Short Report – Special Collection: African Health Systems

The family physician as a primary care consultant – the Mossel Bay experience

Klaus B. von Pressentin, Kartik S. Naidoo, Louis S. Jenkins, Johann Schoevers
African Journal of Primary Health Care & Family Medicine | Vol 13, No 1 | a3061 | DOI: https://doi.org/10.4102/phcfm.v13i1.3061 | © 2021 Klaus B von Pressentin, Kartik S Naidoo, Louis S Jenkins, Johann Schoevers | This work is licensed under CC Attribution 4.0
Submitted: 01 June 2021 | Published: 30 September 2021

About the author(s)

Klaus B. von Pressentin, Division of Family Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
Kartik S. Naidoo, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Mossel Bay Hospital, Garden Route District, Western Cape Department of Health, Mossel Bay, South Africa
Louis S. Jenkins, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, George Hospital, Garden Route District, Western Cape Department of Health, George, South Africa; and, Primary Health Care Directorate, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Johann Schoevers, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Mossel Bay Hospital, Garden Route District, Western Cape Department of Health, Mossel Bay, South Africa


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Abstract

The South African family physician (FP) is an expert generalist who has a number of roles to strengthen the district health system. A research study on FPs in district hospitals has previously demonstrated an impact; however, more evidence on impact in primary health care (PHC) is needed. By serving as a consultant for the PHC team, the FP may improve access to care, capacitate team members, enhance comprehensiveness of care, and improve coordination and continuity of care. This report narrates the story of how one of the FPs at a rural district hospital recorded his experience of being a consultant to the PHC team and was able to self-audit the experience. A self-designed audit tool analysed 1000 patient consultations with the FP and enabled a reflection on the coronavirus disease 2019 (COVID-19)-related changes to the consultant role. There was a clear need for FPs to consult patients with complex multi-morbidity and multifaceted psychosocial aspects to their illness, in consultation with their team members. Patients were referred to them by medical officers, other specialists, family medicine registrars, allied healthcare professionals and nurse practitioners. The FP’s ability to strengthen the PHC service outside the district hospital may be enhanced by creating more FP posts at a subdistrict level to support high-quality, team-based primary care in line with the PHC policy directions.

Keywords

family physicians; primary healthcare; district health system; primary care; consultant; South Africa

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