Abstract Aim: To gain insight into the trend of career choice for family medicine in Croatia in recent years. Methods: Six surveys were performed in the academic years 2006/07-2011/12 at the ...University of Zagreb, School of Medicine. Altogether, 1140 6th year students participated. They anonymously completed a questionnaire containing questions on desired future specialisation as well as other selected characteristics (e.g. gender, desired area and place of work, motivation to study medicine, etc.). Binary logistic regression was used to determine unadjusted and adjusted trends. Results: After adjustment for selected factors, the relationship between observed outcome and the year of observation showed an evident decreasing trend. The odds for intention to specialise in family medicine were in the academic year 2006/2007 1.43-times higher than in the year 2007/2008 (p=0.412), 1.85-times higher than in the year 2008/2009 (p=0.168), 2.38-times higher than in the year 2009/2010 (p=0.051), 2.63-times higher than in the year 2010/2011 (p=0.027) and 3.85-times higher than in the year 2011/2012 (p=0.003). Conclusions: The results of the present study offer evidence that Croatia is experiencing a constantly decreasing trend of career choice for family medicine in recent years. It is obvious that final year medical students are not very much interested in working as family practitioners. At the same time, demand for family practitioners in Croatia is increasing. Both academic and professional societies have a social responsibility to reorient the health care system and medical curricula towards comprehensive primary health care in which family medicine has a key role.
Izvleček Izhodišče: Pridobitev vpogleda v trend izbire poklica zdravnik specialist družinske medicine na Hrvaškem v zadnjih letih. Metode: V študijskih letih 2006/7-2011/12 je bilo na Medicinski fakulteti Univerze v Zagrebu opravljenih šest raziskav, v katerih je skupaj sodelovalo 1.140 študentov 6. letnika. Ti so anonimno izpolnili vprašalnik z vprašanji o želeni prihodnji specializaciji in drugih izbranih karakteristikah (npr. spol, želeno področje in kraj dela, motivi za študij medicine itn.). Za določitev neprilagojenih in prilagojenih trendov je bila uporabljena binarna logistična regresija. Rezultati: Po prilagoditvi izbranih dejavnikov je bil pri povezavi med opazovanim rezultatom in letom opazovanja ugotovljen jasen padajoči trend. Verjetnost izbire specializacije iz družinske medicine je bila v študijskem letu 2006/2007 1,43-krat večja kot v letu 2007/2008 (p = 0,412), 1,85-krat večja kot v letu 2008/2009 (p = 0,168), 2,38- krat večja kot v letu 2009/2010 (p = 0,051), 2,63-krat večja kot v letu 2010/2011 (p = 0,027) in 3,85-krat večja kot v letu 2011/2012 (p = 0,003). Zaključki: Rezultati te raziskave dokazujejo, da je v zadnjih letih na Hrvaškem prisoten stalno padajoči trend pri izbiri poklica zdravnik specialist družinske medicine. Očitno je, da študenti zadnjega letnika medicine niso preveč zainteresirani za delo zdravnika družinske medicine. Hkrati pa se na Hrvaškem povečuje potreba po tovrstnih zdravnikih. Tako akademska kot strokovna združenja so družbeno odgovorna za preoblikovanje sistema zdravstvenega varstva in študijskih programov medicine v celovito primarno zdravstveno varstvo, v katerem ima družinska medicina ključno vlogo.
Although theoretically very effective and apparently quite straightforward, cardiovascular prevention leaves much to be desired in practice. Several reasons, including ethical, conceptual, ...psychological, and operative pitfalls (lifestyle changes are mostly ignored; drug therapy is too often prescribed with no good reason, and performed in an episodic or on/off way) are presented in this essay. Discussed are the grounds of these aberrations and suggested are some intuitive solutions, best achievable in family practice.
Preprečevanje srčno-žilnih bolezni je teoretično zelo učinkovito in na videz precej enostavno, vendar pa je treba v praksi na tem področju še marsikaj storiti. Prispevek opisuje razloge takšnega stanja, tj. etične, konceptualne in psihološke dejavnike ter težave pri izvajanju. Zdravljenje z zdravili prevečkrat predpišemo brez pravega razloga, poteka pa občasno in neredno. Prispevek obravnava vzroke teh slabosti in predlaga nekaj rešitev, ki jih najlaže ponudi družinska medicina.
PDF
