Family Medicine

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World Book of Family Medicine – European Edition 2015 He knows many details of family history and he has the confidence of the parents. He needs to acquire abilities to recognize and manage parents‘ difficulties with their children. He has a major role in primary and secondary prevention of child psychopathology. Original abstract http://www.woncaeurope.org/content/14-helping-family-physicians-managing-families-difficult-child References Marcelli D. Enfance et psychopathologie, Masson, 2009. Houssonloge D. L’enfant-roi, fait isolé ou produit de notre société ? Analyse UFAPEC 2008. © Charley Kondraski 260
World Book of Family Medicine – European Edition 2015 Raluca Zoițanu, MD ralucazo@gmail.com 85 – Family Systems Medicine: A New View of Training General Practitioners into Family Doctors Raluca Zoițanu, MD Romanian National Society of Family Medicine (SNMF) - Young GP Group Coordinator Vasco da Gama Movement - Image Liaison Bucharest, Romania Co-author Carl Steylaerts, MD Introduction Human beings are social beings. They are bred and grow up in families, and nowadays even extended families. We all know the words “he looks like his dad, she resembles her mother” and other little ‘pearls of wisdom’ that reflect the trans-, inter- and intragenerational influence. So, it comes as no surprise that there is a huge influence on people with a disease or illness from their surrounding family members. When you have a patient in front of you, you actually have a whole family sitting there, and even threads to grandparents' sayings, doings and beliefs. You are confronted with a network that speaks from one mouth – even in the case of an influenza presentation. Family systems medicine refers to the intersection between relationship dynamics and medical care. Why a training in Family Systems Theory? In order to provide the best care to patients, family physicians have to know the social and cultural context of their patients. Family Systems Medicine allows practitioners to think of the relationships of their patients, starting from families, to the community and other organisations or networks. Family Medicine focuses on the individual, in his context. At the basis of a Family Systems Medicine training is the understanding that there is more than biology alone. It is argued here that to become a Family Doctor, a general practitioner should be trained in Family Systems Theory. What constitutes good training? A good model is in the Iceberg Model of Futuristic Thinking offered by Sohail Inayatullah. He argues that we are confronted with litanies, offer advice and prescriptions, often to find out that it didn't work. “I want to lose weight, I want to quit smoking, I want my relationship to work, I want to sleep” are some of the litanies in a doctors' daily life. Doctors should then look for the social causes, the world view of the patient and finally the metaphors that are embedded in his family. Inayatullah called it The Causal Layered Analysis. So a good training is one where doctors learn to work with metaphors, give meaning to world views and social causes and act upon it. Asking the “apocalyptic question” (what is the worst thing that can happen?), empowering (what would you do if I 261
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Family Medicine

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