Person Centered Primary Heath Care: The Role and Positionof the Family Physician-Generalist and Implications for Research

Abstract

Aim. This paper analyses how the role and function of family physicians in primary health care relates to person centeredness. Method. Based on the model of the Ecology of Medical Care the interaction of individuals with health care has been deduced and from this were identified main implications for the provision of care. Results. Individuals experience a large variety of health problems over time, of which only a minority is presented to health care professionals, with care in the direct vicinity (community) the most likely place of contact. From this, common health problems and their prognosis, self-care and autonomy, reasons for contact, multi-morbidity and community related social determinants of health define the conditions to provide health care for all health problems in all individuals.Discussion and Conclusions. The variety of health problems presented over time for individual-specific expectations, make the person with the health problem the self-evident focus of care. The person-centered approach serves to relate the patient’s agenda to professional considerations of the nature and prognosis of the health problem identified and the risks and benefits of treatment. From this, the importance can be established of continuity of care, shared decision making, individual prognostication and ascertaining individual risks from community-specific determinants of health. Priorities of research are to come to a better understanding of the mechanisms of continuity of care and the building of professional relations of trust. Other priorities of research are to strengthen the knowledge base of diagnosis, prognostication and interventions of frequent health problems in the community.