Primary health care is provided in our service by our three family doctors and health staff in cabinets organized in accordance with the legislation on the organization and functioning of medical cabinets. The family doctor provides medical assistance to the patients registered on their lists and provides emergency assistance to any person who needs these services.
The insured person’s status is proved by means of supporting documents: the employee’s certificate showing the payment of health insurance and the certificate or the insured person’s booklet issued by the Health Insurance House to which the insured person pays the contribution, until the introduction of the electronic insurance card.
Family doctors provide the insured with the necessary medication on a compensated basis or free of charge, referral tickets to specialist offices or hospital admission tickets, prophylactic services, family planning services, periodic check-ups including screening for TB or venereal diseases, disease prevention activities, step-by-step supervision of infants 0-1 years and counselling on childcare issues, pre and post HIV testing counselling for pregnant women, for prevention and control of cardiovascular risk factors, anti-drug counselling, emergency services, curative medical services, home health care.
The family doctor also provides medical services for a fee when they are not paid by insurance companies: for obtaining a driver’s license, tests for employment, medical records for driving, periodic check-ups for certain professions, prenuptial certificates, medical services on request (regardless of the status of the person requesting these services), etc.
The family doctor’s working hours are from Monday to Friday, minimum 5 hours in the office and 2 hours in the field at the insured’s home.
The regulations concerning the medical services provided by the family doctor in contractual relationship with the Health Insurance House of the Municipality of Bucharest (CASMB) are provided for in Law no. 95/2006 on health reform, Government Decision no. 262/2010 for the approval of the Framework Contract on the conditions for the provision of medical assistance within the social health insurance system and MS/CNAS Order no.265/408/2010 for the approval of the Methodological Norms for the application of the Framework Contract.
BASIC HEALTHCARE PACKAGE
Granted to insured persons on their own list
A. Prophylactic services
- Follow-up of the child’s physical and psychomotor development, from the time of discharge from the maternity ward until 18 months of age, through check-up examinations;
- Pregnancy and breastfeeding surveillance: first trimester check-up; monthly surveillance from the 3rd month to the 9th month; follow-up of the breastfeeding woman at discharge from the maternity ward and at 4 weeks; pre- and post-test counselling for HIV and lues for pregnant women;
- Compulsory annual medical check-up for children from 2 to 18 years – check-up;
- Compulsory annual medical check-up for insured persons over 18 years of age for the prevention of diseases with major consequences in morbidity and mortality;
- Family planning services;
- Immunisations according to the national immunisation programme;
- Medical and health education and counselling for the prevention and control of cardiovascular and oncological risk factors as well as anti-drug counselling;
- Periodic check-ups for conditions requiring dispensing;
- Screening of new TB patients, actively discovered by the family doctor, referred and confirmed by the specialist;
B. Curative health services
- Consultation (medical history, objective examination, diagnosis) in case of illness or accident. Up to 2 consultations per month are granted to the insured person, except for emergencies and annual and regular check-ups, which are not included in this number.
- Minor surgery and injectable treatment;
- Prescription of medical and hygienic-dietetic treatment;
- Referral for paraclinical investigations to establish the diagnosis;
- Issuing referral notes for cases beyond the competence of the family doctor to other medical specialties either in the outpatient system or in the hospital;
- Taking the record of the TB patient confirmed by the specialist doctor, monitoring and applying strictly supervised treatment;
- Medical assistance at home for the cases provided for by the methodological norms of application of the Framework Contract;
- Monitoring the treatment and the evolution of the health status of chronically ill patients;
C. Emergency medical services
- Medical assistance in medical and surgical emergencies (anamnesis, clinical examination and treatment), within the competence of the family doctor and the medical technical possibilities;
- Referral, for cases beyond the competence of the family doctor, to the specialist doctor in the outpatient clinic or for admission to hospital;
Insured persons benefit from these services, regardless of the family doctor on whose list they are registered. Medical services for emergencies are provided in the family doctor’s surgery, within the established working hours, and outside these hours, in on-call centres. Medication is provided from the emergency kit.
D. Support activities
- Issuance of medical documents: certificate of medical leave, referral tickets, medical prescriptions, death certificate, except for suspicious situations requiring forensic expertise, according to legal provisions, medical exemptions for children in case of illness, medical documents required for children in foster care within the social welfare and child protection system.
E. Practical activities according to the specialty and competence of the family doctor
MINIMUM HEALTH CARE PACKAGE
Granted to uninsured persons
- Medical services for emergencies (see basic medical services package);
- Screening for diseases with endemic-epidemic potential (objective examination, presumptive diagnosis, referral to specialist hospitals for confirmation and treatment);
- Family planning services;
HEALTHCARE PACKAGE
Granted to persons who take out voluntary insurance
- Medical services for emergencies (see basic medical services package);
- Screening for diseases with endemic-epidemic potential (see minimum package of medical services);
- Pregnancy surveillance (see basic health care package);
- Immunisations according to the national immunisation programme (see basic healthcare package);
OBLIGATIONS OF THE FAMILY DOCTOR
- Requests from the insured persons, when registering on their own list and in other situations provided for by the legislation in force, the supporting documents attesting the quality of insured person;
- Respect the work schedule which is posted in a visible place;
- Display in a visible place the name of the health insurance company with which they have a contractual relationship;
- Arrange for another family doctor to take over medical activity during periods of absence (rest leave, sick leave, etc.);
- Enrols children who have not been registered with a family doctor, as soon as the first consultation of the sick child in the locality of residence is held. The newborn child will be registered on the list of the family doctor who has cared for the pregnant woman, if the parents of the newborn child do not have another option expressed in writing, immediately after the birth of the child;
- Register pregnant women who are not on the list of a family doctor, at the first consultation, in the place of residence or at the request of the representatives of the community health care system;
- Registers children on the list of insured persons, at the request of parents, legal guardians or at the request of the health insurance company or the town hall, as well as at the request of the community health care system or the child protection directorates;
- Provide medical assistance in case of medical and surgical emergencies, whenever requested, regardless of whether the person is insured or not;
- Respect the quality criteria of the medical services provided and the activity carried out;
- Issue medical documents;
- Informs the insured about the services offered and the way they are provided;
- Provides the insured with the medical services included in the basic package;
- Provides the medical services package for the voluntarily insured persons;
- Provides uninsured persons with the medical services included in the minimum package;
- Prescribes medicines with and without personal contribution from the insured, in accordance with the diagnosis;
- Recommends paraclinical investigations to establish the diagnosis;
- Makes a referral note to the outpatient specialist or to the hospital for hospitalization, when necessary;
- Provides medical services to all registered insured persons, regardless of the health insurance company where the insured person is registered;
- Provides emergency medical services to pregnant women;
- Respects the right of free choice of the insured to choose the family doctor, the specialist doctor and the health unit;
- Respects the right of the insured to change his/her family doctor after the expiry of at least 6 months from the date of registration on the list;
- Respect the confidentiality of all data and information concerning the insured, as well as their privacy and dignity;
- Provide medical services to all insured persons without any discrimination using the most effective forms of treatment;
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