To describe and understand areas of concordance and discordance between the perceptions and experiences of family physicians and policymakers regarding the implementation and use of virtual care within the Nova Scotian primary care system.

COVID-19 brought rapid change to primary care delivery and accessibility. Virtual care rapidly expanded, facilitating primary care access amidst public health restrictions. Health systems leaders facilitated access to virtual care, developed and implemented guidelines, and created new billing codes. Providers integrated virtual care and operation changes into practice.

Semi-structured interviews with family physicians (n = 20), policymakers (n = 9) and a family physician/policymaker (n = 1) were conducted to understand virtual care implementation and outcomes in Nova Scotia, Canada, identifying benefits and challenges.

All participants discussed patient confidentiality concerns, overreliance potential, and virtual care to promote patient care access. Family physicians discussed provider privacy and burnout. Policymakers discussed virtual care increasing capacity for accepting new patients and challenges evaluating virtual care billing codes. Providers and policymakers shared concerns and policy directions for development and expansion of virtual care. As there is little research from policymaker perspectives on virtual care, reconciling these viewpoints is crucial for effectiveness and sustainability.

To characterise baseline levels and contextual triggers of public speaking anxiety (PSA) among family medicine residents and to examine whether a theory-driven educational intervention was associated with short-term changes in PSA across cognitive, behavioural, and psychological dimensions.

Effective communication is a core competency in primary healthcare. However, while clinical consultation skills are prioritised, academic presentation skills are systematically absent from most family medicine residency curricula. This ‘null curriculum’ leaves primary care trainees unprepared for professional advocacy, academic leadership, and teaching roles.

A quasi-experimental one-group pre-test–post-test study was conducted involving 199 family medicine residents at a tertiary hospital in Türkiye. A theory-based single-session educational intervention was delivered. PSA was measured using the validated Turkish Public Speaking Anxiety Scale (PSAS). The study was reported in accordance with TREND and CRISP guidelines for primary care research.

Before the intervention, 87.4% of residents had never received formal PSA training. Academic instructors were the most frequently reported source of anxiety (82.9%) compared with patient encounters (4.0%). Following the intervention, total PSAS scores were associated with a statistically significant short-term decrease (p < 0.001). Significant short-term reductions were observed across cognitive (p = 0.005), behavioural (p < 0.001), and psychological (p < 0.001) dimensions. In exploratory subgroup analyses, married residents (p = 0.026) and senior residents (p = 0.002) appeared to experience larger short-term improvements, although these findings should be interpreted cautiously. These findings suggest that structured educational support may be beneficial for a subset of family medicine residents and that academic presentation skills warrant consideration as part of residency training; however, given the mixed individual-level responses and absence of a control group, this recommendation should be treated as preliminary pending controlled longitudinal evidence.

This study aims to evaluate the feasibility and educational impact of utilizing SHCs as primary care training sites in undergraduate medical education, with the goal of enhancing clinical competencies in young adult healthcare.

Family Medicine (FM) is essential for integrating community-based health services into medical education. In Turkey, final-year medical students complete a one-month rotation at Family Health Centers (FHCs). However, young adults often utilize Student Health Centers (SHCs) on university campuses, resulting in a gap in students’ experience with this age group. Addressing this, our programme initiated the inclusion of SHCs in the FM internship rotation for the 2024–2025 academic year.

A mixed-methodology study was conducted in two phases. A retrospective analysis was performed on medical records of patients aged 18–25 who attended the SHC over a one-month period. A prospective 9-item online survey assessed the educational impact on final-year medical students following their FM internship, which included the SHC rotation. Descriptive and qualitative statistical analyses were performed to summarize the survey and clinical data.

A total of 1228 patients were seen at the SHC, mirroring FHC trends. All 87 interns surveyed rated the FM programme initiative positively, with 94.1% highly satisfied and 85.9% reporting improved primary care skills. Qualitative feedback highlighted the value of practical experience and called for longer rotations.

Integrating SHC rotations into undergraduate medical education is both feasible and beneficial, providing relevant primary care experience for medical students and enhancing training in the care of young adult populations.

This study aimed to adapt the Chronic Conditions Physician–Patient Relationship Scale (CC-PPR) into Turkish and to examine its validity and reliability among patients with chronic diseases receiving care from family physicians.

A methodological study was conducted with 254 adult patients attending the Family Medicine Centers between May 01-October 01, 2025. The adaptation process followed World Health Organization guidelines. Construct validity was examined using confirmatory factor analysis (CFA), and reliability was assessed through internal consistency (Cronbach’s α, McDonald’s ω) and item–total correlations.

The CFA supported the original one-factor, 22-item structure with an excellent model fit (χ2[209] = 59.847, p = 1.000; comparative fit index [CFI] = 1.000; Tucker–Lewis index [TLI] = 1.016; root mean square error of approximation [RMSEA] = 0.000; standardized root mean square residual [SRMR] = 0.048). Sampling adequacy was good (Kaiser–Meyer–Olkin [KMO] = 0.970; Bartlett’s χ2[231] = 5934.429, p < 0.001). All standardized factor loadings were high (0.63–0.81, p < 0.001). Internal consistency was excellent (Cronbach’s α = 0.977; McDonald’s ω = 0.976), and corrected item–total correlations ranged from 0.74 to 0.86. Marital status, employment status, and type of health institution were significantly associated with relationship scores (p < 0.05).

The Turkish version of the CC-PPR is a psychometrically robust, unidimensional, and reliable tool for evaluating the quality of family physician–patient relationships among individuals with chronic conditions. It can be used to assess communication and relational competencies of family physicians, support patient-centred care initiatives in chronic disease management.

Benzodiazepine use among physicians is an important public health issue related to physicians’ well-being and patient safety.

This study aimed to evaluate the patterns and correlates of benzodiazepine use in physicians by comparing the characteristics of heavy users with those of low-dose users.

We identified 4844 physicians with a history of benzodiazepine use as the benzodiazepine cohort from 32 080 physicians from the population-based Taiwan National Health Insurance Research Database from 2014 to 2020. Benzodiazepine users were divided into low-dose, intermediate and heavy users based on their yearly equivalent dosage of <20, 20–150 and >150 defined daily dose (DDD) per year, respectively. Differences in demographic characteristics and specialities between the benzodiazepine and control cohorts were compared via univariate and multivariate logistic regression models. A generalised estimating equation was used to investigate the relationship between benzodiazepine use and comorbidities.

Among all of the physicians, 15.1% used benzodiazepine. Male physicians were more likely to use benzodiazepines and become heavy users. Older age, sleep disorders and depression were significantly associated with heavy benzodiazepine use. Regarding physician specialities, the highest prevalence of benzodiazepine use was observed in otorhinolaryngology (19.8%), followed by family medicine (19.1%). Odds of benzodiazepine use were 2.20 and 2.90 times greater in physicians with sleep disorders and depression, respectively.

Comorbidities of depression and sleep disorders are associated with increased probability of benzodiazepine use. Providing stress-coping strategies and appropriate treatment for mental disorders is recommended to support the overall well-being of physicians.

The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This survey assessed which criteria in the EGPRN concept of multimorbidity could detect decompensating patients in residential care within a primary care cohort at a six-month follow-up.

Family physicians included all multimorbid patients encountered in their residential care homes from July to December 2014. Inclusion criteria were those of the EGPRN definition of multimorbidity. Exclusion criteria were patients under legal protection and those unable to complete the 2-year follow-up. Decompensation was defined as the occurrence of death or hospitalization for more than seven days. Statistical analysis was undertaken with uni- and multi-variate analysis at a six-month follow-up using a combination of approaches including both automatic classification and expert decision. A multiple correspondence analysis and a hierarchical clustering on principal components confirmed the consistency of the results. Finally, a logistic regression was performed to identify and quantify risk factors for decompensation.

Findings: About 12 family physicians participated in the study. In the study, 64 patients were analyzed. On analyzing the characteristics of the participants, two statistically significant variables between the two groups (decompensation and Nothing To Report): pain (p = 0.004) and the use of psychotropic drugs (p = 0.019) were highlighted. The final model of the logistic regression showed pain as the main decompensation risk factor.

Action should be taken by the health teams and their physicians to prevent decompensation in patients in residential care who are experiencing pain.

The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. Identification of risk factors for decompensation would be an interesting challenge for family physicians (FPs) in the management of multimorbid patients. The aim was to assess which items from the EGPRN’s definition of multimorbidity could identify outpatients at risk of decompensation at 24 months.

A cohort study. About 120 multimorbid patients from Western Brittany, France, were included by general practitioners between 2014 and 2015. The status “decompensation” (hospitalization of at least 7 days or death) or “nothing to report (NTR)” was collected at 24 months of follow-up.

At 24 months, there were 44 patients (36.6%) in the decompensation group. Two variables were significant risk factors for decompensation: the number of visits to the FP per year (HR = 1.06 [95% CI 1.03–1.10], P < 0.001) and the total number of diseases (HR = 1.12 [95% CI 1.013–1.33], P = 0.039).

FPs should be warned that a high number of consultations and a high total number of diseases may predict death or hospitalization. These results need to be confirmed by large-scale cohorts in primary care.

The aim of this study was to perform a systematic literature review of the purpose, design, and use of family trees by family physicians (FPs).

Family trees offer a valuable contribution to understanding the relevance of the patient’s family history in comprehensive primary healthcare provision. There is little research on the role of family trees in the everyday practice of FPs. Studies often focus on specific diseases and their context: however, a comprehensive exploration of the usefulness of family trees is crucial for FPs.

A systematic literature review was conducted through a keyword search in the PubMed and Cochrane databases. Based on the inclusion and exclusion criteria selected, 24 studies were identified and a qualitative analysis was performed.

A total of 369 publications were identified across 32 fields. Twenty-four studies were included in the final analysis according to the QUOROM statement. The results underscore the role of family trees and highlight the value of this tool’s multidimensionality. The use of this tool directs FPs to consider a genetic cause and a possible referral to a geneticist. The value of a family tree lies in the personalized patient-oriented treatment in connection with hereditary risks for chronic diseases. For FPs, the greatest challenge in treating patients is determining their risk of developing a chronic disease or cancer. Using a family tree can improve the quality of their healthcare.

Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note – a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers – had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare.

In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (<4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up.

The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes.

Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.

The study examines perspectives of patients in home hospice care; their informal caregivers; palliative health-care providers (HCPs); and family physicians, all regarding patients’ unmet needs and quality of life (QoL)-related concerns.

Participants from all 4 groups were approached within 2 months after the patient’s admission to the home hospice care unit. Participants completed Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCAW) questionnaires, for patient’s QoL-related concerns. Qualitative analysis of short narratives was conducted using ATLAS.ti software for systematic coding.

In total, 78 participants completed the study questionnaires: 24 patients, 22 informal caregivers, 22 palliative HCPs, and 11 family physicians. Informal caregivers gave higher scores (i.e., greater severity) than patients for fatigue on ESAS (p = 0.009); and family physicians lower scores than patients for ESAS drowsiness (p = 0.046). Compared with patients, palliative HCPs gave higher scores for patient emotional-spiritual concerns (77.2% vs. 41.7%, p = 0.02); lower scores for gastrointestinal concerns (p = 0.048); and higher scores for overall function (p = 0.049). Qualitative assessment identified a gap between how patients/informal caregivers vs. palliative HCPs/family physicians regard emotional-spiritual themes, including discussing issues related to death and dying.

The findings of the present study suggest that exploring a multifaceted cohort of home hospice patients, informal caregivers, palliative HCPs, and family physicians may provide insight on how to reduce communication gaps and address unmet needs of patients, particularly regarding emotional and spiritual concerns.

While the 4 groups were similar in their scoring of patient QoL-related concerns, there were discrepancies for some concerns (e.g., patient fatigue) and expectations regarding the need to discuss emotional and spiritual concerns, including on death and dying. Educational initiatives with programs providing training to all 4 groups may help bridge this gap, creating a more open and collaborative hospice care environment.

To assess the opinions of physicians working in family physician teams regarding COVID-19 (threat perception, overall work satisfaction, patient satisfaction with services provided, patient access to services, and the need for new tools for service provision).

An anonymous survey of physicians (N = 191) working in family physician teams. Questionnaires were distributed among family physicians with the permission of the managers of their institutions and were collected by the lead researcher within 1–8 weeks. The quantitative study was conducted from 21 June 2021 to 17 September 2021. In total, 398 questionnaires were distributed, yielding a response rate of 48%, or 9% of the total population. Thirty-nine primary health care institutions (PHCIs) were randomly selected for the study: 11 public and 28 private.

Older respondents and those with more years of work experience strongly agreed that the COVID-19 pandemic threatened their lives and safety, as well as that of their colleagues. Work satisfaction decreased during the pandemic among older respondents, those with more years of work experience, and those who had been employed at their current institution for longer. Respondents with more work experience believed that patient satisfaction with the services provided by their family medical institution decreased. Older respondents with more work experience asserted that patient access to services decreased during the pandemic. Physicians working further away from urban centers indicated a greater need for new tools in the effort to provide consultations compared to city-based physicians.

The current health care crisis prompted by the COVID-19 pandemic is defined by the perception of threats to life and safety among physicians, an overall drop in their work satisfaction, decreased patient satisfaction with services provided, reduced patient access to services, and a greater need for new tools for providing consultations.

A physicians work is closely related to patients and the understanding of their problems. The use of psychotherapeutic methods is a factor for successful care (Swanson, 1994). At the same time burnout is a syndrome that can affect the health of doctors themselves thus reflecting on the quality of care they can provide (Lloyd et al, 2002).

To investigate the use of psychotherapeutic methods in family physicians work in Latvia and the association between burnout rates and the use of these methods in practice as well as different demographic and work-related factors.

A cross sectional study was carried out. An anonymous online form that contained questions about the demographic data, psychotherapeutic methods/techniques mastering and usage and questions from the Maslach Burnout Inventory was sent out to the publicly available email addresses of family physicians in Latvia. The collected data was analyzed using Microsoft Excel and IBM SPSS software.

Together 54 responses were received from all regions of Latvia. The analysis found association between work hours per week, patients seen per week, usage of psychotherapeutic methods and burnout. More hours per week was associated with higher rates of depersonalization (p=0,014) and burnout (p=0,010). More patients per week was associated with higher rates of burnout (p=0,024). Being unsure if they were using any psychotherapeutic methods was associated with higher rates of depersonalization (p=0,028).

The data obtained allows a better insight in to the usage of psychotherapeutic methods, everyday work and the association with burnout rates in family physicians.

Family medicine practitioners (FMP) take care of a varied range of patients with undifferentiated conditions over a lifetime. Although it was incepted in Saudi Arabia in 1980, limited data exists on FMP. This paper explores what family physicians deem relevant.

A cross-sectional survey was conducted among FMP in Saudi Arabia in 2018–2019 who responded to an online questionnaire that listed 20 activities usually done by FMP asking them to rate their meaningfulness on a 5-point Likert Scale, and select the top 3 they would like to spend the most and the least time on. Chi-square statistics were used to compare preference for time spent on these six activities by participant characteristics

Of the 415 survey participants, the majority were male (246) and had a Bachelor’s degree (176). The management of risk conditions, follow-up of chronic illnesses and running preventive health clinics were listed as most meaningful. The majority wished to spend more time on managing health risks, handling daily common complaints and follow-up of chronic illnesses and less time on terminal care activities (46.8%), emergency care (32.3%) and addiction medicine (23.4%). Bachelor’s degree holders wished to spend more time on emergency care compared to Diploma, Board-certified and Fellowship holders (63%, 21%, 10% and 5%, respectively; P = 0.01).

The activities preferred by FMP align with prevailing disease epidemiology. Variations in preferences of ‘managing emergencies’ reflect the varied format of training. Training of FMP should be standardized and further studies investigate reasons for specific preferences.

In our study, we intended to observe the impact of recommending the pneumococcal vaccine to individuals who were called on the phone or interviewed face-to-face by their doctors on vaccination rates.

Two hundred individuals who were 65 years old and older were included in our study. They were questioned about their awareness regarding adult immunisation, and their knowledge level and vaccination statuses were determined regarding the tetanus, influenza, hepatitis, and pneumococcal vaccines. After they were given information about the pneumococcal vaccine, they were asked about their interest in being vaccinated. Those who agreed to be vaccinated were invited and vaccinated.

According to the questionnaire, 150 people (75%) knew of the influenza vaccine, 130 people (65%) knew of the tetanus vaccine, 53 people (26.5%) knew of the hepatitis B vaccine, and 49 people (24.5%) knew of the pneumococcal vaccine. A total of five people (2.5%) had received the pneumococcal vaccine. Fifty-eight of 97 patients (59.8%) who completed the questionnaire during a phone call and 84 of 103 patients (81.6%) who completed the questionnaire during a face-to-face interview received the pneumococcal vaccine. As a result, the rates of pneumococcal vaccination increased from 2.5% before the study to 73.5% after the study.

The findings show that the vaccination rates for pneumococcus were very low among our participants. The immunisation rates increased when doctors provided consultation to participants about adult immunisation.

The Alma-Ata Declaration was a big step in the development of primary care, defining the main tasks and populations’ expectation. Celebrating the 40th year’s anniversary is a good opportunity to make an analysis. Development of primary care was not parallel in the Eastern and Western part of Europe.

To provide an overview on the societal and economic situation, structural and financial changes of healthcare systems in the former ‘Soviet bloc’ countries, to present an analysis of the primary healthcare (PHC) provision and to find relationships between economic development and epidemiological changes of the respective countries.

Epidemiological data, healthcare expenditures and structure, and financing schemes were compared; systematic literature search was performed.

Visible improvements in population health, in the national economic condition, structural changes in healthcare and more focus to primary care were experienced everywhere. Higher life expectancies with high inter-country variation were observed in the former ‘Soviet bloc’ countries, although it could not be clearly linked to the development of healthcare system. PHC provision improved while structural changes were rarely initiated, often only as a project or model initiation. Single-handed practices are yet predominant. The gate-keeping system is usually weak; there were no effective initiatives to improve the education of nurses and to widen their competences. Migrations of workforce to Western countries become a real threat for the Central-East European countries.

Lack of coordination between practices and interdisciplinary cooperation were recognized as the main barriers for further improvement in the structure.