Opombe
Diaprojekcija
Oris
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Family medicine in Slovenia
Allgemeinmedizin in Slowenien
  • Dr. Jožefa Jeraj, Kranj
  • Prof. Igor Švab, Ljubljana
  • Doc. Janko Kersnik, Kranjska Gora
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Slovenian health care system
Slowenisches Gesundheitssistem
  • one of the transition countries in CE
  • independent in 1991
  • care providers: several public (non-profit) health care centres (hospitals and primary health care centres) and private contractors
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Slovenian health care system
  • compulsory health insurance, partly from the wages, and partly from employers
  • universal coverage
  • compulsory health insurance covers over 80% of all health care costs.
  • purchase of the voluntary insurance for co-payment
  • only one insurance company National health insurance institute (NHII).
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Primary care
  • before and after II. world war - influence of Andria Stampar school
  • health care system was one of the parading horses of the former socialist regime
  • large investments in the premises
  • primary health care centres framework
  • distribution according to the population
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Preventive services
  • well baby clinics,
  • well mother clinics,
  • clinics for women,
  • clinics for tuberculosis,
  • clinics for trachoma,
  • clinics for workers,
  • clinics for schoolchildren and students etc.
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“Specialistaion” of clinics
  • at the end of 50’ and the beginning of 60’ there was a threat that general practitice will sooner or later die out
  • specialisation of clinics in primary care,
  • the decline in holistic and generalist thinking in specialised medicine and
  • the Soviet policlinic approach
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Extermination of family practice
  • Only a few enthusiasts believed in family medicine as an important source of care.
  • In 1960 the code on the medical fields declared family medicine (in that time general medicine) as one of the specialist fields.
  • Vocational training was not a prerequisite for working in general practice.
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Self-organising the discipline
  • Slovene family medicine society in 1966
  • The first attempt to establish General practice department in 1975.
    • rhetoric question: “How something that holds in its name general (general practice) can be treated as special (specialist field),” undermined well prepared plans for the department as well for the institute of general practice.
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Lessons to learn
  • the question is the same today in whole Europe and specially in UK
  • there is no king’s path,
  • there are only hard work,
  • clear aims and
  • devotion that can build a critical mass which could not be resisted in appropriate time frame.
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Clear aims
  • own research,
  • own continuing medical education,
  • own publications
  • own academics.
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New era
  • independence 1991
  • after one test year Department of family medicine established in 1995
  • the numbers of vocationally trained family physicians recently raised to the 2/3 of all practising in general practice
  • mandatory vocational training for family medicine from 2000.
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The curricula are unique
  • during seven week course lectures are kept to a maximum one hour per week,
  • one day a week students spend with an assistant teacher in small group work
    • reports about the experience in the practice,
    • project reports,
    • medical decision making sessions,
    • videotaping and discussing communication skills.
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The curricula are unique
  • The rest of the week students stay with their specially trained tutors in the practice to test
    • the knowledge they gain on communication skills,
    • medical record keeping and
    • to learn practice skills.
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Conclusions
  • Family medicine face the same challenges all over the world.
  • Slovenian family medicine can be seen as an example of success story.
  • Clear aims should be set: own research, CME, publication and career development.
  • Welcome to WONCA EUROPE 2002 in Slovenia