Table 4. An exploratory mapping of the principles of family medicine in relation to the changing health system models.
Chronic care, medical care, primary care, and primary health care models.
| MODEL
|
||||
|---|---|---|---|---|
| PRINCIPLES OF FAMILY MEDICINE* | CHRONIC CARE MODEL | FAMILY MEDICINE AS MEDICAL SPECIALTY | FAMILY MEDICINE INTEGRATED WITHIN PRIMARY CARE | NEW ORIENTATIONS OF PRIMARY HEALTH CARE |
| Family medicine locates the patient journey through health, disease, and illness at the centre of health systems
Empowerment, with self-care, and peer and community support, is essential |
++ | 0 | ? | + |
| The family physician is a skilled clinician who integrates disease management and an understanding of illness | ? | ++ | ? | ? |
| Family medicine is a community-based discipline | ? | + | ++ | ++ |
| The family physician is a resource to a defined practice population | + | + | ++ | ++ |
| Patient-physician relationship is central to the family physician role | ? | + | ++ | 0 |
| Family medicine operates in multiple health system models—leading and adapting health system redesign | ++ | 0 | + | ++ |
++—large role, +—small role,
?—possible role, 0—no current role.
*
The 2 elements implied but “missing” from the 4 principles of family medicine are the centrality of the patient journey, including self-management (blue shading), and the role of family medicine in multiple health system models (green shading).