Family medicine in post-communist Europe needs a boost. Exploring the position of family medicine in healthcare systems of Central and Eastern Europe and Russia

BMC Fam Pract. 2012 Mar 12:13:15. doi: 10.1186/1471-2296-13-15.

Abstract

Background: The countries of Central and Eastern Europe have experienced a lot of changes at the end of the 20th century, including changes in the health care systems and especially in primary care. The aim of this paper is to systematically assess the position of family medicine in these countries, using the same methodology within all the countries.

Methods: A key informants survey in 11 Central and Eastern European countries and Russia using a questionnaire developed on the basis of systematic literature review.

Results: Formally, family medicine is accepted as a specialty in all the countries, although the levels of its implementation vary across the countries and the differences are important. In most countries, solo practice is the most predominant organisational form of family medicine. Family medicine is just one of many medical specialties (e.g. paediatrics and gynaecology) in primary health care. Full introduction of family medicine was successful only in Estonia.

Conclusions: Some of the unification of the systems may have been the result of the EU request for adequate training that has pushed the policies towards higher standards of training for family medicine. The initial enthusiasm of implementing family medicine has decreased because there was no initiative that would support this movement. Internal and external stimuli might be needed to continue transition process.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • After-Hours Care
  • Attitude of Health Personnel
  • Clinical Competence / standards
  • Clinical Competence / statistics & numerical data
  • Delivery of Health Care / trends*
  • Education, Continuing
  • Europe, Eastern
  • Family Practice / education
  • Family Practice / standards
  • Family Practice / trends*
  • Health Care Surveys
  • Humans
  • Physicians, Family / education
  • Physicians, Family / psychology
  • Quality Assurance, Health Care / standards
  • Quality Assurance, Health Care / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Russia
  • Social Control, Formal
  • Specialization / statistics & numerical data*
  • Surveys and Questionnaires
  • Workload / psychology