Family Medicine in Europe: A Cross-Country Analysis of Differences and Similarities

Limor Adler, Yochai Schonmann, Michal Shani, Ilan Yehoshua, Galia Zacay, Robert Hoffman, Anthony Heymann, Shlomo Vinker

Keywords: Family medicine; General practice; differrences; similarities

Background:

Family medicine, formally established as an academic discipline in Europe during the 1960s, demonstrates both shared principles and significant variation across countries. While holistic, patient-centered care and primary care accessibility are common goals, marked differences exist in funding structures, training programs, and the scope of practice, reflecting diverse cultural, economic, and policy environments.

Research questions:

To investigate the differences and similarities in Family Medicine among European countries.

Method:

A cross-sectional, multi-country study. A questionnaire will be developed with the group in a consensus process. Later, each representative from every participating country will fill out the questionnaire. A second researcher from each country will check the data and ensure its accuracy. The questionnaire will include the following domains:
1. Healthcare System Structure and Payment Models
a. The role of family medicine as a gatekeeper or direct access provider within healthcare systems.
b. Payment structures, including capitation, fee-for-service, salary models, or hybrid systems.
c. Healthcare coverage, universal access, healthcare payments.
2. Training and Professional Development
a. Residency program length and content, including variations in curricula and competencies required.
b. Availability and structure of fellowship programs or subspecialty training options (e.g., geriatrics, emergency medicine).
c. Research – in residency and later throughout the career.
d. Ongoing Training for specialists.
3. Scope of Practice and Clinical Responsibilities
a. Inclusion of fields such as gynecology, obstetrics, psychiatry, pediatrics, and chronic disease management in the day-to-day practice of family physicians.
b. Comparison of service delivery between urban and rural settings.
4. Technology and Innovation in Primary Care
a. Utilization of technologies like point-of-care ultrasound (POCUS), immediate point-of-care blood tests, telemedicine, and electronic medical records.
b. Manual skills – dry needling, injections, minor surgeries.
5. Access, Continuity, and Patient-Centered Care
a. Differences in patient access to family medicine services, average consultation times, continuity of care, and multidisciplinary team collaboration.

Results:

Conclusions:

Points for discussion:

What are the differences and similarities in family medicine across Europe?

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