["Training cum research" an obligatory form of continuing medical education in Croatia].
Family medicine as a discipline is more than other specialties oriented to holistic approach to patient. The physician has to know and use the possibilities of clinical, first of all somatic but also psychosociological medicine, and to continuously evaluate and follow-up results of his/her own work. The aim of the article is to present differences in clinical judgment before and after postgraduate study in family medicine. A 60-year-old woman living with her disabled son is presented. She visited her family physician many times complaining of a number of symptoms: itching, hypertension, sleep disturbance, poor general condition, trembling. It took ten months to diagnose hyperthyroidism and to begin appropriate therapy. Polysymptomatolgy of the disease based on the patient's psychological and family situation was the reason for the long-lasting wandering to definitive diagnosis. Analysis of the case revealed that neither clinical nor holistic approach was properly used in family medicine. The wrong clinical approach could be explained by fact that this physician worked for years without specialization or continuing education in family medicine. The authors conclude that postgraduate education as part of professional training in family medicine enables physicians to recognize and distinguish the interference of psychological, somatic and environmental factors, which is a major characteristic of good family practice.
Milaković
Sanja Blazeković
SB
Skola narodnog zdravlja Andrija Stampar Medicinski fakultet Sveucilista u Zagrebu, Hrvatska. sanja10@net.hr
Stojanović-Spehar
Stanislava
S
Marković
Biserka Bergman
BB
Katić
Milica
M
Zupanić
Gordana
G
Supe
Svjetlana
S
D002983:Clinical Competence; D017523:Croatia; D003951:Diagnostic Errors; D004503:Education, Medical, Graduate; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis*; D008875:Middle Aged