Family Medicine: A Frontline Approach to Preventive Healthcare in Low Middle-Income Country - Pakistan

Abstract

Family medicine is a medical specialty that provides first contact and continuous, comprehensive healthcare for individuals, families and communities across their entire lifespan, while also including care of all genders and reproductive stages”, this is the widely used definition given by the American Academy of Family Physicians.¹ Further, family medicine integrates the biological, clinical and behavioural sciences, extending care to all ages, genders and illnesses, making it the worldwide cornerstone of the healthcare system.²

Family medicine, frequently called the "doorstep of healthcare," ensures that medical services are accessible near people's homes for treating acute and chronic conditions, focusing on preventive and overall health. It is a unique medical specialty integrating preventive and therapeutic approaches to deliver holistic healthcare. Family physicians handle a variety of medical conditions and recommend patients to specialists, making it the starting point for healthcare. Further, they offer immunisations, health screenings, lifestyle advice, and early disease detection to prevent illnesses and promote health.³

Family medicine is distinct from primary health care and primary care; it is an adaptive and evolving specialty, but the boundaries of these three are often blurred. Some consider family medicine a subset of primary care, whereas family physicians are specialists who provide contextual healthcare according to health needs and available resources. They treat various illnesses and serve as gatekeepers, handling specialist referrals when needed. Their long-standing patient connections and in-depth knowledge of community health dynamics uniquely position them to provide preventative care. Thus, they play a crucial role in preventive care, where both communicable and non-communicable diseases are common, and the role of family physicians in preventive care is indispensable.⁴

Family medicine is a well-recognized specialty in high-income countries (HICs), including the United States, Canada, Australia, and the United Kingdom. It has been incorporated into universal healthcare models in nations such as the UK, emphasizing its importance in patient care through the National Health Service (NHS).⁵ Family Medicine education and training are incorporated in medical education curricula encompassing eight core principles: first-contact care, comprehensiveness, continuity of care, coordination, prevention, family orientation, community orientation, and patient-centre-dness.⁶