Those who are working in the health service sector need to have a model suitable for the 21st century with its different problems and challenges in order to treat patients while maintaining and improving standards of care.
The state has many hospitals which deliver primary care. These sources are generally underutilised due to the lack of facilities and trained doctors who are transferred from place to place.
We need a model in place which would suit our country with its resources, culture and different alternative systems of care. We need people with commitment who could implement such a system which has already been planned and approved that could restructure the present system with its strengths, weaknesses and the opportunities available, without major upheavals and develop the existing system into a strong primary care-led system.
The College of General Practitioners of Sri Lanka (CGPSL) has taken a lead to train doctors who are in general practice. It was the CGPSL that introduced training programmes for postgraduates. Currently, they conduct a diploma to award its membership as well.
Also, the speciality of Family Medicine was introduced into universities and a new generation of medical students learnt the basics of family practice through devoted teachers.
We are partnered with other countries as a result of globalisation. We maintain cooperation. The royal colleges support us. We conduct exams which award degrees from the Royal Colleges of GPs in the UK. The exams are conducted by a South Asian Board chaired by a Sri Lankan doctor. We also have support from the World Organization of Family Doctors. Our specialists are trained not only in this country, but also in Western countries where standards are set for good practice. They bring back new ideas and expertise to the country.
We are no longer looking at the 20th century model due to its division of hospital and general practice. Instead, we consider the 21st century model of integrated care where patients are always put first and professionals work closely together, irrespective of speciality or location. We also need to realise the importance of teamwork with other paramedical staff who can contribute to better patient care.
We need to ensure that our training programmes prepare every doctor for his or her full role as a generalist.
To achieve this goal, we need stronger undergraduate programmes as well, as we need to reach the doctors delivering primary care. The focus should be on particular needs and challenges of primary care.
The time has come to shift patient care to the patient’s home from more of hospital-based care. It is less costly to all concerned and more comfortable for the patient and family. This is now more so with the fast-growing elderly population. Training in a tertiary care setting does not prepare doctors well to carry out these tasks. More community-based learning experiences need to be introduced into all curricula.
Today, May 20, is World Family Doctor Day. The World Organization of Family Doctors extends its hands to support all countries. In developed countries, it is mandatory for the GP to undergo training to enter general practice. We too need to look ahead and achieve this for better patient care at the primary level.
(The writer is an Emeritus Professor of Family Medicine at the Sri Jayewardenepura University, Past President of the College of General Practitioners of Sri Lanka, Hony. Fellow of Royal College of General Practitioners of the UK, and a Fellow of the World Organization of Family Doctors)
from daily news