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Progress of family medicine in Slovenia |
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| Current position of family physicians in Slovenia Academic and political position of family physicians in Slovenia is rather good. There is Family Medicine Department at Medical School in Ljubljana University and there will be another one in University Maribor, which will start Medical School in autumn 2003. Also professional position has improved. The salaries has raised fivefold and under new legislation it is possible to work also as an independent contractor not only as an employee in the non-for-profit public institutions [1]. As our country acknowledged the lead of the primary care, much higher responsibility for the patients lies with the family physicians who have got a gate-keeping role [1, 4]. Every patient has to choose his/her own "personal" family physician, if he/she wants to enter the health care system [1]. Personal family physician has the responsibility to provide primary care for the patients on the list including emergency care 24 hours a day. Outside working hours physicians are working in rotas for the defined populations. Family physicians' a gate-keeping role puts them in the focus of cost containment and quality assurance efforts of the health care system. These tasks could present a potential threat to the doctor-patient relationship [1, 4]. Also emergency medical services are provided by the family physicians as part of their daily routine, as part of out of hours services or as separate services. |
Quality of care Quality of care is an important issue in the debates in our country. Proposal of national policy on quality was prepared and the strategies for family practice were presented [7, 8], and quality report for WHO has been finished recently. Several courses on quality assurance were prepared in 1994 and since then two books on quality, few guidelines and some working materials were published [9]. We are working on guidelines development in several fields. Systematic and scientific evaluations of quality of care in family practice is still missing. There is a project on on-line reporting on quality indicators for management of hypertension currently running and we plan together with foreign partners projects on practice assessment and quality awards. Public opinion towards quality of the health care system and especially family practice are encouraging [4, 10]. Despite financial constrains and limitations imposed by the new legislation patients praise the accessibility, availability, equity and quality of the current health care system [4]. Regarding health care system as a whole the patients claim only waiting lists for certain types of secondary care. The satisfaction with family physicians is very high and can be compared to the levels of satisfaction in the other European states [10, 11]. |
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