The versatile role of modern-day family physicians

Man-kuen Cheung 張文娟

HK Pract 2007;29:449-450

A few days ago, while I was driving home from work, I heard a short clip over the radio, which was positively heartening to me. An ENT doctor was talking about the symptoms and signs of nose bleeding, and urging the audience to "consult your family doctor" in case such symptoms or signs arise, so as to see if further investigation or referral was needed.

Indeed, family medicine in Hong Kong in the past few decades has seen many changes. One very significant change, as I see it, is the establishment of family medicine as an integral part of the healthcare system, recognized by other medical specialties, patients and community at large. This change is no small feat. And the credit goes to all the hard-working colleagues in our specialty.

But, with this rising awareness and popularity of family medicine, we face high expectations as never met before. Apart from superior clinical competence, we are expected to have good understanding of the various needs of our patients, and to contribute to the development of new trends in healthcare of our population. This issue of Hong Kong Practitioner fittingly demonstrates our versatile role.

From page 452 to 462, Dr Lee and colleagues set out to examine Hong Kong Chinese women's sexuality after termination of pregnancy (TOP). Their result showed that TOP had no significant impact on sexual dysfunction. However, more women reported decreased sexual desire and post-traumatic stress disorder (PTSD) after TOP. This piece of information is important, since every now and then family physicians may see a female patient presenting with decreased libido, or hear her partner lament about it. Tactful questioning of possible history of recent TOP may help in identifying the root cause of the problem. After all, patient may not relate the symptom with the episode of TOP, or may not volunteer this piece of information unless we ask about it.

From page 463 to 469, Dr Keith Lau and colleagues update us on the management of asymptomatic microscopic haematuria in children. Asymptomatic microscopic haematuria is a common clinical problem encountered by family practitioners, and might be quite alarming to the patient and physician alike. As mentioned by the authors, "patients referred for consultations of haematuria vary from immediate consultation without any prior workup to comprehensive investigations. Most of the referrals reflect inappropriate and unrealistic approaches in primary care setting." Hong Kong is an affluent society which enjoys the best of technology. Technology advanced at an amazing pace and our patients were informed of such through the mass media. This article gave us the evidence-based approach to employing technology and making appropriate referral.

Hong Kong is now facing an aging population with a greater burden of chronic illnesses. It is important for us family physicians to get prepared for the new challenges ahead. From page 470 to page 480, Dr Chan and her colleagues examine the evolution of the management of hypertension in their various locality over the past 3-4 years. It is encouraging to see that through concerted effort, the standard of hypertension management can be improved significantly. The same can apply to other chronic illnesses and health service models, with family physicians playing a pivotal role.

Indeed, the evolution of our specialty in the 21st century requires concerted effort from all of us. We need to lead and manage change, and to bring greater benefit to our patients and communities. Let's all contribute our best towards this goal.