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28
February 1998
Family
Medicine deserves higher priority in local medical scene
(Keywords:-
Family Medicine, General Practitioners, estate doctors)
The recently announced result of a survey on the usage
pattern of estate doctors released by the Hong Kong Council of
Social Service, albeit a good one, has brought on mixed feelings.
Some view it an accusation of estate doctors not having
adequately discharged their duties of health care promotion and the
whole concept of family physician.
Experience and records have shown that many sicknesses could
be dealt with and cured in a primary health care setting without
requiring hospital admission. The long standing myth that ¡§you
need to be admitted to hospital for proper cure¡¨ is thus a
misnomer.
On an economic basis, hospital treatment is much more
expensive -- take the public hospital as an example, the average
cost of running a hospital bed is more than $3,600 whereas the cost
of a consultation at a public general out-patient clinic is
around $200 by Government standard. There are other
disadvantages: you are separated from your family and cannot enjoy
their care when you need them most; the incidents of cross infection
in a hospital setting is a potential danger and hospital ¡§bugs¡¨
are usually more virulent; just to mention a few.
It is a well known fact that many diseases are closely
related to the environment where one lives, the mental and physical
stress and illnesses of other members of the family. Understanding
these background will not only assist in the way a sick person
should be handled, but help in getting that individual well quicker
in no small way.
Yet, the survey report could also be looked at from a
positive angle. It is here that the medical practitioners,
especially those that have been the guardians for primary health
care ever since the pioneering days of housing estates can take
solace on the constructive side of the comments.
To wit, it must be a pleasant surprise to all that, as
reported, 90% of respondents visit doctors of their own estates;
60% interviewed and their families stick to one doctor and
one doctor alone. Estate doctors should be proud that they are being
acknowledged as the first point of contact for any health related
measure. The criticism that 80% of estate doctors spent less than
six minutes with each patient; while only 40% have quizzed patients
on their lifestyle or diet signified the yearn that patients in
housing estates have on their neighbourhood doctors to be their
family friends.
All these could symbolise the dawn of a new era where the
concept of primary health care for proper treatment is slowly being
accepted.
But more need to be done. At a start, a wide and yet in-depth
education on primary health care is essential. It would be counter
productive, if on one hand the physician would like to understand
the patient more, yet on the other hand the patient may complain
that the doctor is wasting his time because he just seeks
consultation for a headache.
Furthermore, the education must also be extended to the
health care workers, many regrettably have engraved In their culture
that the only ¡§panacea¡¨ is hospitalisation.
Secondly, there must be an adequate number of well trained
family physicians. With the majority of our six million plus
population seeking primary health care doctors as their first point
of contact for illness of any kind, there are only 107 Fellows in
Family Medicine of the Academy of Medicine; including
only a handful serving in the public sector. Regrettably,
whilst the College of Family Physicians has been established under
the Academy of Medicine, there is hardly available facilities to
provide the designated training.
The profession has repeatedly called on Government to upgrade
primary health care by providing the necessary revenue for training.
The survey report in essence has echoed the call from the public. It
is for Government to act now. With such a high reserve ¡§locked
up¡¨ and left unused, there is no excuse for Government to further
procrastinate!
(Hongkong Standard)
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