Healthcare reform consultation document - what Family Medicine is about

Donald K T Li 李國楝

Dear Editor

It appears initial public reaction to the Healthcare Reform Consultation Document is about whether the elderly and patients with chronic illnesses can be taken care of with the proposed reform. Most of the antagonism was towards the suggestion of shifting medical care from the heavily subsidized public sector to the private sector, which requires a fee for service. Moreover, there were doubts on the responsibilities placed on our Family Doctors. Unfortunately, the majority of the public does not understand what Family Physicians are capable of doing and the kind of training we have undergone. Family Doctors provide continuous, comprehensive, holistic care. The holistic care provided by Family Doctors is well sought after and is an attitude that hospital / secondary care specialist providers should also adopt. In my mind the report encourages the upgrading of the quality of primary care in Hong Kong, and is recommending to the public that this is something Family Doctors can provide. Perhaps without sufficient elaboration, this point has not been appreciated. Patients with chronic illnesses worry about their specialist care at present provided by public hospitals being shifted to the community and worry about the qualification of the private primary care providers taking over this role. They worry that Family Doctors unlike "super" specialists cannot deal with cancers, mental illness, disabilities etc. not realizing that Family Doctors are not only here to work in partnership with the hospital specialists but can also provide additional care such as psychological counselling and advise on family support as well as on utilization of public resources for rehabilitation for the patient. By our role as gatekeepers, Family Doctors can refer the patients back to hospital care when there is such a need.

I agree that without a viable sustainable financial solution to the proposals laid out in the document, the public will have little faith in a favourable outcome of the healthcare reform. Nonetheless, the step towards upgrading the quality of primary care by recommending the services of Family Doctors should be regarded with more optimism when the public understands more about Family Medicine.

Donald K T Li 6/F Hing Wai Building
36 Queen's Road, Central
Hong Kong
Tel: 25226744
Fax: 28684626