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Objective: Family medicine (also called general practice) is a specialty with a focus on primary care. In Turkey, not all primary care is provided by specialists. Efforts are underway to improve primary care by improving the provision of primary care, establishing referral chains, and having care provided by general practitioners after transition training or by family medicine specialists. We investigated the relationship between evidence-based medicine (EBM) and primary care in Turkey, to provide a snapshot of the current situation and baseline data to assess the effects of current and future reforms., Methods: A cross-sectional survey was done of 375 primary care physicians: 138 general practitioners (GPs), 121 family medicine (FM) trainees, and 116 FM specialists. They were asked 30 questions assessing general characteristics, knowledge, and training in EBM; general attitudes towards EBM; resources used to support clinical decisions; possible barriers to EBM practice; and opinions on future practice of EBM. Data were analyzed with SPSS 12.0., Results: Compared with the other physicians, FM specialists had significantly more Internet access, used the Internet for medical purposes more often and for longer hours, had published more scientific papers, searched MEDLINE or similar databases more often, and were more confident about conducting literature searches. FM specialists had significantly higher rates of training in EBM and critical appraisal. For all types of physicians surveyed, the main reported barrier to practicing EBM was lack of training in EBM., Conclusions: Attitudes toward EBM differ significantly between GPs and FM specialists working in primary care in Turkey, which we believe results in variation in medical provision. The differences between these two groups of physicians should be investigated further, and means of improving the provision of care should be reported to policy makers., (© 2009 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.)

Objectives: The Turkish healthcare system is currently undergoing reform, and efficient use of resources has become a key factor in determining the allocation of resources. The objective of this study was to analyze strengths, weaknesses, opportunities, and threats (SWOT) in the development of a health technology assessment (HTA) program in Turkey., Methods: A SWOT analysis was performed using a literature review and interviews with key people in the Turkish Ministry of Health and Ministry of Labor and Social Security., Results: Regarding recent reforms in health care, investments for information network and databank are the strengths, but the traditional "expert-based" decision making, poor availability of data, and poor quality of data could be seen as some of the weaknesses. Another major weakness is lack of general awareness of HTA. Increasing demand for transparency in decision making, demand for evidence, and demand for credibility by decision makers are some of the opportunities, and current healthcare reforms, i.e., restructuring of healthcare and general health insurance, could also be seen as major opportunities. These opportunities unfortunately could be threatened by lack of funding, and resources are challenged by large, recent national investments., Conclusions: There is a good opportunity for Turkey to use the skills in HTA currently being developed through activities in Europe and the Americas to assist in the development of a much more cost-effective and transparent healthcare system in Turkey.