Primary Health Care development requires the implementation of structural (territorial structures, multi-professional team) and process (integration of local structures and hospitals, professional integration) interventions.
Both structures (e.g. health centre, professional team for chronic patient integrated management) and processes (e.g. protected discharges, social and health integration) require not only individual skills by professionals involved in care pathway (skills of diagnosis and treatment, nursing and support activities, rehabilitation, health and therapeutic education etc.), but also working-in-team aptitudes (needs assessment, individual care plans draft) and coordination abilities (of team, of care and support pathways, of health centers). These skills are essential because they permit the realization of the "global care of patient in the services network."
The Specialist in Community Medicine has clinical, welfare and coordination expertise, (health + care + coordination) that are particularly useful for taking charge of complex patients in territorial services. Therefore, the Specialist in Community Medicine finds its position in multi-professional team, playing role of coordination and interface with the Local Health Agency for finding resources and checking outcomes.
Also GP is involved in multi-professional team , with traditional tasks of diagnosis, treatment, health education, patient education, counseling. GP must, however, participate in team activities of evaluation of the needs of complex patient and, always in team, in the planning of individual care pathway that should be developed in the service network.
Reading the features of General Practice / Family Medicine (WONCA Europe), it can be observed that, in '"WONCA tree", they appear the concepts of "primary care management", "community orientation" and "care coordination", which outline, also for GP, tasks of clinical governance of care and treatment pathways. These tasks require innovative skills, which can only come from an adequate education.
The training of future GPs should therefore find "points of contact" with the training of the Specialist in Community Medicine.
So, we need to ask: are the Health Ministry and the
General Medicine Professional Area able to grasp opportunities for a synergy between existing Regional Training in General Practice and Community Medicine Specialty, in order to obtain cultural and professional development for the category? Are GPs interested in the job profile of a primary care physician (WONCA model)?
For this purpose, it’s necessary a regional/national-wide comparison among different actors of training and assistance, involving Unions and, we hope, .... citizens (
Citizens Advisory Committee