Foundational Knowledge for the Practice of Family Medicine in West Africa

Book excerpt: Foundational Knowledge for the Practice of Family Medicine in West Africa is a selection of introductory concepts from literature using literature search and review; a collection of lectures from eminent family physicians from South Africa, Canada, United Kingdom, and United States; lecture notes; seminal essays; and journal articles that guided the author through the transition from general practice to family medicine in the 1980s and 1990s. The concept of family medicine in West Africa was a paradigm shift from a specialty conception of a conglomeration of independent specialties in general practice to a unique specialty with its own distinct identity with a fundamental principle based on the biopsychosocial model. The specialty draws a distinctive identity from its approach to care by placing emphasis on the contextual setting of the patient, starting with the family and extending to the sociocultural and economic environment. This composite approach to health care was new and confusing to the uninitiated medical graduate undergoing a residency training taught in the traditional biomedical reductionist model and to other medical specialists who asked what new knowledge we were bringing to the table that other specialists were not already teaching. As for those teachers of family medicine in the subregion, it was quite clear as to the need for this conceptual framework in family medicine as opposed to the limitation of general practice. This book documents the struggle to position family medicine as a separate specialty of medicine in West Africa.