Boundaries of professional responsibility of a general practitioner (family doctor): results of a Russian national study

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Abstract
Aim. To define the boundaries of professional responsibility of general practitioners (family physicians) and develop algorithms for their interaction with specialist physicians. Material and methods. Fifty individuals meeting the inclusion criteria, representing 13 Russian regions, were recruited as experts. Expert assessment cards for job functions were developed for 14 areas in which general practitioners (family physicians) practice. It included information on 252 different diseases. Results. It was found that general practitioners (family physicians) can independently manage patients in 9,9% of cases, monitor treatment prescribed by a specialist in 35,7% of cases, refer patients for followup care with a specialist in 40,5% of cases, and hospitalize patients in 13,9% of cases. With regard to internal medicine, the predominant job functions are independent patient management (21,6% of all cases) and monitoring of treatment prescribed by a specialist (52,7%). Other areas of professional activity are primarily related to monitoring treatment prescribed by a specialist or preliminary diagnostics. Conclusion. The obtained results should be taken into account when defining the professional competencies of the educational standard for general practice (family medicine) during next revision, improving educational programs. This should also form the basis for interaction algorithms between general practitioners (family doctors) and specialist physicians.

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