UNIT 1 PCM - Achieving the unifying vision of a “Filipino
FAMILY MEDICINE is one of the recognized medical Family Physician for every Filipino Family”
specialties in the Philippines
Key Players in its Development: PATIENTS RIGHTS RESPECTED BY
Philippine Academy of Family Physicians PHYSICIANS
(PAFP) - is the body that represents the 1. The right to appropriate Medical Care and
discipline of Family Medicine humane treatment
Philippine Society of Teachers of Family 2. The right to his religious belief
Medicine (PSTFM)
3. The right to refuse treatment
Department of Family and Community
Medicine of the College of Medicine – 4. The right to inform consent
Philippine General Hospital – University of 5. The right to choose his physician
the Philippines Manila 6. The right to medical records
7. The right to privacy and confidentiality
Growth of Family Medicine in the Philippines 8. The right to a second or third opinion
1960s – Birthing pains; Building the foundation 9. The right to leave
*A group of 15 general practitioners led by
10. The right to information
Dr.Ramon Angeles formed the Philippine
Academy of General Practitioners (PAGP) 11. The right to self determination
1970s – Recognition as a Specialty 12. The right to refuse participation in medical
*In 1971, the PAFP established its first research
chapter in Cebu. 13. The right to express grievance
1980s – Medical education and standards for training 14. The right to be informed of his rights and
and accreditation. Focus on the members’ welfare obligation
*2000 only the residency tract is recognized
for specialization in Family Medicine
1990s – Professionalization of primary care and its RIGHTS INHERENT IN THE PRACTICE OF
being a specialty organization MEDICINE
2000s – Enhancing access and equity to quality 1. The right to choose his patients
primary care 2. The right to limit the practice of his
2010s – Family physicians as champions of family profession
health: the key to universal health care 3. The right to determine appropriate treatment
procedures in the discretion and judgement
Comparison of the Vision Statements of the Four of the physician
Strategic Plans 4. The right to avail of hospital privileges after
First Strategic Plan (1996 – 2000) being qualified
Aiming to provide every Filipino a family 5. The right to receive just and fair
physician to attain optimum family health
compensation from his patients
Second Strategic Plan (2001 – 2005)
- Providing a family physician for every 5 Institutions involved in Undergraduate Medical
Filipino and his family to attain optimum Education in the Philippines:
health through a holistic approach 1. Commission on Higher Education( CHED )
Third Strategic Plan (2006 – 2010) o Has a Technical Committee on Medical
Leading in the promotion of holistic care Education ( TCME ) tasked to study and
by competent and socially responsive Family
make recommendations and policies,
Medicine specialists, committed to the achievement of
optimum health for the Filipino families guidelines and standards of medical
Fourth Strategic Plan (2011 – 2015) education
2. Association of Philippine Medical Colleges o In 1998, another WHO initiative,
(APMC) “Towards Unity for Health” called for the
o Reviews post graduate internship integration of public health and clinical
programs and the internship – matching medicine.
mechanism o October 2002, Filipino teachers of
3. Professional Regulatory Board of Medicine Family Medicine and Community
(PRBM) of the Professional Regulation Medicine hold a workshop and conduct
Commission ( PRC ) a curriculum review of Community
o Which administers the Physician Medicine.
Licensure Examination (PLE ) and o The workshop explored the possibility of
regulates the practice of medicine integrating Family Medicine and
4. Philippine Medical Association ( PMA ) through Community Medicine.
the Commission on Professional Specialization o There were 80 faculty participants of the
( CPS ) disciplines representing 32 medical
o Which reviews and revises the Code of schools.
Professional Specialization ( CPS ) and o CHED Memorandum Order (CMO) 10,
monitors the activities of specialty series of 2006, a document which
divisions and their various specialty and covers Standards, Policies and
subspecialty societies in compliance Guidelines (SPG) on medical education.
with the law. This SPG included Family and
5. In the near future, in cooperation with the Community Medicine as one of the
Accredited Professional Organization in Medicine course for the Doctor of Medicine
( APOM ) shall formalize the Joint Accreditation degree.
Council for the accreditation of programs and
certifying examinations
Historical Background OVERVIEW AND INTRODUCTION
o In 1985, the Philippine Academic FAMILY MEDICINE
Society of Community Medicine Train “doctors for all ages along with minor
(PASCOM) formulated the core surgeries and some Obstetrics and
curriculum in Community Medicine from Gynecology training.
the first year to the fourth year in Are well trained in different department to be
able to handle all clinical health needs of the
college.
thousand people and have referral system
o It was later adapted by medical schools for tertiary care in major hospital
o The components of the core curriculum Is a medical specialty devoted to
are Biostatistics, Epidemiology, comprehensive health care for people of all
Research, Health Programs and four to ages
eight weeks’ rotation in a Community The specialist is named a Family Physician,
Health Program. Family Doctor or formerly Family Practitioner
In Europe the discipline is often referred to
o In 1994, during the WHO – WONCA
as General Practice and a practitioner as a
joint strategic forum, there was a call for General Practice Doctor or GP
all medical schools around the world to This name emphasizes the holistic nature of
offer Family Medicine as an this specialty
undergraduate course for a medical It is a division of primary care that provides
degree. continuing and comprehensive health care
for the individuals and family across all ages, o Who are engaged in research and
genders, disease and all parts of the body teaching in the field
GOALS OF COMMUNITY MEDICINE
o To identify health problem and
needs ( Community Diagnosis)
COMMUNITY MEDICINE o To plan and implement measures
Branch of medicine which deals with the ( community health care/services)
study of provisions of preventive, promotive, o To evaluate extent of effectiveness
curative, rehabilitative and evaluative ( health care evaluation )
services to the community through an ULTIMATE GOALS OF COMMUNITY
organize health care delivery system MEDICINE
The goal is to identify the health problems o To prevent the disease
and health needs of the defined population o To promote the health
( community diagnosis) and to provide the
o To prolong the Life
comprehensive health care (preventive,
promotive, curative and rehabilitative
PUBLIC HEALTH
services) in an organized manner followed
by evaluation of the services The science and art of preventing diseases,
prolonging life and promoting health through
The term community medicine is only a new
organized community efforts.
terminology. It is the successor of the term
hygiene, preventive medicine, social The efforts are control of infections,
medicine and public health. sanitations, health education, and provisions
of health care services
It is often considered synonymous with
Preventive and Social Medicine ( PSM ), Deals with maintenance and improvement of
Public Health and Community Health sanitation, cleanliness and personal hygiene,
proper waste disposal, provision of safe
Branch of medicine that is concerned with
water, safe food and over all safe
the health of the members of a community,
environment
municipality, or region
Three Core Public Health Functions
The emphasis in community medicine is on
o Assessment – The assessment and
the early diagnosis of disease, the
recognition of environmental and monitoring of the health of
occupational hazards to good health, and communities and population at risk
the prevention of disease in the community to identify health problems and
priorities.
Study of health and disease in a defined
o Policy Development – The
community
formulation of public policies
Is a public health services emphasizing
designed to solve identified local
preventive medicine and epidemiology for
and national health problem and
members of a given community
priorities
Is a branch of medicine which deals with the
o Assurance – To assess that all
prevention, promotion and curative services
population have access to
through organized community efforts
appropriate and cost effective care,
CONCEPT OF COMMUNITY MEDICINE
including health promotion and
o The specialty which deals with
disease prevention services and
population evaluation of the effectiveness of
o Comprises those doctors who try to that care
measure the needs of sick and
healthy SOCIAL MEDICINE
o Who plan and administer the The study of man in his social environment
services to meet the needs and the study of social factors affecting
health and disease
The importance of social factors in the Intervention: - Individual and
aetiology of disease Mass Health Education
o Primary Prevention - Action taken prior
to the onset of disease, which removes
the possibility that a disease will ever
PREVENTIVE MEDICINE occur
Branch of medical science concerned with Population mass strategy:
the prevention of disease and promotion of directed at the whole
physical and mental health through the study population irrespective of an
of the etiology and epidemiology of disease individual risk levels
processes. High Risk Strategy: aims to
Medical techniques and treatments intended bring preventive care to
to prevent diseases before it happens. individuals at special risk. This
Art and science of health promotion and requires detection of
disease prevention individuals at high risk by the
The aim of preventive medicine is the optimum use of clinical method
absence of disease, either by preventing the Interventions:
occurrence of a disease or by halting a 1. General Health Promotion
disease and averting its complications after a. Health education to improve healthy
its onset habits and health consciousness in
Focuses on the health of individuals, the community
communities and defined populations b. Environmental Modification
Its goal is to protect, promote and maintain ( Housing, water supply, excreta
health and well being and to prevent disposal) are in good working
disease, disability and death. conditions
c. Nutritional Interventions –
Medical practiced that are designed to avert
improvement in nutritional
and avoid disease.
standards of the community
* Screening for hypertension and treating it
d. Lifestyle and Behavioural Changes
before it causes disease
e. Marriage Counselling
* Preventive Care given when you’re
f. Periodic selective examinations of
symptom free; often given as part of a
risk population
routine physical check up
2. 2. Specific Protection
Preventive measures are carried out
a. Use of specific immunization
o to deter expected aggression by
b. Chemoprophylaxis
hostile forces Ex. Dapsone for leprosy, chloroquine for
o to prevent or slows the course of malaria
an illness or disease c. Use of specific nutrients ( vitamin A
Diagnostic Care is what you receive when for children, iron-folic acid tablet for
you have the symptoms or risk factors and pregnant women)
your doctor wants to diagnose them d. Protection against accident ( use of
helmet, seatbelt)
LEVELS OF PREVENTION IN HEALTH e. Protection against occupational
Definition of Prevention - Management of the hazards
factors that could lead to disease so as to f. Protection from air pollution
prevent the occurrence of the disease g. Avoidance of allergens
( Mosby dictionary )
o Primordial Prevention - Prevention of o Secondary Prevention - Action which
emergence of risk factors in population, halts the progress of a disease at its
in which they have not appeared incipient stage and prevents
complication
Objectives:
Complete cure and prevent the
progression of a disease process
To prevent the spreads of disease
by curing all the known cases
To prevent the complication and
sequel of the disease
To shorten the period of disability
Interventions:
a. Individual and mass case
finding measures
b. Screening surveys ( urine
examinations for diabetes)
c. Selective examinations
o D. Tertiary Prevention - measures available
to reduce or limit impairment and disabilities
minimum suffering caused by existing
departure from good health
to promote the patient’s adjustment to
irremediable conditions
Interventions
a. Disabilities Limitation
b. Rehabilitation
a. Medical rehabilitation – restoration of
bodily function
b. Vocational rehabilitation – restoration of
the capacity to earn a livelihood
c. Social rehabilitation – restoration of
family and social relationship
d. Psychological rehabilitation – restoration
of confidence
Examples of Rehabilitation
- Reconstructive surgery
- Change of profession for a more
suitable one
- Establishing schools for the blind
- Modification of life in general
