Accessibility in family medicine: re-examining a core concept

Abstract

[Excerpt] If you want to limit your workload as a family doctor, make sure your clinic is open only from 2 to 3 a.m. on a Wednesday morning.” Dr. Arthur Furst, a pioneer of modern academic family medicine in Israel, made this provocative challenge to highlight the conflict surrounding accessibility in family medicine. Our patients’ needs are endless yet our resources and our abilities to meet them are limited. How do we find a happy balance? In order to answer this question, we need to re-examine access as a core concept in family medicine. Accessibility is one of the 4 A’s of the profession along with ability, affordability, and affability. We need to be good doctors and good people. We also need to provide an affordable service that our patients can use easily. This also fits in with the 5 C’s of family medicine. We work in a community-based specialty, with continuous and comprehensive care, excellent communication with the patient, and attention to the family context. However, we need to critique the value of accessibility so that attention to access, at all costs, does not jeopardize the others. [...]