Family physician in Lithuania

Family physician position in Lithuania has been introduced taking into account the experience of other countries. It is an institution, which acts as a counselor or a coordinator guiding through the health system, consulting on elementary health issues, observing the development of chronic diseases and helping to find a necessary specialist.

Family physician, possessing an appropriate license, takes care of health of the inhabitants registered at the primary health care institutions (out-patient clinics, family doctor centers). They are in charge not only of treatment but also of health preservation and improvement, disease prevention. General practitioner who decides what kind of aid the patient needs, in the first reference point to the patient. Family physician must know the main characteristics of diseases and the features of the main pathogenic conditions within their competence, possible complications and prevention means as well as prescription indications of the most often used drugs and their possible side effects. They also decide when the patient should go to see a specialist. General practice physicians work in team with other specialists. Their services are paid by the State Patients’ Fund. Recently a number of private primary health care institutions has increased, with one or several general practice physicians working there. If such an institution signs an agreement with the State Patients’ Fund, services to the patients are rendered free of charge. Current legislation provides that each person can freely choose the most convenient to access or the closest primary health care institution or a general practice physician. If the patient is registered to such institution, he or she can change it free of charge no earlier than within six months. This limitation is not valid to those who come to study at an education institution or those who come back after the studies to their permanent place of residence.

Family medicine education in the Program of Medicine of Vilnius University and Kaunas University of Medicine encompasses three phases: undergraduate education, graduate medical education (3 years GP residency), continuing medical education, which includes the courses provided by the lecturers of Vilnius University and Kaunas University of Medicine. The discipline “Fundamentals of Family medicine is delivered during the 6th year of education. Duration of the course is the total of 48 hours in Vilnius University and 70 hours in Kaunas University of Medicine. During this time, career choices are made, including the decision whether or not to seek a residency in family practice. In 1992 first group residents was accepted to family medicine residency. Residency is implementing according to the common programme for the both high medicine schools. Studies duration is 3 year. Since 1992 more than 2200general practitioners were prepared, two thirds of them- former district internists and pediatricians after retraining.

At the moment primary healthcare centres, belonging to municipalities, dispensaries, polyclinics, separate general practitioners‘ offices, primary centres of mental health provide services of the primary healthcare. According to the ministry of health, in 2010 primary healthcare will be provided only by family physicians teams with assistance of dentists and psychiatrists. At the moment, rather hard process of adaptation and recognition of a new speciality of family physician takes place.