Biopsychosocial (BPS) approach to care is essential in family practice. Teaching this approach in family medicine is usually highlighted in family case presentations and counseling sessions. Little is done in showing how the biopsychosocial approach can be used in the day to day family practice. This article discusses the development of a learning tool called the PFC matrix which is a patient-centered, family-focused and community-oriented approach to care for individual patients and their families. The patient-centered care utilizes understanding of the interplay of biomedical psychosocial factors disease in order to implement management that is tailor-fitted to the needs and values of the patient. The family-focused component of the matrix utilizes family assessment to generate assumptions on how the family dynamics affect or facilitate the prescribed management of the patient’s disease. Lastly, the community-oriented component enables the family physician to use social determinants of health and health systems as a lens to understand how larger systems support or hinder the provision of care. Through the use of this matrix, the family physician is able to manage the patient in a holistic manner by recognizing patient needs, creating an enabling family support environment and helping the patient and family navigate various community resources. This results not only in optimal health for the patient but impacts to create a more responsive health system. In the future, further documentation of the use of the PFC matrix particularly in primary care in the light of universal health care and how it impacts on outcomes and how it connects patients and families at the correct tiers of the health system.
Patient-Centered Care ; Humans ; Physicians, Family ; Family Practice ; Family Support ; Counseling

BACKGROUND

The COVID-19 pandemic had a profound impact on medical education, particularly in Family and Community Medicine training programs. This study aimed to assess the impact in the Philippines by comparing the number of cases and procedures before and during the pandemic, as well as the adaptations made by these programs.

OBJECTIVE

The objective of this study was to determine the effect of the COVID-19 pandemic on Family and Community Medicine training in the Philippines by comparing the average number of cases and procedures done before and during the pandemic and the changes implemented by the different accredited training programs.

METHODS

A cross-sectional study utilizing an explanatory sequential mixed methods approach was undertaken. The quantitative portion collected data on cases and procedures from the participating institutions’ residents using the standardized checklist of the Philippine Academy of Family Physicians. The qualitative portion was done through a focused group discussion (FGD) following a prepared set of FGD questions. Analysis of variation (ANOVA) was used to compare the average cases seen and procedures across the four years and content analysis for the qualitative data.

RESULTS

There was a significant decrease in the average number of adult and pediatric cases during the pandemic years (2020-2021) compared to before (2018-2019). Various organ systems cases such as neurology, ophthalmology, dermatology, and gastrointestinal, showed significant differences (p-value<0.05) were found for several organ system cases when comparing the years before (2018-2019) and during the pandemic (2020-2021), including neurology, ophthalmology, ENT, dermatology, cardiology, gastrointestinal, genitourinary, reproductive health, musculoskeletal, and endocrinology cases. The trainers adjusted training activities to support the hospital's COVID-19 response and that prompted an abrupt shift to online strategies for patient consultations, teaching sessions, and examinations.

CONCLUSION

The COVID-19 pandemic led to a reduction in the variety of cases and procedures in Family and Community Medicine training, impacting the fulfillment of specialty training requirements. However, it also drove innovation through the integration of technology, including online teaching methods. These experiences underscore the importance of resilience and adaptability in medical education and offer valuable lessons for future training programs, potentially leading to improvements in training and patient care through innovative methodologies.

Covid-19 ; Education, Medical