The submerged part of the iceberg and the family physician.
The paper describes an effort to make contact with a part of the population registered with a family practice in an Israeli neighbourhood health centre. Of 407 files reviewed, of patients aged 45 years and over, 15.5% showed there had been no contact with the family doctor for at least three years. The patients were invited to make an appointment for an examination. The experience of the study led to the following conclusions: (1) files are often out-of-date, containing patients no longer in the practice; (2) an invitation is insufficient motivation for most patients to visit the doctor but it can serve as a trigger when there is an existing problem; (3) a considerable number of patients with some direct contact with the health care system obtain care in what is called 'corridor medicine'; (4) significant health problems were identified among those who came and ease of mind was provided for others; (5) data in the files for earlier periods indicated significant untreated illness in all patients. If this survey in a single practice is in any way typical, a serious problem of health care delivery confronts the family practitioner.
Biderman
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Department of Family Practice, Ben-Gurion University of the Negev, Beersheba, Israel.
Antonovsky
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D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D010817:Physician-Patient Relations; D011364:Professional Practice; D012017:Referral and Consultation / Q000706:statistics & numerical data*