Family medicine is a community based discipline of medical work carried out by skilled clinicians or doctors. These doctors or physicians demonstrate competence in the patient centered clinical method; they integrate a sensitive, skillful, and appropriate search for disease.

Family medicine is a speciality of medical practice that has not been practiced and promoted in Rwanda and other developing countries but with valuable importance to the health care of the society.

Family physicians should demonstrate an understanding of patients’ experience of illness, particularly their ideas, feelings, and expectations of illness on their lives.

They use repeated contacts with patients to build on the patient-physician or doctor relationship and promote the healing power from these interactions.

Over time, the relationship takes on special importance to patients, their families, and the physician. As a result, the family physician becomes an advocate for the patient.

Family physicians use their understanding of human development and family and other social systems to develop a comprehensive approach to the management of disease and illness in patients and their families.

They also work with patients to reach common ground on the definition of problems, goals of treatment, and roles of physician and patient in management.

Doctor Marcos Alberta is a Cuban doctor working at the university teaching hospital (at the National University of Rwanda), he says that family doctors are skilled at providing information to patients in a manner that respects their autonomy and empower them to take charge of their own health care and make decisions in their best interests.

Family physicians have an expert knowledge of the wide range of common problems of patients in the community, and of less common, but life threatening and treatable emergencies in patients in all age groups. Their approach to health care is based on the best scientific evidence available.

The doctor points out that family practice is based in the community and is significantly influenced by community factors. As a member of the community, the family physician is able to respond to people’s changing needs, to adapt quickly to changing circumstances, and to mobilise appropriate resources to address patients’ needs.

Clinical problems presenting to a community based family physician are not pre-selected and are commonly encountered at an undifferentiated stage. Family physicians are skilled at dealing with ambiguity and uncertainty.

They will see patients with chronic diseases, emotional problems, acute disorders ranging from those that are minor and self-limiting to those that are life threatening. Most importantly the family physician may provide palliative care to people with terminal diseases.

The family physician may care for patients in the office, those in the hospital including patients who are in emergency department, other health care facilities, or at home. Family physicians see themselves as part of a community network of health care providers.

Organisation of such practice requires the ability to evaluate new information and its relevance to the practice, knowledge and skills to assess the effectiveness of care provided by the practice, the appropriate use of medical records and/or other information systems, and the ability to plan and implement policies that will enhance patients’ health.

Doctor Marcos further reveals that family physicians have effective strategies for self-directed and life long learning. This is because family physicians have the responsibility to advocate public policy that promotes their patients’ health.

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