Keywords: Consultative center, residency training
Among the main problems in primary care institutions in Ukraine are burning out of doctors, caused mostly by endless patients' phone calls, and lack of possibility for residents to make their own decisions, gain practical skills and autonomy in their work. For solving them in the "InterFamily" clinic, opened for helping refugees, was created a consultative center runned by residents.
In the work of the consultative center 8 residents were involved (now 10). One of them is a manager and is responsible for creating the duty roster and coordination of consultants shift. The center has its own phone so patients can call and get a distant consultation, e-referrals or e-prescriptions without disturbing the family doctor. Also consultants can receive extra patients, do some procedures (ECG, nebuliser therapy, injections etc.) and can contact the family doctor or specialist if it is needed.
The consultative center in the "InterFamily" clinic became a connecting link between a family doctor and his/her patients. It helps free a doctor from overcalls, helps deal with extra patients and takes a part of routine work off from them. On the other hand, residents received an opportunity to get a lot of communicative and practical skills, management skills, specific problems solving skills and possibility to make their own decisions. Between the main call reasons - e-referrals (47%), e-prescriptions (10%) and administrative operations (10%). But if the consultative center is not a separate structure in the clinic and residents combine it with assistance, it can lead to overload and burning out of residents.
The consultative center runned by residents is a good instrument to unload the family doctors and to give residents more opportunities to gain practical, communicative, management and other important skills.
Points for discussion:
Are there similar structures in other medical centers and if are residents involved in the work in it?
Which alternative ideas for giving residents more autonomy and responsibility in their work do you have?