Quaternary prevention: the basis for its operationalization in the doctor-patient relationship
DOI:
https://doi.org/10.5712/rbmfc10(35)1011Keywords:
Quaternary Prevention, Physician-Patient Relations, Medicalization, Primary Health Care, Family PracticeAbstract
The aim of this paper is to present the clinical and conceptual basis to operationalize quaternary prevention in primary healthcare services and teaching contexts and/or residency programmes in family medicine. The enhanced Calgary-Cambridge model of medical consultation is used as an organizational matrix to insert quaternary prevention in two moments: diagnosis and care plan. To strengthen quaternary prevention in these two consultation moments, the discussion explores: a) conceptual disease axes (pathological, physiopathological, semiological and epidemiological); b) illness explanatory approaches (ontological and dynamic); and c) suffering in relation to time (present and future), differentiating present lived suffering from concerns about future health. We conclude that despite limitations of the proposed framework, formalising quaternary prevention in the consultation process can help reduce the diagnostic and prescribing automatism, which has medicalized many illness expressions in the routines of primary health care services.
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