Family Physician as a Counsellor Focused on Sexual and Family Problems: Cheonan Practice-Based Research Network Study

BACKGROUND: The primary concern of a family physician is the healthcare of patients and their families, with the patient's disease itself being secondary. Family physicians should make efforts to discuss personal issues with their patients. This study examined how many patients were counseled about their private problems, especially family or sexual issues in the private clinics of Cheonan. METHODS: The subjects were the patients who visited a practice-based network from April to June in 2003. The data were collected through simple questionnaire about sociodemographic features of patients and their family and sexual problems. RESULTS: Eighty eight patients were studied for a total of 107 cases that consisted of 67 cases of family problems (62%) and 40 cases of sexual matters (38%). The common issues about family problems were `the partners' (23 cases, 21%) and `the patients` children' (29 cases, 27 %). The most frequent sexual problems were 'sexually transmitted diseases' (13 cases, 32.5%), `impotence' (7 cases, 17.5%), 'loss of libido, and unsatisfaction' (6 cases, 15.0%). Most physicians were involved in family and sexual issues with medications, and simple counseling with reassurance. Simple counseling was given for 14 cases (21.0%) for family issues and 18 cases (44.0%) for sexual issues. The patients were treated with medications in 47 cases (70.0%) for sexual and 15 cases (38.0%) for family problems. CONCLUSION: The most common issue for family problems was their partners and for sexual problems was 'sexually transmitted diseases'. Most family physicians were involved with both simple counseling and medications.

Family Medicine Residents' Perception of Attitude Towards Request for Referral in Out-patient

BACGROUND: After amendment of the national health insurance law to enforce and reform primary health care, the number of family medicine out-patients was increased. Some patients requested referral. Therefore, this study was made to reveal family medicine residents'perception of attitude towards request for referral. METHODS: The self-administered questionnaires were collected by post mailing (July 1 to July 30, 2002) and by e-mailing (July 25 to August 10, 2002). The questionnaire contained the followings: general characteristics, issues of referral request, influence of referral request in training, and influence in private family clinics. RESULTS: The overall response rate was 22.2% (93/418). Patients need was the most common cause of referral (62.0%). Among the total, 46.2% of respondents gave answers that increasing number of patients at the family medicine out-patient clinic was beneficial in increasing their experience. Also, 55% of respondents replied that the present state of family medicine out-patient system influenced lowering of motivation in training. Overall, 63.4% of respondents replied that the present state of family medicine out-patient system led a trend of distrust to private family clinics. CONCLUSION: Patients request was the most common cause of referral in family medicine out-patient clinic. The present state of referral system in family medicine out-patient clinic influenced lowering of motivation in training and a trend of distrust to private family clinics.