Family and Community Medicine and its role in preventing health overuse (preventive, diagnostic, therapeutic and rehabilitative).

In Medicine, it is critical "to offer 100% of what is needed and avoid 100% of what is not needed." Unfortunately, this primary issue is challenging, and generally, more than required is offered, and everything that is unnecessary is not avoided. This is a nonsystematic review with a teaching objective that reviews the general issue in primary care and suggests ways to avoid overuse and shortcomings concerning preventive, diagnostic, therapeutic, and rehabilitative interventions.

[Strategies to promote testosterone deficiency syndrome: a paradigm of disease mongering].

The so-called «testosterone deficiency syndrome» is a blend of nonspecific symptoms typical of the physiological process of aging. This syndrome has been the subject of intense promotional activity that has presented the phenomenon as highly prevalent and with a major public health impact. This strategy has been accompanied by the emergence of new and easy to administer testosterone devices into the pharmaceutical market and has generated significant sales for drug companies.

[Quaternary prevention in the elderly].

Quaternary prevention is a group of measures taken to prevent, decrease and/or alleviate the harm caused by health activities. Health activities not only generally produce benefits, but also harm. That is to say, although medical intervention is mainly favourable, there is a dynamic balance that requires continuous assessment of the clinical situation as naturally only those health activities that achieve more benefit than harm at the end are justified.

[Longitudinality, prestige, good reputation (social and professional) and general/family medicine. Clinical and public health aspects. SESPAS Report 2012].

The reform of primary care in Spain in 1984 focussed mainly on skills and knowledge (physician training and working hours) and material resources (new buildings). The reform did not succeed in improving longitudinal care nor did it give primary care physicians greater power, that is, the reform did not increase coordination or strengthen the central role of the family physician in services provision. The lack of longitudinality has persisted over the years since the working methods that encourage it (and its resulting clinical and public health benefits) have not been stimulated.

[Health expenditure on primary care in Spain: not enough to provide attractive services to patients and health professionals. SESPAS Report 2012].

The relatively low health expenditure on primary care in Spain is a result of the status quo in the health system, in which hospital/specialized care is much more widespread and better financed than primary care. Another cause consists of the health policies developed in the last 30 years, which have prioritized the development of the private ambulatory health sector over primary care.

[Public health crises in a developed society. Successes and limitations in Spain. SESPAS report 2010].

The perception, acceptability and management of risks are social construction. Consequently, in managing public health crises, the gap between facts, beliefs and feelings tests the responsiveness of official institutions to health alarms that can be objective, potential, or imaginary. On balance, a strong point of the Spanish experience of health crises is the presence of clinicians and public health officers working in an organization capable of responding adequately, although the quasi-federal Spanish political structure has both advantages and disadvantages.

Political borders as scientific barriers in general practice. Portugal and Spain as a case study.

Introduction: Borders do not only mean the existence of limits, but also of barriers. For example, despite the cultural and geographic proximity, there seems to be a considerable lack of awareness and ignorance among Portuguese and Spanish GP's of their Iberian neighbour's scientific production, particularly among the Spanish side, which is biased towards the work and publications of authors from Anglo-Saxon and Northern European countries.

Methods: The authors thus carried out an analysis of the last 12 issues of both the Portuguese and Spanish General Practice flagship journals, counting back from the last issue of 2008.