Difficult Problems for Family Physicians in Clinical Practice

ABSTRACT

BACKGROUND: Real performance in practice is one of the criteria by which residency training program can be evaluated. We surveyed the difficult problems in which family physicians underwent in their practices after a university hospital training program to evaluate our family physician training program. METHODS: The study subjects were all physicians who fulfilled our family physician residency training program in a university hospital from February 1993 to February 1999. Data on facing difficult problems were collected via questionnaire which was distributed in advance and answered by practicing physicians. The study period was the first week of each month from March 1999 to December 1999. RESULTS: The participating physicians were 13 among 20. Total collected cases were 179. The reasons why family physicians faced difficulty in their practices were persistent symptoms of patients, lack of knowledge, lack of skills and facilities, vague symptoms, multiple symptoms of patients, low compliance, negative feelings, and patients' economic problems. Common difficult problems were abdominal pain (15), low back pain (14), cough (14), arthralgia and myalgia (12), skin rash (11), dyspnea (8), multiple somatic complaints (8), otitis media (7), nasal stuffiness (6), and dizziness (6) among 179 cases. Rare diseases comprised 22.2% of difficult problems. CONCLUSION: The problems of difficulty that family physicians faced in their practices were persistent symptoms of chronic diseases despite active treatment, lack of knowledge and skills in differential diagnosis of acute illness, and rare diseases in the communities.