Family Medicines: a Strategic Weakness in Healthcare Structure in Vietnam & Some Proposed Solutions and Recommendations

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FAMILY MEDICINES
A STRATEGIC WEAKNESS IN HEALTHCARE STRUCTURE IN VIETNAM & SOME PROPOSED SOLUTIONS AND RECOMMENDATIONS

CONTENT
1. Introduction
2. Family medicine and its roles in global healthcare system 3. Family medicine situation in Vietnam
4. Impacts of Family Medicine weakness in Healthcare system & Family physician insufficiency in Vietnam 5. Some proposed solutions & recommendations to improve Family medicine 6. Conclusion.

1. Introduction
Recently the trends of urbanization and fast population increase expose several problems to healthcare system in Vietnam like shortage of healthcare manpower, low quality of care, unreasonable distribution of healthcare manpower in different geographic areas, particularly the serious shortage of physicians in Mekong Delta and North-west highland areas as specialists tend to locate their practices in urban medical centers where they could have access to advanced technology, supportive services and consultations from other specialists while rural areas are underserved and patient care becomes highly technocratic, fragmented and episodic. Furthermore, the shortage of physicians in major cities results in a seriously permanent overload at Central level and some specialty hospitals like Oncology, Pediatrics, Obstetrics and Gynecology ..etc.. In sustainable issues, deficit of Family medicine - a basic foundation of modern healthcare in the world, is identified as one of main causes of such problems in Vietnam healthcare system. The purpose of this Essay is to provide a theoretical discussion and analysis about the Family medicine weakness in Healthcare system and Family physician insufficiency in Vietnam to better understand about their impacts to the healthcare system at present and some proposed solutions and recommendations to improve these deficits. 2. Family Medicine and its roles in global healthcare system. In contemporary medicine, Family medicine remains the foundation stone of healthcare service in the community. As the most interesting and challenging of medical disciplines it is based on six fundamental principles: * primary care

* family care
* domiciliary care
* continuing care
All above principles are all designed to achieve:
* preventive care
* personal care (Pereira Gray, 1980).
In the contemporary climate where medical services are fragmented and there are competing interests there is a greater need than ever for generalists. In those principles, primary care is the backbone of the health care system and encompasses the following functions: * It is first – contact care, serving as a point of entry for the patient into the healthcare system * It includes continuity by virtue of caring for patients in sickness and health over some period * It is comprehensive care, drawing from all the traditional major disciplines for its functional content. * It serves a coordinative function for all the healthcare needs of the patient * It assumes continuing responsibility for individual patient follow-up and community health problems * It is a high personalized type of care (Rakel 2011)

In the 2008 report, the World Health Organization (WHO) reaffirmed the importance of primary health care with its report “Primary health care now more than ever” and its emphasizes that primary care is the best way of coping with the illnesses of the 21st century, and that better use of existing preventive measures could reduce the global burden of disease by as much as 70%. The commentary emphasizes that ‘primary care brings promotion and prevention, cure and care together in a safe, effective and socially productive way at the interface between the population and the health system’. The key challenge is to “put people first since good care is about people” (WHO, 2008). Rather than drifting from one short-term priority to another, countries should make prevention equally important as cure and focus on the rise in...
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