The community medicine is a branch of medicine aimed at the dissemination of the culture and professionalism of the doctor in the area of Primary Health Care (ASP) (see Bibliography), according to the directions of the Primary Health Care (PHC) supported by the World Health - WHO in the documents of 1978, 2001 and 2008.
In Italy at the end of Primary Health Care have been assigned different names (primary care, primary care, care services, primary care general practitioners, primary care system), creating confusion about the meaning of Primary Health Care wanted by the WHO (integrated health care and social centered on the individual, family, community). This view gives a special meaning to Community Medicine, outlining it for clinical, care and coordination (health + care + coordination).
The Community Medicine in Italy
Historical Background
In 1982 a working group of the National Association of Physicians Condotti Italian, engaged in the study of health care reform (L 833/1978) he obtained a SSN by the laws of the emerging profile of first-level physician who was called "medical community" for its specific characteristics of health of the global population in a given area. The group defined the professional profile of this doctor subsequently updated in 1992 The same working group outlined the profile of the health district as an area of service delivery of the first level of reference of a community (see bibliography). The Medical Community was identified by the Medical District and the working group in 1992 called it the job profile. This profile included the functions of health promotion and prevention, diagnosis, treatment, rehabilitation, research for diagnosis epidemiological and operational services, planning and evaluation of interventions, organization and coordination, and administrative certification service, health advocacy, training of personnel.
The working group noted that the same professional duties were in fact the responsibility of the family physician in the community of his clients. The Community Medicine assumed, therefore, the meaning of family and community medicine attributing to General Practitioner (GP) the responsibility for the overall care of the individual and of his family, potentially extendable to the community of the District. By analyzing these professional features, the working group pointed out that training deficiencies brought to light the need to start training until then missing.
Areas of Community Medicine
Discipline at Degree in Medicine and Surgery
The DM as sorting of teaching degree in Medicine and Surgery being replaced by DM 16.3.2007 [9] provide an integrated multidisciplinary course (SSD DM 09, DM 17, DM 34, DM 38, DM 42) having as main training objective "to provide basic skills in the area of family medicine and the territory."
School of Specialization
The DM 3.7.1996 institutionalizes the specialization of Community Medicine at the purpose of forming "Doctors specialists in the professional field in Family Medicine and Community, suitable for leadership roles in the area of primary health care."
The DM 1.8.2005 ranks the School of Specialization in 'Area Medical, Class of general medicine clinic. The degree aims specific training "to provide expertise for the management of primary care services (Districts, Services / Units / Departments of Primary Care / of Community Medicine) and the coordination of the network of Primary Care" and how learning profile the acquisition of "skills for prevention and health promotion, diagnosis, treatment and rehabilitation of acute and chronic diseases, organization-coordination of care pathways to the person in the network of primary health care integrated with the hospital, coordination of UO and direction of primary care services. "
Currently, there are Schools of Specialization in Community Medicine in the universities of Padua (Specialization activated in 1997) and Modena-Reggio Emilia (Specialization activated in 2000).
Area of CME
The Primary Health Care (ASP) is an area of ECM training for professionals already engaged in services. Main educational objectives are "to develop culture and skills for multi-professional integration (team activities), continuity of care (care pathways and care for chronic patients, protected discharges), the activation of the participation of the patient and family (empowerment, health education and therapeutic caregiver).
Association scientific and professional
As the professional scientific movement finds its place in Community Medicine ASSIMEFAC (Interdisciplinary Scientific Association of Family Medicine and Community) which aims to spread culture, tools and methods of the Primary Health Care. The Association is open to physicians, other professionals in the health and social services, education, information, who have an interest in developing cultural initiatives multi-dimensional, multi-professional and inter-sectoral person-centered and aimed at achieving / consolidate integrated services, participation individual and community in the promotion, protection and management of health, activities multiprofessional team, for the fair and equitable use of resources.
Functions, activities and tasks of the Medical Professional Community
Taking into account the DM 1.8.2005 which places a specialization in the medical class of clinical medicine generally, the Medical Community may hold positions in the Districts, Departments, Divisions of Primary Care with clinical and management tasks. For example, doctors may perform duties within hospital or territorial team evaluation (assessment of needs and drawing up individual care plans), coordinate care pathways and care for patients complexes etc. ...
Today addresses programmers national [and regional authorities, in line with the European guidelines provide for the development of primary care, presenting a model-based organizational activities multiprofessional team territorial territorial structures (health houses), strengthening of home care and care long-term reorganization of continuity of care ... etc. In this model, the Medical Community, the skills acquired in his formative years, may also carry out professional tasks innovative, working with general practitioners, pediatricians, family and the various professions health and social care for the development goals of the community welfare (medicine initiative) and the overall care of complex patients in the territorial structures of primary care.
The Community Medicine in Europe
Spain: The family and community medicine in spain is a recognized medical specialty since 1978. Its field of application is the PHC. Access to graduate school in family medicine and community (2012), has a duration of 4 years and is organized by the MIR (Internal Medical Resident).
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