The Department of Health has announced plans to increase the number of family physicians serving as clinical managers in district hospitals. This move follows years of lobbying by the South African Academy of Family Physicians (SAAFP) for greater recognition of the role of family physicians in the country’s public health system.
The push to appoint family physicians, described as “super generalists,” is a strategic move to improve patient care in district hospitals. These physicians undergo an additional four years of training, gaining expertise in clinical governance and understanding the social determinants of health. The government’s five-year district health blueprint, recently approved, aims to ensure these physicians lead multi-disciplinary teams across hospitals.
Focus on cost-effective healthcare
Family physicians are seen as a cost-effective solution to improving healthcare services. Their ability to diagnose and treat patients quickly while mentoring junior colleagues makes them vital in enhancing healthcare delivery. The Western Cape has already seen success with family physicians in leadership roles, and the Department of Health plans to replicate this model nationwide.
Despite being registered as a speciality in 2007, family physicians have been underutilised in the public health system. Professor Bob Mash, a leading advocate for family medicine, believes their potential has been overlooked, especially in district hospitals. Many family medicine graduates struggle to find posts, with only a third remaining in the public sector.
A call for more posts
While the government’s plan is a positive step forward, experts like Professor Steve Reid of UCT highlight the need for a multi-disciplinary approach to maximise the impact of family physicians. Structural challenges, including budget constraints and resource shortages, hinder progress. The success of this initiative will depend on provincial healthcare leaders recognising the value of family physicians and creating more posts for them.
To meet the growing need, the SAAFP estimates that 400 additional family physicians will be required to serve in district hospitals and community health centres across the country. However, at the current training rate, achieving this target could take up to 20 years.