Change from health center to family physician period in the Turkish health system: A qualitative study

Abstract

Introduction Health care reforms in Turkey have been implemented resolutely in the last 12 years. The shift from health center (HC) to a family physician (FP) approach is 1 of the basic interventions of these reforms. The goal of the current study is to evaluate opinions of patients, health care workers, and managers, using qualitative methods. Methods In-depth interviews were conducted with patients who received health care services in both the FP and the HC periods, and with health care workers and managers in health care facilities that served in both periods. The interviews were recorded after obtaining permission, and then transcribed. Both health care staff that worked in the 2 periods and the patients that received health care services in the 2 periods reported that FP system was superior to HC system in attention showed by the family physicians, being followed by the same physician, and having confidence in physicians. Results The current FP period is superior to HC in facilities such as patient records, computer, internet, and phone. The strengths of HC period include home visits, environmental health studies, and family planning services. According to health care workers who worked in the 2 periods, HC was superior to FP in team spirit, public service delivery, and surveillance of communicable diseases. Conclusion Public service delivery and environmental health studies and primary care practice in rural areas must be scrutinized in the context of the FP approach.