Care, trust, rescue: how a modern family doctor works

A family doctor is the first person to hear the silent signals of illness and becomes a guide on the way to recovery. He or she treats, but also supports, consoles and helps find answers to the most important health questions. It is more than a specialty - it is the ability to be there at the right time.

For Oksana Bruiaka, a family doctor from Bucha, Ukraine, medicine is not just a job, but a way of life. "I have always wanted to work with people, to help them be healthier. At university, I realized that family medicine is the future. It is the patient's first point of contact with the medical system, but also offers the patient constant support all the way through to his or her recovery."

She points out that this is a very big responsibility. "You don't leave the patients alone, you accompany them, help them, explain to them and guide them. This is especially important now, when many patients get lost in the health-care system."

Oksana says that this can happen in the secondary-care system in particular. "They come back to us because they lack information. That's why the nurse and I always try to provide a clear route for further examination and next steps. Even after the diagnosis has been made, we do not disappear - we always call the patient back in a week or so, find out about his or her condition, and remind them about the examination or consultation. This helps people feel cared for."

Preventive examinations

According to Oksana, medical examinations play an important role in the prevention and early detection of diseases, although patients are often sceptical about them.

"Primary care doctors are more focused on prevention, and our daily task is to inform people that disease prevention prevents advanced cases. But, perhaps the most important thing is to find a way to approach the patient, to revive his or her trust."

She adds, "People often think that preventive examinations are just a whim of ours that carries no benefits. Patients ask: 'What do these preventive examinations do? Who needs them?' But during such examinations, we can detect serious diseases that the patient did not even suspect. For example, we measure blood pressure, blood sugar, do basic examinations and find problems that have not yet manifested themselves as symptoms. Then people come and thank us because they realize that early detection is a chance for recovery."

Oksana points to the critical role of trust in this process-patients' trust that health systems will deliver for them when and where needed. When a patient feels supported, he or she cannot betray either themselves or the doctor. Mutual responsibility is born along with a mutual goal to cure the disease."

‍Health-care reform

In recent years, health-care reform has opened up new opportunities for both doctors and patients. "Patients have access to the Affordable Medicines Programme," Oksana explains. "Thanks to this, they can receive medicines to treat cardiovascular diseases, diabetes, and now neurological or mental disorders. Many medicines are fully paid for by the state, and this is a great support for people."

She notes, "At the primary-care level, we are conducting more examinations. For example, thanks to portable ultrasound sensors, dermatoscopes or otoscopes, we can diagnose a patient's condition right at the appointment. This saves time."

In Oksana's opinion, the electronic health-care system has been a real breakthrough. "Now, the patient's information is stored in an electronic card. There is no need to look for paper medical records, which people often forget at home. All the results of examinations, tests, consultations are available on the computer, and I can see them at any time. This is very convenient when you need to make a quick decision or make changes to a treatment. Prescriptions have also become electronic: in just a minute, you can prescribe medication to a patient, and they will receive it via the phone."

Progress despite war

Unfortunately, the war has brought a serious challenge for both doctors and patients. "The war stopped our work for a while. Many patients left, outpatient clinics were destroyed and communication with people was lost. In the first months of the war, as health-care workers, we found it difficult to recover from what we had experienced, it was difficult to work, but we continued to do our best for patients."

Oksana continues, "After the de-occupation of Bucha, the situation was even more complicated: diseases had progressed due to the lack of timely care, patients needed additional treatment, and we had to establish the system."

She believes that despite all the challenges, Ukrainian medicine is not standing still. "Over the past 5 years, medicine has made a huge step forward. Today, patients can get most of the necessary services at the primary-care level, and their family doctor has become a real friend and adviser. I am confident that every year our medicine will develop even more, and we, as doctors, will master new skills and technologies to help people even more."

Building trust

Oksana highlights the comprehensive nature of family medicine. "We observe all body systems, from the heart to the stomach, from the skin to the nervous system. It is very interesting and extremely useful for the patient. But this requires new knowledge, and I am always trying to improve myself: I take courses, learn new techniques and master the equipment. This makes me a better doctor, which means I can help my patients better."

According to Oksana, the greatest satisfaction in her work is gaining the trust of patients. "There are people who come to me after consulting another doctor to hear my opinion. This shows how important it is to build trusting relationships with patients. We become for them not just doctors, but those to whom they can come with any problem."

This story was developed by the WHO County Office in Ukraine in collaboration with the Ministry of Health of Ukraine, and with financial support from the European Union and within the Universal Health Coverage Partnership.

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