The family doctor and the family nurse
The first contact of a person with health concerns in the health care system is his or her family doctor or family nurse. In situations requiring urgent medical intervention one should indeed turn to the ambulance or the accident emergency medicine department, but in all other cases, the family doctor with his or her team is the first health consultant. A family doctor is a highly skilled physician who is able to diagnose and treat most diseases. In case of concern needing a medical specialist consultation, the family doctor will refer the patient to the relevant specialist.
A family doctor in collaboration with a family nurse diagnoses and treats most diseases, monitors the child’s progress and persons with chronic conditions, performs minor surgical procedures, refers patients to examinations and analyzes, vaccinates, binds the wounds and removes stitches and, if necessary, makes home visits, gives advice on care, injuries or intoxications, and in terms of preventive measures, advises all persons included on his or her list.
The family nurse has independent appointments where he or she teaches, advises and guides people in promoting and maintaining health and preventing disease. The family nurse provides assistance in the event of illness and organizes medical records, in addition, the role of a nurse to monitor people with chronic illnesses. If necessary, the family nurse consults with the family doctor or refers the person to the appointment of the family doctor. Everyone has the right to choose their own family doctor. If he or she fails to do so, the family doctor shall be appointed by the Health Board who will notify the Health Insurance Fund thereof.
For registration on the list of the family doctor or for exchanging the family doctor, an application for inclusion in the list must be submitted to the family doctor preferred by the person. The application form can be received from the family doctor or the Health Insurance Fund website. Also, newborns must be registered on the list of the family doctor with an application. If the family doctor has not notified of the refusal of including on the list in writing within seven days, the person submitting the application belongs to his or her list the latest as of the first day of the month following the submission of the application. In Estonia, there are approximately 800 family doctors on whom information can be found on the website of the Health Board at: http://terviseamet.ee/en/information.html
The family doctor has the right to refuse to accept a person onto their list if the maximum size limit set for the list of the family doctor has been exceeded. In Estonia, the maximum amount of the list of the family doctor is 2000 people (or 2400, if also an assistant doctor works in the doctor’s office).
Development of the family doctor system and increasing the role of the family doctor and the family nurse in our health care system is an important strategic objective of the Health Insurance Fund.