Promote family medicine through sharing among healthcare professionals

Wai-man Yeung 楊偉民

HK Pract 2024;46:1-2

In this issue of the Hong Kong Practitioner, some of our colleagues have shared their valuable experience with us. Dr. Sio-pan Chan reported an unusual case of tuberculosis presenting with cervical lymphadenopathy and extensive pelvic and peritoneal lesions. In order to make a correct diagnosis, a high index of suspicion must be maintained and diagnostic tools needs to be used appropriately. In this case, Dr. Chan accompanied the patient throughout the entire process, from “uncertainty of diagnosis” to “cure of the disease”, which demonstrates the importance of continual care from our family doctor perspective. The appropriateness of referrals to other specialties was also discussed in his report.¹ Dr. Ka-ming Ho et al reported a case of vitamin B₁₂ deficiency presenting with loss of taste in a primary care setting. As the authors stated, the clinical manifestations of vitamin B₁₂ deficiency can be subtle, especially in the elderly, and some cases can have serious or even life-threatening consequences. An alert attitude and careful physical examination can save lives.² These excellent clinical cases were not only worthy as valuable materials for our learning but also cases which can demonstrate the nature of the work of family doctors to other healthcare professionals.

Not long ago, I was honoured to be invited by the Hong Kong Academy of Nursing and the Hong Kong College of Community and Public Health Nursing to give lectures to the nursing colleagues in the Post-Registration Certificate Course in Primary Health Care Nursing. One topic I taught was Concept of Family Doctor. Although the several characteristics of family doctors, namely first point of contact, holistic, continual, comprehensive, coordinated and preventive care, have been widely publicised by the Health Bureau³, on this day these concepts were re-introduced and explained again. In addition, some of the functions of family doctors in the healthcare system were discussed, such as early diagnosis of life-threatening and serious diseases, and serving as gate-keepers for referrals to secondary or tertiary specialist care. In fact, these are what our family medicine colleagues strive to practice every day. When clarifying the concepts of family doctors, I have used some cases encountered by family doctors in their work similar to the two cases mentioned above.

On the other hand, during my teaching this time, from the responses of the audience, I observed that many of them have a strong interest in psychosocial care, such as how to help patients and their relatives in their individual specific situations, accept unexpected diagnoses, how to walk with them in the process of chronic illness, how to face the difficulties encountered in treatment, bearing the frustrations together, continuing to encourage, and share the joy of successful treatment. To do this, it is necessary to understand the different physical, psychological and social dimensions of patients in order to tailor the most suitable treatment plan for them. Furthermore, the best way to talk about psychosocial care is to share cases. Real-life examples have the power to change our attitudes, the way we think and do things. In addition to using previously published examples of patients with obesity and cancer^4,5, I also shared other examples of psychosocial care in daily practice.

I was asked in class if I encountered any setbacks in practising these family doctor concepts, and my answer was a resounding yes. In fact, all walks of life will have their difficulties. This is an inevitable fact of life. Everything cannot be perfect all the time. We may be limited by external factors such as resources and time, or by personal factors such as fatigue or illness. We all need to know how to face adversity. This can be said to be a philosophy of life. Treat the current limitations as the norm, adopt a positive attitude, continue to learn, and continue to accumulate experience, and we will gradually master ways to overcome difficulties. Furthermore, we need other people’s opinions, support, and help just as patients need ours. If we have the experience of growing up in adversity, we should also be able to better understand patients, walk with them, express empathy to them, and provide them with more practical advice when they face adversities. Humans are social beings. We cannot live alone. We must work with each other to build a better world.

This lecture was a good experience for me. In addition to sharing my own knowledge, I was grateful to be able to interact with the nursing colleagues who were present. With changes in socioeconomic conditions, there are now more and more patients with chronic diseases, and many people are affected by mental health problems. Patients’ expectations and wishes for healthcare services are also different from those many years ago. Today, we need a strong multidisciplinary healthcare team to care for these patients, in terms of their physical, psychological and social health. In addition to doctors and nurses, we need different allied health professionals who can make different contributions for our patients. Communication between different members of the healthcare team, sharing each other ’s experiences, and allowing everyone to understand the difficulties encountered by each other will be the basis for the success of this team, which can ultimately better serve our patients from different backgrounds. Such educational and exchange activities should be promoted.

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