Primary care directory: More than just atelephone directory

Dear Editor,

The recent "Primary Care Development in Hong Kong Strategy Document in December 2010"¹ recognises the pivotal role that primary care places in a health care system. Its strength lies in the well-evidenced core principles of primary care in the provision of accessible first-contact care that is comprehensive, continuing, co-ordinated and person-centred care in the context of the family and community. Along with this, the need for a more responsive approach in tackling the increasing burden of chronic disease in Hong Kong is emphasized. One of the uniqueness of the strategy is the acknowledgement of achieving this goal by the multidisciplinary team to forge a more effective preventive approach together from the start.

The provision of a more comprehensive community-based care diverting the over-reliance on hospital and specialist care for management of common chronic disease is much needed. Major strategies outlined in the document forecast the need for quality improvement in raising a "primary care workforce with suitable professional skill-mix for effective delivery of the whole range of primary care functions" and to "improve the availability of quality care, especially for chronic disease patients". This stance from the Primary Care Office is to be applauded.

Individuals navigating the health system in Hong Kong can be overwhelmed by the challenges of the existing system. Persons seeking medical care face a fragmented, uncoordinated, mainly out of pocket service with variability in provider and clinical standards. Hence the development of the Primary Care Directory, initially a sub-directory of doctors (and dentists) would be an opportunity to map out primary care providers that have accredited training in Family Medicine.

Professional training in Family Medicine has long been associated with a better process and outcome of care and those doctors who have Family Medicine training are more involved in chronic disease care than those without. Along with the expressed views of the public in welcoming the principles of good primary care and Family Medicine, the initiative to establish a family doctor register is indeed overdue.

But alas, where there is the raising of hopes comes disappointment. This apt opportunity at the introduction of the Primary Care Directory in setting the standard of primary care is missed and the outlook for the future of primary care returns to grey. The Primary Care Directory has such a wide inclusive approach; thus to include not only general practitioners, specialists in Family Medicine but also other specialists such as paediatricians, physicians and geriatricians and indeed, any registered doctor who claims to provide primary healthcare. Whilst future upgrading of entry requirements are promised, it seems the Primary Care Directory is choosing to delay and lose the full advantage of its position in leading primary care in Hong Kong.

For us, doctors, however this is a fantastic opportunity! Those working in the public or private sector that truly believe in the vision of comprehensive, continuing and co-ordinated person-centred primary healthcare (or not), I hope you have already registered. More than a telephone directory, users can search online for your name, profession, location of practice, service hours, etc. The Primary Care Directory is now being launched from March 2011 and will authenticate you and your practice as a good primary care provider, advertise your services and all this without your having to achieve an extra CME point. I hope every fellow primary care provider doctor will in the meantime and without further delay join and enroll yourself in the Directory, and make this a success.