, and making referrals to the family doctor are among the duties of the neighborhood doctor.
The payment system in this proposed plan is per capita based on performance, which will be in accordance with the assigned roles of the group of doctors in relation to the treatment and care of each individual. The basis of per capita payment based on the deductible paid by patients will be different for each insurance. According to the payment mechanism in this study, the amount received by the group of doctors to the family doctors is directly calculated by the integrated system and sent to the portal of the national fund system, so that the Ministry of Finance, after deducting the relevant taxes, directly from this fund to the doctors’ accounts all over the country, monthly.
Author: Dr. Ebrahim Nouri Goshki, family medicine specialist, Shahid Beheshti University of Medical Sciences
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