Transition to family practice in Turkey.

INTRODUCTION: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary health care and the family medicine model that is in the process of implementation and discusses implications of the transition for family physicians and the challenges faced in meeting the needs for health care staff. In Turkey a trend toward urbanization is evident and more staff positions in rural PHC centers are vacant. Shortages of physicians and an ineffective distribution of doctors are seen as a major problem. Family medicine gained popularity at the beginning of the 1990s, as a specialty with a 3-year postgraduate training program. Medical practitioners who are graduates of a 6-year medical training program and are already working in the PHC system are offered retraining courses. Better working conditions and higher salaries may be important incentives for medical practitioners to sign a contract with the social security institution of Turkey. DISCUSSION: The lack of well-trained primary care staff is an ongoing challenge. Attempts to retrain medical practitioners to act as family physicians show promising results. Shortness of physician and health professionals and lack of time and resources in primary health care are problems to overcome during this process.

The effect of exercise prescription of primary care physician on the quality of life in patients.

PURPOSE: The aim of this study was to examine the effect of exercise prescribed by primary care physicians (PCPs) on the quality of life (QoL) of elderly people. METHOD: Randomisation was performed at PCPs level from 16 primary healthcare centers. Patients were divided into intervention and control groups. Both groups of physicians received theoretical training (14 h), and the intervention group received additional practical training on exercise prescription (10 h). Patients in the intervention group were prescribed endurance, flexibility, balance, and strength exercises and were given training packs. QoL was measured using Short Form-36. Measurements were taken at the beginning of the study, after the 3rd month, and at the end of the 6th month to evaluate the effectiveness of the intervention. RESULTS: The age of participants (Intervention group n = 69, Control group n = 110) was 57.68 ± 5.08 years. At the end of the study, physical function, physical role function, social role function, mental health, vitality, general health perception, and emotional role function scores increased and body pain scores decreased in the intervention group. Significant differences (p < 0.05) between the intervention and control groups were observed for physical function, physical role function, body pain, mental health, vitality, and emotional role function scores but not for social role function or general health perception scores. CONCLUSIONS: Exercise prescriptions given by PCPs containing endurance, strength, flexibility, and balance exercises improve QoL in elderly people.