Hong Kong College of Family Physicians

There was a very interesting health article in the South China Morning Post last week titled “Specialist visit may increase hospital stays”. This is based on a scientific report by Prof. Samuel Wong and his team at the School of Public Health and Primary Care, The Chinese University of Hong Kong. If you log onto www.nature.com/scientificreports and browse 20 July 2016 and open “The association between types of regular primary care and hospitalization amongst people with and without multimorbidity: A household survey on 25,780 Chinese”. This article will make every hard working and dedicated Primary Care doctor proud.

The results revealed a significant association between having regular source of primary care from general practitioners and reduced hospitalization amongst respondents with multimorbidity. Chronic patients who consulted specialists rather than general practitioners for care were twice more likely to be admitted to hospital! The holistic, comprehensive, patient-centred and community care by us really works. With an ageing population, it is projected that the long term expenditure for elderly healthcare will increase to 4.9% of GDP by 2036. We improve the health outcomes, lower the morbidity and mortalty, provide better preventive and cost effective care. What more can a community ask for!

The next question is how many general practitioners/family physicians primarily engaged in primary care are existing in Hong Kong? The answer is nobody knows. One of the patient’s right groups commented the work of Primary Care Office under the Department of Health has been limited despite the effort to create a primary care directory. The Office is better off to operate directly under the Food and Health Bureau in order to boost its influence. I hope our health officials will listen to our patients’ suggestion.

Here comes my favourite topic: MANPOWER. If we do not have well trained family doctors, our crown as the city with the longest life expectancy will soon be dethroned. Back in 2011, Dr. Mark Chan, one of our Council members led a team to provide a written submission to the Manpower Planning Committee of the HKAM. The estimation was based on one family doctor serving 2,450 people and therefore 2,855 trained family doctors were required to serve the 7 million Hong Kong population. Assuming an annual output of 100 Family Medicine specialists, it will take 28 years to achieve the full competence of family physicians (HKAM specialist standard). The reality is over the past five years there is an average annual intake of 35 trainees entering the 4-year basic training and 22 trainees entering the 2-year higher training. The simple arithmetic means we need 130 years to train enough clones of our type. In UK, 50% of medical graduates are trained in general practice. In China, 150,000 primary care doctors will be trained in the next five years. In Hong Kong, each medical graduate costs the taxpayer $5 million to train as “undifferentiated” doctor and is not a finished product as Family Physician. If the Hospital Authority is not providing more training posts in Family Medicine, my only wish is “Long Live Everybody, Long Live the President.” We may have to extend our retirement age to serve the community.

Dr. Angus M W CHAN
President

Back