RT Journal Article
SR Electronic
T1 Developing the evidentiary basis for family medicine in the global context
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP 596
OP 600
VO 61
IS 7
A1 David Ponka
A1 Katherine Rouleau
A1 Neil Arya
A1 Lynda Redwood-Campbell
A1 Robert Woollard
A1 Basia Siedlecki
A1 Lynn Dunikowski
YR 2015
UL http://www.cfp.ca/content/61/7/596.abstract
AB Objective To provide an overview of the main methodologic challenges to finding definitive evidence of the positive effects of family medicine and family medicine training on a global scale.Composition of the committee In 2012, 2013, and 2014, the College of Family Physicians of Canada hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences.Methods We performed a scoping review to determine the methodologic obstacles to understanding the positive effects of family medicine globally.Report The main obstacle to evaluating family medicine globally is that one of its core dimensions and assets is its local adaptability. Family medicine takes on very different roles in different health systems, making aggregation of data difficult. In many countries family medicine competes with other disciplines rather than performing a gatekeeping role. Further, most research that has been conducted thus far comes from industrialized contexts, and patient continuity and its benefits might not be achievable in the short term in developing countries when clinical demands are great. We must find frameworks to permit strengthening the evidentiary basis of the discipline across different contexts without sacrificing its beneficial adaptability.Conclusion We believe that developing family medicine and its attributes is one of the keys to achieving global health. These attributes—including its comprehensiveness, adaptability, and attention to both local and patient needs—are key to advancing global health priorities, but make common evaluative frameworks for the discipline a challenge. The spread of family medicine over the past decades is indirect evidence of its utility, but we need to generate more evidence. We present some of the initial challenges to a broader and more rigorous evaluative framework.