Family medicine in post-communist Europe needs a boost. Exploring the position of family medicine in healthcare systems of Central and Eastern Europe and Russia

A key informants survey in 11 Central and Eastern European countries and Russia using a questionnaire developed on the basis of systematic literature review.Formally, family medicine is accepted as a specialty in all the countries, although the levels of its implementation vary across the countries and the differences are important. In most countries, solo practice is the most predominant organisational form of family medicine. Family medicine is just one of many medical specialties (e.g. paediatrics and gynaecology) in primary health care. Full introduction of family medicine was successful only in Estonia.Some of the unification of the systems may have been the result of the EU request for adequate training that has pushed the policies towards higher standards of training for family medicine. The initial enthusiasm of implementing family medicine has decreased because there was no initiative that would support this movement. Internal and external stimuli might be needed to continue transition process.Central and Eastern Europe (CEE) experienced dramatic changes by the end of the 20th century. The changes were marked by the fall of communist ideology and regimes in late 1980s and early 1990s. After that, the former communist countries took different ways of social and political transformation. Some of the countries became members of the European Union, while the others struggled with economic and political instability.The expansion of the European Union had an important effect on CEE countries. Although organization of health care is left to the member states, Europe is moving towards common standards in health care provision [1].The health care systems of CEE countries were not identical before transformation and they roughly fall within two categories: the systems based on the Soviet Semashko model [2-10] and the system of former Yugoslavia [11,12]. The changes were far-reaching in all areas of the health care system, especially in primary care. In the post-Semas