Abstract
In Nigeria, family physicians are doctors with specialised training to manage a broad range of clinical conditions and pathologies when they first present, considering the psychosocial, economic, cultural and environmental context of the individual and his or her family. In Nigeria, family physicians may be found at district hospitals but are more likely to be located at tertiary health care facilities, where their roles in medical education, research and clinical services cannot be overemphasised. Many patients present to tertiary facilities with primary-care problems, bypassing primary and secondary care. They are often seen initially by family physicians in general outpatient clinics, where 70% of all problems are managed without referral to other specialists. These physicians are also in charge of most of the National Health Insurance Scheme (NHIS) clinics nationwide. They are thus the gatekeepers to the majority of tertiary hospital services.
Highlights
Physicians (FPs) in Nigeria provide patient-centred, comprehensive, coordinated, integrated, longitudinal and holistic care to patients irrespective of their age, gender or disease presentation, in the context of their family, culture and environment.[1]. They provide primary care to patients in primary health care (PHC) settings, district hospitals and specialist or teaching hospitals using the principles of PHC.[2]
The relevance of Family physicians (FPs) in district hospitals can be depicted by the clinical experience of one of the authors (Box 1)
Medicine educators have helped to improve the impact of family medicine in district hospitals through the introduction of a Diploma in Family Medicine programme by the National Postgraduate Medical College of Nigeria.[5]
Summary
Physicians (FPs) in Nigeria provide patient-centred, comprehensive, coordinated, integrated, longitudinal and holistic care to patients irrespective of their age, gender or disease presentation, in the context of their family, culture and environment.[1]. Medicine educators have helped to improve the impact of family medicine in district hospitals through the introduction of a Diploma in Family Medicine programme by the National Postgraduate Medical College of Nigeria.[5] A good number of general practitioners have obtained the Diploma in Family Medicine This is expected to improve health care services and reduce unnecessary referrals from these hospitals to tertiary centres as well as decrease morbidity and mortality across the country. They lead the accident and emergency units of some tertiary hospitals in the country Their role in overseeing and coordinating the care of the elderly in the very few geriatric centres in the country cannot be overemphasised.[11] The FP plays a key role in ensuring a multidisciplinary approach in care of the elderly, by coordinating other stakeholders involved in elder care, such as family members, nurses and other specialists. There has been a progressive decline in the numbers of FPs and trainees in Nigeria because of migration overseas
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