Strategies for Development and Strengthening of General Practice/Family Medicine as Part of Primary Health Care

Abstract

The health reforms went diverse ways in different countries, but everywhere under powerful influence of political, economic and social changes. The market principles were proposed (and not very successfully applied) to a situation of poor and apparently egalitarian systems. The importance of primary care was underlined, but it was often disintegrated, overspecialized and inadequately supported. Facing a burden of social problems the centralized state solutions as well as participatory social movements had only momentary effects, so that strengthening of local and family capacities, supported by a team of generalist professionals emerged as the best choice. It was advocated by empirical results in most of developed countries. Based on experience from Croatia and other countries the strategies were identified for implementing the generalist professional approach as a basis of PHC services. Firm political decision, vocational training and development of professional identity of general practice/family medicine (physicians and nurses) were essential starting points. Organizational arrangements, academic/scientific support, and international relations have to stabilize further development.