Table 3 Final list

R3–1.

Cultural competence

can understand the diverse socio-economic status and cultural background of patients and provide care that takes into account diverse medical needs.

understand the diverse socio-economic status (social status, education level, lifestyle, occupation, income, insurance, etc.) and cultural background (race, religion, thought, beliefs, customs, etc.) of patients and provide care that takes into account the diverse medical needs that accompany the situation.

R3–2.

Care for people at a social disadvantage

can understand social determinants of health and health inequalities, and can work with multiple occupations to provide appropriate care to a wide variety of populations with inadequate medical care.

understand social determinants of health and health inequalities, and can work with multiple occupations to provide appropriate care to a wide variety of populations with inadequate medical care (social isolation, withdrawal, poor areas, low income, uninsured, homeless, race/ethnic minorities, immigrants, LGBT, HIV/AIDS patients, commercial sex workers, criminal history, etc.)

R3–3.

Family-oriented care

can consider diverse values ​​and relationships with the family, communicate effectively with the necessary stakeholders, and provide appropriate care for the patient.

share information about the patient’s medical condition and make important decisions by taking into consideration various values and relationships with family members (not limited to blood relatives, but including common-law relatives and close acquaintances, various household structures and residential situations, etc.) and by communicating effectively with necessary parties. By communicating effectively with the necessary parties, they are able to provide support for decision-making that is appropriate for the patient and appropriate care.

R3–4.

Adjustment of the scope of care

can flexibly adjust the scope of care they provide to meet the diverse needs and problems of patients, taking into account the characteristics of a wide variety of surrounding medical institutions.

GPs can flexibly adjust the scope of care they provide to meet the diverse needs and problems of patients in terms of expanding or contracting the scope of care based on the characteristics of the various surrounding medical institutions (segmented specialties, trends in treatment policies, access, etc.) while maintaining a complete picture of the patient.

R3–5.

Coordination of care with specialized medical institution

can grasp the characteristics of a wide variety of medical institutions with fragmented specialties, and make appropriate referrals to and coordinate care with specialized medical institutions according to the needs and circumstances of the patient.

GPs can grasp the characteristics of a wide variety of medical institutions with fragmented specialties, and make appropriate referrals and linkages to specialized medical institutions according to patients’ diverse needs and circumstances (medical conditions, underlying diseases, socioeconomic status, transportation).

R3–6.

Integration of fragmented medical care

can take responsibility for the integration of medical care for patients who are experiencing the negative effects of fragmentation of care.

can take responsibility for organizing medical visits and providing comprehensive care to patients who have multiple diseases and are suffering from the negative effects of fragmented care due to visits to multiple specialties, by building trusting relationships and collaborating with doctors in specialties and other professionals inside and outside the facility.

R3–7.

Coordination of care with multiple professions

can grasp the characteristics of a wide variety of care and welfare services and community social resources, and make appropriate referrals and collaborations in collaboration with multidisciplinary professionals according to the needs and circumstances of the patient.

can grasp the characteristics of a wide variety of care and welfare services (e.g., nursing homes, long-term care facilities, home nursing agencies) and community resources (e.g., civic activities, hobby groups), and can make appropriate referrals and collaborate with them according to the patient’s situation in collaboration with multidisciplinary professionals (e.g., care managers, nurses, community comprehensive support center staff).

R3–8.

Community Oriented Care -Health Promotion

can identify health issues that are characteristic of the region/community and effectively collaborate with a wide variety of stakeholders to address them.

can identify health issues that are characteristic of the region and community in which they practice, and work effectively with a wide variety of stakeholders, including the people concerned, surrounding residents, and multidisciplinary professionals, to address health issues through ongoing planning, implementation, and evaluation.

For example, it is possible to address the health problems of specific groups, such as poor areas, areas with frequent ambulance use, elderly single households, foreign residents, night shift workers, and single-parent families.

R3–9.

Community Oriented Care -emergency care

can collaborate and tackle the issues of emergency medicine that are characteristic of each region at the field level of primary care.

can share issues with related parties (hospitals, clinics, ambulance crews, etc.) regarding emergency medical care in each medical area, cooperate from the field level of primary care, and implement some measures. For example, there are discussions on cases of tampering with emergency patients, efforts to ensure the continuity of patient information during emergency consultations on holidays and nights, and measures for patients who frequently undergo emergency consultations.

R3–10.

Details

-Occupational health

can provide appropriate care for occupational health-related health problems that are common or characteristic of each practice area.

can provide appropriate care as an industrial physician or in collaboration with an industrial physician for health problems related to industrial hygiene that are common or characteristic in each medical area.

For example, not only chemical and physical health disorders such as organic solvents, dust, noise, and vibration, but also psychosocial health disorders such as mental health and overwork, ergonomic health disorders such as VDT work and working attitude, or overseas workers. It is possible to flexibly respond to different needs depending on the medical treatment area, such as biological health problems like measures against infectious diseases.

R3–11.

Details-Infectious diseases

The GP can identify patients with suspected frequent infections in urban areas and take appropriate initial action.

GP can identify patients with symptoms and risk factors that should be suspected to be frequent infectious diseases in urban areas such as tuberculosis and sexually transmitted diseases such as HIV infection, and recall those diseases as a differential diagnosis, which is necessary. Appropriate initial measures such as conducting tests and coordinating/introducing with health centers and specialized medical institutions can be performed.

R3–12.

Details-Mental Health

can respond appropriately to mental health problems in patients of all ages and collaborate with psychiatrists and related agencies.

can respond appropriately to mental health problems in patients of all ages (especially children and young people with developmental disabilities, school refusal and elderly depression, delirium, or multi-generational drinking, smoking, drug addiction, etc.) It is possible to deal with various primary care levels and cooperate with psychiatry and related organizations.

R3–13.

Details-Dementia care

can carry out appropriate diagnosis and treatment for patients suspected of having dementia, and care management in collaboration with multiple occupations.

can appropriately cooperate with specialists in the diagnosis and drug treatment for patients suspected of having dementia, and can cooperate with multiple occupations (nurses, rehabilitation workers, care managers, caregivers, etc.) in care management to improve the quality of life, and also appropriately cooperate with administrative procedures as necessary (such as the written opinion of the attending physician for the use of long-term care insurance and the preparation of documents for the adult guardianship system).

R3–14.

Details-Behavioral transformation

can provide guidance using behavior modification theory to patients with lifestyle-related diseases.

can provide guidance to patients with lifestyle-related diseases using behavioral change theory based on various lifestyles.

R3–15.

Details-Palliative care

can provide appropriate decision support and palliative care to patients with cancer or non-cancerous diseases.

can continuously and appropriately support the decision-making of the patient, their family, or the surrogate decision-maker for patients in the treatment stage to the terminal stage of cancer or non-cancer disease.

In addition, it is possible to provide appropriate palliative care at the place (home, admission facility, hospital, hospice, etc.) according to the patient’s wishes and circumstances while coordinating and coordinating with each person concerned.

R3–16.

Organization management

can work on the organizational management of clinics and hospitals based on the role of primary care in each region.

can work on appropriate organizational management of clinics and hospitals (improvement of patient convenience, improvement of quality of medical care provided, division of roles with surrounding medical institutions and network formation, etc.) based on the role of primary care in each region.

R3–17.

Lifelong learning

GPs can learn about common illnesses to maintain their ability to practice regardless of the frequency of treatment opportunities.

can intentionally learn to maintain competence in common diseases, including emergencies and chronic diseases, regardless of the frequency of opportunities to practice in a setting with good access to surrounding specialty care facilities.

R3–18.

Education

can provide opportunities to learn the characteristics and significance of urban primary care in student and internship education.

can provide opportunities to learn the characteristics and significance of urban primary care at various student and internship education opportunities in community medical training.

For example, through clinical training in urban areas, it is possible to provide an opportunity to learn that primary care is necessary not only in non-urban areas and depopulated areas but also in urban areas.