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Glossary of Primary Care - Second Draft

Library Documents

A. GENERAL TERMS
B. TERMS OF MEDICAL EDUCATION
C. TERMS OF THE EDUCATIONAL PROCESS
D. TERMS USED IN VOCATIONAL TRAINING
E. TERMS OF PERFORMANCE REVIEW AND CONTINUINE MEDICAL EDUCATION

A. GENERAL TERMS
A.1.	HEALTH
	A state of optimal physical mental and social well-being and not merely the absence of disease or infirmity. IGPC: WONCA modified WHO definition )
	That state of physical mental and social equilibrium which permits optimal independent function of individuals or communities. (MJB:NLG)
	Health designates a process of adaptation. It is not the result of instinct, but of an autonomous yet culturally shaped reaction to socially created reality. It designates the ability to adapt to changing environments, to growing up and ageing, to healing when damaged, to suffering. and to the peaceful expectation o-f death. Health embraces the future as well. and there-fore includes anguish and the inner resources to live with it... (Ivan Illich "The Limits of Medicine" 1976)
A2.	HEALTH CARE
	Assessment, health maintenance, therapy, education, promotion of health, prevention of illness, and related activities (provided by qualified professionals) to improve or maintain health status. (IGPC: WONCA)
	Concern for and attention to the provision of that which is necessary to preserve or improve health. (OED: MJB: NLG)
A.3.	HEALTH CARE SYSTEM
	The organizational structure through which health care is provided. (16PC:WONCA)
	A methodical arrangement of competent personnel, facilities and administration, for the provision of health care. (OED: MJE: NLG)
A.4.	PRIMARY HEALTH CARE
	(Syn. Primary Care, Primary Medical Care)
	That part of health care provided by qualified professionals in a defined locality which is directly-accessible to individuals, families and communities, which they freely contract to use, and which shares with them on a continuing basis the responsibility for the management of their health and their appropriate use of the health care system. (MJB: NLG)
	Health care that emphasizes responsibility for the patient, beginning at the time of the first encounter and continuing thereafter. This includes overall management and coordination of health care, such as the appropriate use of consultants, specialists, and other medical / health care resources. In addition, maintenance of continuity on a long term basis, including coordination of secondary and tertiary care is required. (IGPC: WONCA)
	Primary health care is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford. It forms an integral part both of the country's health system of which it is the nucleus and of the overall social and economic community. ( Declaration of Alma Ata. )
A.5.	COMMUNITY MEDICINE
	Syn. Social Medicine.
	That specialty of medicine devoted to meeting the health care needs: of particular populations rather than individuals and therefore includes epidemiology, mass screening. environmental health etc.(MJB:NLG)
A.6.	HEALTH CARE PROVIDER
	Syn. Health Care Professional and Paraprofessional.
	A qualified person who renders health care services. (IGPC:WONCA)
A.7.	TEAM
	A group of people who make different contributions toward the achievement of a common qoal. (PRITCHARD)
A.8.	PRIMARY CARE TEAM
	A group of health care providers and ancillary staff serving the same population or geographical area, sometimes occupying the same building, working together to provide different but complementary services which are directly available on demand. (MJB:NLG from IGPC:WONCA)
A.9.	GENERAL PRACTITIONER
	Leeuwenhorst Definition. Revision Nov. 1981.
	A physician who provides and coordinates personal primary and continuing comprehensive health care to individuals and -families. He provides care for both sexes of all ages, -for physical, behavioural, and social problems. (IGPC:WONCA)
	A medical practitioner with whom the individual primarily shares responsibility for his/her health, who attempts to define problems in their full context, who attempts to help the individual to integrate medical information, advice, treatment, services, and other Solutions in his/her life, and who assumes this as a continuing responsibility unless temporarily and appropriately delegated. (MJB
	Synonyms in other countries. (See booklet).
A.10.	GENERAL PRACTICE
	The medical specialty composed of general practitioners. (MJB
A.11.	SPECIALIST
	A medical practitioner who by his training, or his experience, or both is specially competent in one particular field of medicine, defined in terms of physiology, pathology, a particular skill or a level of patient care. (MJB from IGPC:WONCA)
A.12.	CONSULTANT
	A medical practitioner who is specially competent in a. particular -field of medicine and who provides services-related to that -field at the request o-f another health care provider. (N.JE -from IGPC;WONCA)
A.13.	COMMUNITY PHYSICIAN
	A medical practitioner whose primary concern is the health status o-f the population within a defined geographic area, who is usually responsible -for assessment and evaluation o-f the community's health needs and -for the organisation of health services to meet those needs. He will generally not render primary health care, except -for specific disease entities such as selected communicable diseases. His role varies from country to country, but he is usually employed by a government agency. (IGPC:WONCA)
A.14.	TO PRACTISE (verb.)
	To exercise the profession of medicine. (OED)
A.15.	PRACTICE (noun.)
	The professional work of a medical practitioner. (OED)
	Also a vague term applied variously to the organisation buildings and other structural elements used, or the geographical area or population served, by one or more medical practitioners. (MJB from IGPC:WONCA)
A.16.	PERFORMANCE
	The execution of a professional duty or role. (OED)
A.17.	SERVICE
	The process by which professional assistance is rendered and health needs are satisfied. (OED)
A.18.	REDUCTIVE THEORY'
	Syn. ontological theory.
	'According to which diseases are entities, caused by external agents, with an existence almost separate from the people who suffer from them. The physicians task is to place the patients illness in its correct disease category and prescribe a remedy that will remove or neutralize the causal agent.' (McWHINNEY)
A.19.	HOLISTIC THEORY
	The tendency in nature to produce wholes from the ordered grouping of units. (J.C. Smuts 1926)
A.20.	HOLISTIC MEDICINE
	Syn. Whole Person Medicine
	The science and art concerned with the cure alleviation and prevention of disease and with the restoration and preservation of health primarily in the interests of the whole person. (OED, FUNK&WAGNALLS)
	(It)… recognises that illness is closely related to the personality and life experiences of the patient, and that man cannot be understood in isolation -from his environment. (It).. acknowledges that every illness is different, just as every patient is different„ and that the physician himself is an important aspect o-f the healing process. (McWHINNEY)
A.21.	ANTICIPATORY CARE
	Primary health care devoted to anticipating patients' •future problems and trying to prevent them from occurring. (N.STOTT attributed to Van Den Dool 1970)
A.22.	EPISODIC CARE
	Primary health care confined to the management of presenting problems. (N.STOTT)
A.23	CONTINUITY OF CARE
	Syn. Personal Care
	Primary health care in which the patient usually sees the same health care provider at each encounter. (N.STOTT)
A.24.	CONTINUING CARE
	Primary health care devoted to the appropriate follow-up of acute episodes and chronic problems. (N.STOTT)
A.25.	COMMUNITY HEALTH
	Syn. PubIic Health
	A branch, of medicine concerned with achieving a state of optimal physical mental and social well being -for whole communities. ( MJB from OED
A.26.	COMPREHENSIVE CARE
	Health care of all embracing scope. (OED)
	"Since the family physician is available for any type of health problem, the care he provides is comprehensive."(McWhinney) '
A.27.	DISEASE
	A pathological process of the body or the mind, which may be expressed as a disease label (as contained in a recognised classification). (THE FUTURE GP 1972)
A.28.	ILLNESS
	The patient's total experience of being unwell including diseases but also a wide variety of maladaptive responses to the patient's total environment, physical, psychological, and social .(THE FUTURE GF' 1972)
	The patients subjective perception of the disease process, (IGPC:WONCA)
A.29	PROBLEM
	A provider determined assessment of anything that concerns a patient, the provider (in relation to the health of the-patient). or both. Problems should be recorded at the highest level of specificity determined at that particular visit, using ICHPPC- 2 to classify and code problems. (lGPC:WONCA)
A.30.	EPISODE
	A problem or illness in a patient over the entire period o+ time -from its onset to its resolution. (IGPC:WQNCA)
A.31.	ENCOUNTER
	Any professional interchange between a patient and one or more members of the health care team. One or more problems or diagnoses may be identified at each encounter. (IGPC:WONCA)