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The Role of General Practice in Complex Health Care Systems

According to the WHO, in a complex system, “there are so many interacting parts that it is difficult (…), to predict the behavior of the system based on knowledge of its component parts. “In countries without general practitioner (GP)-gatekeeping, the number of possible interactions and therefore th...

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Autores principales: Schmalstieg-Bahr, Katharina, Popert, Uwe Wolfgang, Scherer, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655229/
https://www.ncbi.nlm.nih.gov/pubmed/34901044
http://dx.doi.org/10.3389/fmed.2021.680695
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author Schmalstieg-Bahr, Katharina
Popert, Uwe Wolfgang
Scherer, Martin
author_facet Schmalstieg-Bahr, Katharina
Popert, Uwe Wolfgang
Scherer, Martin
author_sort Schmalstieg-Bahr, Katharina
collection PubMed
description According to the WHO, in a complex system, “there are so many interacting parts that it is difficult (…), to predict the behavior of the system based on knowledge of its component parts. “In countries without general practitioner (GP)-gatekeeping, the number of possible interactions and therefore the complexity increases. Patients may consult any doctor without contacting their GP. Family medicine core values, e.g., comprehensive care, and core tasks, e.g., care coordination, might be harder to implement and maintain. How are GPs perceived and how do they perceive themselves if no GP-gatekeeping exists? Does the absence of any GP-gatekeeping influence family medicine core values? A PubMed and Cochrane search was performed. The results are summarized in form of a narrative review. Four perspectives regarding the GP's role were identified. The GPs' self-perception regarding family medicine core values and tasks is independent of their function as gatekeepers, but they appreciate this role. Patient satisfaction is also independent of the health care system. Depending on the acquisition of income, specialists have different opinions of GP-gatekeeping. Policymakers want GPs to play a central role within the health care system, but do not commit to full gatekeeping. The GPs and policymakers emphasize the importance of family medicine specialty training. Further international studies are needed to determine if family medicine core values and tasks can be better accomplished by GP-gatekeeping. Specialty training should be mandatory in all countries to enable GPs to fulfill these values and tasks and to act as coordinators and/or gatekeepers.
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spelling pubmed-86552292021-12-10 The Role of General Practice in Complex Health Care Systems Schmalstieg-Bahr, Katharina Popert, Uwe Wolfgang Scherer, Martin Front Med (Lausanne) Medicine According to the WHO, in a complex system, “there are so many interacting parts that it is difficult (…), to predict the behavior of the system based on knowledge of its component parts. “In countries without general practitioner (GP)-gatekeeping, the number of possible interactions and therefore the complexity increases. Patients may consult any doctor without contacting their GP. Family medicine core values, e.g., comprehensive care, and core tasks, e.g., care coordination, might be harder to implement and maintain. How are GPs perceived and how do they perceive themselves if no GP-gatekeeping exists? Does the absence of any GP-gatekeeping influence family medicine core values? A PubMed and Cochrane search was performed. The results are summarized in form of a narrative review. Four perspectives regarding the GP's role were identified. The GPs' self-perception regarding family medicine core values and tasks is independent of their function as gatekeepers, but they appreciate this role. Patient satisfaction is also independent of the health care system. Depending on the acquisition of income, specialists have different opinions of GP-gatekeeping. Policymakers want GPs to play a central role within the health care system, but do not commit to full gatekeeping. The GPs and policymakers emphasize the importance of family medicine specialty training. Further international studies are needed to determine if family medicine core values and tasks can be better accomplished by GP-gatekeeping. Specialty training should be mandatory in all countries to enable GPs to fulfill these values and tasks and to act as coordinators and/or gatekeepers. Frontiers Media S.A. 2021-11-25 /pmc/articles/PMC8655229/ /pubmed/34901044 http://dx.doi.org/10.3389/fmed.2021.680695 Text en Copyright © 2021 Schmalstieg-Bahr, Popert and Scherer. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Schmalstieg-Bahr, Katharina
Popert, Uwe Wolfgang
Scherer, Martin
The Role of General Practice in Complex Health Care Systems
title The Role of General Practice in Complex Health Care Systems
title_full The Role of General Practice in Complex Health Care Systems
title_fullStr The Role of General Practice in Complex Health Care Systems
title_full_unstemmed The Role of General Practice in Complex Health Care Systems
title_short The Role of General Practice in Complex Health Care Systems
title_sort role of general practice in complex health care systems
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655229/
https://www.ncbi.nlm.nih.gov/pubmed/34901044
http://dx.doi.org/10.3389/fmed.2021.680695
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