Academic general practice/family medicine in times of COVID-19 - Perspective of WONCA Europe.

COVID-19 outbreak has significantly changed all aspects of general practice in Europe. This article focuses on the academic challenges for the discipline, mainly in the field of education, research, and quality assurance. The efforts of the European Region of the World Organisation of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (WONCA Europe) to support academic sustainability of the discipline in the time of pandemic are presented. Medical education was affected by the pandemic, threatening both its productivity and quality. Emerging new educational methods might be promising, but the results of their rapid implementation remain uncertain. A relatively small number of publications related to COVID-19 and general practice is available in the medical literature. There is a shortage of original data from general practice settings. This contrasts with the crucial role of GPs in fighting a pandemic. COVID-19 outbreak has opened widely new research areas, which should be explored by GPs. Maintaining the quality of care and safety of all patients during the COVID-19 pandemic is the utmost priority. Many of them suffer from poor access or inadequate management of their problems. Rapid implementation of telemedicine brought both threats and opportunities. The COVID-19 pandemic also challenged doctors' safety and well-being. These aspects will require discussion and remedy to prevent deterioration of the quality of primary care. WONCA Europe is making a multi-faceted effort to support GPs in difficult times of the pandemic. It is ready to support future efforts to uphold the integrity of family medicine as an academic discipline

The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results : person centred care, comprehensive and holistic approach

The recently published ‘ Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe ’ summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe defi nition of GP/ FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a fi rst article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies ‘ primary care management ’ and ‘ community orientation ’were presented. This article refl ects on the three core competencies, which deal with person related aspects of GP/FM, i.e. ‘ person centred care ’ , ‘ comprehensive approach ’and ‘ holistic approach ’ . Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defi ned and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.peer-reviewe

Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 2. Results: Primary care management and community orientation

At the WONCA Europe conference 2009 the recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' was presented. It is a background paper and reference manual, providing advocacy of general practice/family medicine (GP/FM) in Europe. The Research Agenda summarizes the evidence relating to the core competencies and characteristics of the WONCA Europe defi nition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a fi rst article, background, objectives, and methodology were discussed. In this second article, the results for the core competencies 'primary care management' and 'community orientation' are presented. Though there is a large body of research on various aspects of 'primary care management', it represents a very scattered rather than a meta view. Many studies focus on care for specifi c diseases, the primary/secondary care interface, or the implications of electronic patient records. Cost effi ciency or process indicators of quality are current outcomes. Current literature on community orientation is mainly descriptive, and focuses on either care for specifi c diseases, or specifi c patient populations, or on the uptake of preventive services. Most papers correspond poorly to the WONCA concept. For both core competencies, there is a lack of research with a longitudinal perspective and/or relevant health or quality of life outcomes as well as research on patients' preferences and education for organizational aspects of GP/FM

Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases:Summary of the consensus report by the European Federation of Periodontology and WONCA Europe

BackgroundPeriodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing.ObjectivesTo outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD).MethodsThe consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings.ResultsPeriodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors.ConclusionCloser collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population

ECCO Essential Requirements for Quality Cancer Care: Primary care.

ECCO Essential Requirements for Quality Cancer Care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to cancer patients. They are written by European experts representing all disciplines involved in cancer care. This paper concerns the integration of primary care into care for all cancers in Europe. Primary care integration

General practitioners’ perceptions of using virtual primary care during the COVID-19 pandemic: An international cross-sectional survey study

With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. We explored GPs’ perspectives on the main benefits and challenges of using digital virtual care. GPs across 20 countries completed an online questionnaire between June–September 2020. GPs’ perceptions of main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patients’ preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital virtual care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions and support the long-term development of platforms that are more technologically robust and secure

General practitioners’ level of knowledge about their rights and criminal liabilities according to legislation in Turkey

Background . To know legal regulations and to comply with them while providing health care is indispensable for physicians to work in a proper way. Ignorance of the criminal laws may not be an excuse according to Turkish Criminal Code. There is an obligation for physicians to know the law, as well as all citizens. Physicians should possess the scope of competences regarding medicolegal regulations at least. Objectives . The aim of this study is to investigate the knowledge and behaviors of GPs regarding their rights, criminal liabilities and common rules of law that are regulated by legislation. We also aimed to determine how the answers were influenced by sociodemographic factors, educational status of participants and if the participants received any punishment. Material and methods . A total number of 381 physicians working at primary health care services located in Ankara were interviewed face-to-face. We used a 38-item questionnaire that was developed according to current legislation. The collected data was analyzed using SPSS software (Version 11.5). The chi-square test was used in order to compare knowledge-based questions with sociodemographic factors. The Mann-Whitney U test was used for assessing whether the number of correct answers differs with socio-demographic factors or not. A p-value of 0.05 was considered statistically significant. Results . 21.8 percent of the participants were FM specialists, and 78.2% of them were GPs. The mean age of physicians was 46.9 ± 7.6. The median score for correct responses in 18 knowledge-based questions was 8 (min–max: 3–14). In comparison with the working experience with correct answers, there was a statistically significant difference between 1–5 years of experience and 11–15 years and ≥ 16 years (p < 0.001). There was a significant difference in correct answers between the two groups, which were separated according to whether or not they received punishment as a result of a legal investigation. In our study, the doctors who have taken education about physician’s rights and criminal liabilities before had a higher number of correct answer than those who have not taken (p < 0.001). Conclusions . As a result of our survey, we determined that our physicians have insufficient levels of knowledge about medico-legal issues. The findings reveal the requirement for comprehensive education about a doctor’s rights and liabilities during residency or via in-service trainings. The importance of the situation should be investigated by further studies and constructive steps should be initiated as soon as possible