5 Star Dr. Baord 2015

Assist. Prof. Dr. Huda Adnan Habib AL- Mousawie

Family Medicine Consultant Family & Community Medicine Department /AL-Kindy college of medicine

five-star doctorThe term five-star doctor has been promoted to represent the model physician for today's society, who should be able to respond to the needs of both individual patients and their community.

five-star doctorThe Five-Star Doctor is one who improves the quality of care by responding to the patients total health needs with integrated preventive, curative and rehabilitative services while considering the patient as an integral part of a family and a community.

five-star doctorThe Five-Star Doctor makes optimal use of new but cost-effective technologies, bearing in mind ethical and financial considerations and the final benefits as well as costs to the patient and society.

five-star doctorThe Five-Star Doctor promotes healthy lifestyles by effectively communicating with individuals and groups and empowering them for their own health protection and well-being.

five-star doctor

The Five-Star Doctor works and functions efficiently and effectively in teams, both within and across the health sector and the socio-economic sectors influencing health.

In much of the world, both (health care beneficiaries and those who plan, finance and provide health care) are increasingly aware of the need to reform health care systems but have very different priorities and expectations.

For example, consumers primarily want high-quality health services in adequate quantity;

health professionals want to expand their knowledge base and exercise independent judgment in providing the best possible care;

health care policy-makers want care for all citizens that is cost-effective.

For a health care system to make the necessary changes and run efficiently, however, the main stakeholders must decide to work together and must agree on a set of fundamental values:

Relevance, quality, cost-effectiveness and equity

Relevance, quality, cost-effectiveness and equity are values implicit (understood) in the goal of health for all, endorsed (authorized) by all nations and governments, which offers such a basis.

The stakeholders policy-makers, health system managers, researchers, care providers, educators and consumers all alike must consider readjusting their expectations to ensure that these values are upheld and peoples health needs are better met. It is in this context that the future role of health professionals, and in particular, the medical doctor, should be thought of ; (the above values)..

Relevance:Relevance (synonyms: importance, significance).

Relevance in health care can be defined as the degree to which the most important problems are tackled first.

Relevance:Although priorities may be interpreted in different ways in different societies or by different groups within the same society, primary attention should be given to those who suffer most, to (diseases) that are most prevalent, and to conditions that can be addressed with locally available means.

It is fundamental that health policy reflect these priorities.

Relevance:Relevance also implies an organized effort to constantly update a plan to address the priority health needs.

Relevance:Certain aspects of relevance may be considered universal (general) as articulated in the Declaration of Alma-Ata, these include issues of : universal access, primary health care services, essential public health services and availability of essential drugs.

Quality

Quality:High-quality health care uses evidence-based data and appropriate technology to deliver comprehensive health care to individuals and populations, taking into account their social, cultural and consumer expectations.

Quality:WHOs definition of health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity should be a guiding light for health care *reformers and communities.*Reformers: A change for the better; an improvement

Quality:The search for high-quality care by consumer modified to respond to their specific needs for well-being.

High quality in health care must therefore encompass (cover) the technical criteria set by health care providers and the comfort criteria set by health care consumers.

Quality:Primary care provided by physician specifically trained to care for problems presenting to personal physicians,(who know their patients over a span of time) , is of higher quality than care provided by other physicians. This has been confirmed by a variety of studies comparing the care given by physicians in different specialties.

Cost-effectiveness

Cost-effectiveness:Cost-effective health care systems are those that have the greatest positive impact on the health of a society while making the best use of its resources.

Whatever the level of resources available, cost-effective care can be provided.

Cost-effectiveness:The rise in health care costs is due to universally observed phenomena:specialization in health care, which implies the use of costly procedures; increased access to health services due to socio-demographic changes; increased demand from individual consumers as expectations for a better quality of life result from wider access to information.

Cost-effectiveness (continue):As these phenomena will persist and even be amplified in the future in any society, all health policy-makers and health care providers concerned with the health system improvement must give urgent attention to the containment (suppression) of cost without compromising effectiveness in health care.

Cost-effectiveness (continue):This issue is extra urgent as in governments under socioeconomic pressure which offer no increase in health budgets; in many countries, health budgets are decreasing even as the health status of the people is deteriorating.

Cost-effectiveness (continue):Many studies showed that:Countries with strong primary care have :Lower overall health care costs, Improved health outcomes , andHealthier populations.

Cost-effectiveness (continue):Many studies showed that:Physicians who is well familiar (up-to dated) with the patient not only provides more personal and humane medical care but does so more economically than does the physician involved in only episodic care.

Cost-effectiveness (continue):Because of the fact that family doctor-patient close , ongoing relationship, the family physician is under less pressure to exclude diagnostic possibilities by use of expensive laboratory and radiological procedures than is the physician who is not familiar with the patient,

Cost-effectiveness (continue):Many studies showed that:The greater the number of the primary care physicians practicing in a country the lower the cost of health care.

Equity:

Equity:Equity, which is central to a socially accountable (responsible) health care system, means motivated towards making high-quality health care available to all. The central goal of the WHO Global Strategy for Health for All is that all people receive at least such a level of health that they are capable of working productively and of participating actively in the social life of the community in which they live.

Equity: To attain such a level of health, every individual should have access to primary health care and through it to all levels of a comprehensive health system. Consumers expect health services to be comprehensive, continuous and their seek for relevance, quality, cost-effectiveness and equity is universal. Societies at every level of socioeconomic development seem to adhere to the same fundamental principles.

Equity:

Attaining each of these values is indeed a challenge for health reformers, but even more demanding is the need to address this challenge in a balanced way. But the tensions that exist in a health reform process that aims of finding technically appropriate and socially acceptable compromises ( ) among all values at the same time.

The Emergence of the 5-Star Doctor The optimal (best) model of health service delivery may be one that contributes to the meeting of different inputs towards the satisfaction of the values of relevance, quality, cost-effectiveness and equity in health.

The Emergence of the 5-Star Doctor

In 1994, in the joint WHO and WONCA (World Organization of Family Doctors) conference, reference was made to the five-star doctor particularly when recommendation was made that the family doctor (general practitioner/family physician) should have a central role in the achievement of quality, cost-effectiveness and equity in health care systems.

The Emergence of the 5-Star DoctorTo fulfill this responsibility the family doctor must be highly competent(skilled) in patient care and must integrate individual and community health careIn 1995 the World Health Assembly, the principal governing body of the WHO, adopting Reorientation of medical education and medical practice for health for all, urged WHO and its Member States to undertake coordinated alteration in health care and in health professions practice and education.

The Emergence of the 5-Star DoctorIt also called for a Coordination of worldwide efforts to reform medical practice and medical education in line with the principles of health for all and more relevant to peoples needs by cosponsoring consultative meetings to put forward appropriate policies, strategies and guidelines".

The Emergence of the 5-Star DoctorThe WHO global strategy for implementing this resolution, as articulated in the document Doctors for health, mentions that "Doctors of tomorrow may not be doctors of the day-after-tomorrow, as societies and health systems start change and version (form) to current and expected needs.

But certain universally essential skills characterize what WHO calls the "five-star doctor".

:FUTURE TRENDS

New thinking and courageous attempts must be made to counteract (work against) the fragmentation of the health care delivery system, which is characterized by at least three splits : the first is the relative isolation of individual care from population-based care, or in other words, the split between medicine and public health; the second is the split between generalists and specialists and the third is the split between the health sector and other sectors with a bearing on health .

In SummaryThere is a need for: alteration of medical practice and medical education to be more relevant to peoples needs.health services to be comprehensive, continuous under the umbrella of values (relevance, quality, cost-effectiveness and equity). Doctors of tomorrow with universally essential skills. De -fragmentation of health care delivery system.

Qualities of the Five-Star Doctor

The concept of the five-star doctor is planned as an ideal profile of a doctor that carry out the range of services that health settings must deliver to meet the requirements of values of relevance, quality, cost-effectiveness and equity in health.

Qualities of the Five-Star DoctorAn authoritative WHO publication gives the following qualities of the Five-Star Doctor: 1) responds to the patients total health needs 2) makes optimal use of new technologies 3) promotes healthy lifestyles 4) balances patients and community expectations 5) works efficiently in teams


A doctor with all five might be called a "five star doctor". He would be expected to fulfill the following functions:

Assess and improve the quality of care by responding to the patient's total health needs with integrated preventive, curative and rehabilitative services Make optimal use of new technologies, bearing in mind ethical and financial considerations and the ultimate benefit of the consumer Promote healthy lifestyles by means of communication skills and the empowerment of individuals and groups for their own health protection


Reconcile (merge) individual and community health requirements, striking a balance between patients' expectations and those of society at large, both short term and long term.

Work efficiently in teams both within the health sector and across the health sector and other socio-economic sectors influencing health .

World Health Organization Attributes of 5 Star DoctorsThe 5-Star Doctor should be:Care ProviderDecision MakerCommunicatorHealth Advisor and Community LeaderManager and Team Member

qualities Attributes1) responds to the patients total health needs 2) makes optimal use of new technologies 3) promotes healthy lifestyles 4) balances patients and community expectations 5) works efficiently in teams

Care ProviderDecision MakerCommunicatorHealth Advisor and Community LeaderManager and Team Member

Care-provider :Besides giving individual treatment five-star doctors "must: take into account the total needs of the patient (physical, mental and social). They must ensure that a full range of treatment (curative, preventive or rehabilitative) This care will be dispensed in ways that are complementary, integrated and continuous. And they must ensure that the treatment is of the highest quality.

Decision-maker:five-star doctors will have to take decisions that can be justified in terms of efficacy and cost. From all the possible ways of treating a given health condition, the one that seems most appropriate in the given situation must be chosen. As regards expenditure(cost), the limited resources available for health must be shared out fairly to the benefit of every individual in the community.

:CommunicatorLifestyle aspects such as a balanced diet, safety measures at work, type of relaxation (vacation), respect for the environment and so on all have a determining influence on health.

The involvement of the individual in protecting and restoring his or her own health is therefore vital, since exposure to a health risk is largely determined by ones behavior.

:CommunicatorThe doctors of tomorrow must be excellent communicators in order to persuade individuals, families and the communities in their charge to adopt healthy lifestyles and become partners in the health effort.

:Community leaderThe needs and problems of the whole community - in a neighborhood or a district - must not be forgotten. By understanding the determinants of health inherent in the physical and social environment and by appreciating the breadth of each problemor health risk five-star doctors will not simply be treating individuals who seek help but will also take a positive interest in community health activities which will benefit large numbers of people.

: Manager and Team memberTo carry out all these functions, it will be essential for five-star doctors to acquire managerial skills. This will enable them to initiate exchanges of information in order to make better decisions, and to work within a multidisciplinary team in close association with other partners for health and social development.

Although the five attributes described above may equally apply to any health professional, family doctors come close to fulfilling the concept of the five-star doctor, and it is fair to say that they are seen as playing important roles as primary care providers who can bring together quality and cost-effectiveness in care.

What Makes a Good Doctor

Many studies showed that A good doctor should have three qualities ( from patient point of view): knowledge, empathy and philosophy.First, knowledge: a good doctor should be knowledgeable and should keep side by side of developments in his or her field of expertise. A good doctor should be a skillful diagnostician. A good doctor should neither under-prescribe nor over-prescribe medication to his patients.


Second, empathy:a good doctor should have a high Emotional personalityIt was noticed that most of patient chose to go to the doctor of old age . Probably because he had a warmer personality, was a better listener and communicator and was able to inspire his patients confidence in him.


Third, philosophy :a good doctor should also be a good philosopher. A good doctor should treat his patients in a holistic way. He should counsel his patients on their diet, exercise, and stress management. A good doctor should understand the limits of efficacy of western medicine and should have an open mind to what is called alternative medicine. A good doctor should be wise and humble not strict and superior. Thank you

Thank You


the qualities of a good doctor can be summed up by the word ASK.A is for AttitudeThe attitude of a medical practitioner to his work, his profession, the patients he sees, is of greatest importance. a good doctor is one who truly cares for his patients, who possesses a deep compassion for them and is committed to alleviating suffering. He is motivated by the well-being of his patients rather than material or other gains, such as fame or status.


He is empathic, placing himself in the positions of his patients and seeing it from their points of view. He asks, seeks clarifications and listens actively to their difficulties, and not assume that he knows them. He then decides on the diagnosis and treatment modality.Since he has had the privilege and benefit of medical education, he recognizes his obligation to society. He thus serves not only the individual patients that he sees, but the wider community in various ways e.g.. committees, public education programmes.


S is for SkillAnother very important quality of a good doctor is skill. He is skilled and competent in his trade, able to make accurate diagnoses and treat his patients appropriately to ensure the best possible recovery, without having to put them through a series of unnecessary and/or expensive tests, resulting in unnecessary suffering and hardship. This instills confidence in his patients.


K is for Knowledgeskills and the right attitude must be undergirded by sound medical and professional knowledge. A good doctor should keep himself abreast (side by side) of latest research findings and developments that would enhance his professional practice as this would affect the quality of care that he provides to his patients. In addition, he should be adequately informed about the services that are available in the community. He could then make appropriate referrals for his patients e.g.. rehabilitation centers, to enhance their total well-being.

Wonca Award of Excellence in Health Care "The 5-Star Doctor"

This is an award to be conferred on physicians, who in the opinion of the Council, have made a significant impact on the health of individual and communities, through personal contributions to health care and the profession.

Wonca Award of Excellence in Health Care "The 5-Star Doctor"

It is instituted in an attempt to increase the global development of Family Medicine, global networking and partnership. The award is preferably given to those who are still active in the field for which they are nominated.

Wonca Award of Excellence in Health Care "The 5-Star Doctor"The award will be offered on a Regional (Wonca Regions are: Africa, America's, Asia-Pacific, Europe, Middle East South Asia Regions) and Global basis. The Regional Awards may be awarded on an annual basis and the Global Award be awarded every third year. The award will take the form of a medal and a certificate.

Wonca Award of Excellence in Health Care "The 5-Star Doctor"The criteria to be considered by the selection committee/s will include the following.

impact on health care of individuals and community contribution to regional/global development community perspective and involvement networking for the benefit of the community innovative (advanced) services

5-Star Family Doctor 5-Star means Top Quality means Adherence to the right standards means High Level of Excellence means 5-Star (*****) 5-Star Family Doctor means

Top Quality

means Adherence to the right standards means High Level of Excellence means 5-Star (*****)

Wonca Award of Excellence in Health Care "The 5-Star Doctor"development of services in previously underserved / disadvantaged areas demonstrated support of colleagues in another region/country/college performance of academic work of quality and relevance including teaching and research the development of models which could be applied to other regions/areas best meet the criteria of the "5-Star" health professional - Care provider - Decision maker - Communicator - Health Advisor and Community Leader - Team member

The concept of the "Five Star Doctor", as the ideal doctor for today's society, sits comfortable with those who provide health care in community settings. Traditionally, the family doctor has exhibited the attributes of the five star doctor even when specialization and technology threatened to overwhelm medicine. The swing back to the generalist in recent times makes it essential that these attributes be spelt out, understood and accepted by all health care workers.

WONCA, the World Organization of Family Doctors, has a global objective to improve the health of the people of the world through education, research and health service provision.It sees the family doctor as central to any health care system which sets out to provide high quality personal health care at a cost the community can afford.So how well do today's family doctors match the ideal five star doctor?

It is part and parcel of the role of the family doctor to "assess and improve the quality of care by responding to the patient's total health care needs with integrated promotive, preventive, curative and rehabilitative services". Whilst most patients still present to their doctors with complaints for which they seek a cure, family doctors are alert to seize the opportunity to give advice and take actions which will prevent disease and disability.

They do so through primary prevention such as immunization, through secondary prevention by the early detection of disease in its presymptomatic phase, and through tertiary prevention where the doctors' efforts are directed towards minimizing the progress of established disease. Additionally, it is in the field of promotion of health and the enrichment of life that the family doctor excels.

Family doctors have always been conscious of the need to "promote healthy life-styles by means of communication skills and the empowerment of individuals and groups for their own health protection". They have shown their patients the advantage of a healthy diet, exercise, relaxation, good family relationships and a congenial working environment. They spend much of their time educating individual patients and in providing health education at a more general level for their patient population.Health promotion is the stock in trade of the family doctor who realizes that most of the major disabling diseases can be avoided by healthy living and preventive care.

Family doctors have been particularly mindful of the need to "make optimal use of new technologies, bearing in mind the ethical and financial considerations and the ultimate benefit of the consumer". Diagnostic technologies which have high predictive value in specialist hospital settings have an entirely different predictive value in community settings. Conscious of this, family doctors use those technologies which through experience are found to be most efficient and effective in detecting illness in the clinic and in the patient's home where the prevalence and pattern of disease differs sharply from that seen in the hospital.

In recent years, with the escalating cost of health care, and particularly high technology, the family doctor has been sensitive to the need to"reconcile individual and community health requirements, striking a balance between patients'expectations and those of society at large, both short and long term". Family doctors have moved from the "spare no expense" approach to being conscious of the cost to the community.

They use expensive resources prudently and recognize that priorities need to be established to govern how these resources are deployed. Theyrecognise that it may be wiser to spend money on building a facility for elderly people than on high technology equipment which has limitedvalue in community terms.

Although family doctors are often seen as individuals working somewhat in isolation, they often work in groups, and even the solo doctor has a team of assistants such as receptionists, nurses and dispensers. Family doctors increasingly recognize the need to work not only within the health sector but also with other sectors such as social welfare, urban planning, etc. So the family doctor is already a five star doctor, but like some modern hotels, which now boast a six star rating, maybe the family doctor needs to be a six star doctor.

It is becoming increasingly apparent that if doctors are to practice in an ideal way, not only do they need to be properly educated themselves, but society itself also needs to be educated to know what to expect of its health care service and its doctors. It is sometimes the unrealistic expectations of the public and traditional health beliefs of individual patients which bring pressure to bear on the doctor to behave in a way which is not ideal. .

For example, in some societies, the doctor is under continual pressure to prescribe more and more drugs, not just for curative purpose or symptomatic relief, but for imagined or hear-say belief that the drug can do them good.The doctor who attempts to prescribe rationally runs the risk of his patients leaving him for doctors who will meet their unprofessionaldemands.

Therefore the family doctor has a sixth role:

that of educating patients and the community to change their expectations to those that are consistent with good medical practice as we understand it today. So perhaps we should beadding a sixth star: "to educate individual patients and the community at large about the nature of health and illness, what medicine can and cannot do, the dangers of over-medication or self medication and the most cost-effective way of utilizing the community's health care resources".

Thank You

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Documents

5 Star Dr. Baord 2015