Family Medicine and Primary Care
Family medicine tests continuity, prevention, and managing undifferentiated problems in the community with limited resources.
Core rules
- Screening is age- and risk-based: blood pressure at every visit, colorectal cancer screening from 45–75, cervical screening, mammography 50–74, lipid and diabetes screening in adults ≥35 or with risk factors.
- Antibiotic stewardship: no antibiotics for viral upper respiratory infection, acute bronchitis, or uncomplicated otitis media in children over 2 without clear indication.
- Chronic disease: treat to individualized targets - A1c around 7% for most, BP <130/80, statin by 10-year cardiovascular risk.
- Biopsychosocial assessment: screen for depression, alcohol, smoking, and social determinants at comprehensive visits.
Worked example
A 56-year-old smoker, BMI 31, BP 148/92, asymptomatic. Confirm hypertension on repeat measurement, calculate cardiovascular risk, start lifestyle counselling plus one antihypertensive (thiazide-like diuretic or ACE inhibitor), order A1c and lipids, offer colorectal and lung cancer screening, and review in 4 weeks - rather than ordering a battery of tests at once.
Traps
- Screening without confirming the diagnosis from a single elevated reading.
- Ignoring vaccination status at every contact.
- Treating the lab value rather than the patient - check adherence and side effects before escalating.
- Missing red flags requiring referral: weight loss, night sweats, rectal bleeding.