The contribution of family physicians and primary care doctors to community-orientated primary care

Abstract

South Africa envisages a community-orientated approach to primary health care (PHC). Family physicians and primary care doctors have important roles to play in leading, implementing, supporting and maintaining community-orientated primary care (COPC). In this article, we define COPC, its key principles and approaches to implementing it in health services. Following this we describe the key competencies expected of family physicians and primary care doctors in leading and supporting its implementation; providing clinical support to the PHC teams and linking these teams to other parts of the health system, other sectors and the community. The required knowledge and skills underlying these competencies are also discussed and some specific tools included.

The contribution of family physicians to district health services in South Africa: A national position paper by the South African Academy of Family Physicians

“…30 Family physicians are also trained in community-orientated primary care and the clinical support required by wardbased outreach teams (WBOTs). 31 For example, they can perform a home visit in support of the WBOT or consult on patients seen in the community setting. They are the only clinical specialist explicitly trained in the community oriented primary care (COPC) approach, and therefore invaluable to the implementation of COPC and WBOTs.…”

“…35 One of their more specific roles is to help lead the implementation of COPC and WBOTs. 31 Not only do they assist with upholding the principles of COPC during implementation but they also help to connect teams with the rest of the health system, other stakeholders in the area and community engagement.…”

Updated programmatic learning outcomes for the training of family physicians in South Africa

“…The collated results were presented to the ETC, and all changes and comments were discussed. From the results of the survey, it was recognised that unit standard three, on community-orientated primary care, 9 needed more extensive revision and careful thought. A sub-group was tasked with re-writing these outcomes completely and presenting the results to the ETC.…”

The views of family physicians on National Health Insurance in Gauteng Province, South Africa

“…The distinct professional identity of FPs as agents of change, unique in their primary care expertise and a systems-oriented lens facilitates multidisciplinary collaboration, referrals and gate-keeping stewardship, and health system governance both internationally 11 as well as in SA. 10 , 12 , 13 Furthermore, the family medicine curriculum is situated in PHC and DHS services, whereas other medical specialists are trained in central tertiary hospitals. 13 This contrast in training context allows FPs’ unique insight into the operationalisation of NHI through PHC and DHS services.…”