Role of Family Medicine Practitioner for Increased Quality of Care with Decreased Cost

The World Health Organization (WHO) has identified unequal access to prevention and care, rising costs of health care, inefficient health care systems, and lack of emphasis on generalist training as major barriers to equitable health care in developing countries. It also acknowledges the family medicine practitioner as an important contributor in overcoming these barriers.

Participants from 11 countries attended the Family Medicine Conference at AKU.

A three-day international conference on family medicine highlighted these concerns and made recommendations for providing better access to high quality health care to the burgeoning populations in developing countries. The conference, on the theme, "Family Medicine – Challenges for the Next Decade",  welcomed delegates from medical institutions in the UK, Ireland, Tanzania,  Kenya, Saudi Arabia, Lebanon, Afghanistan, Sri Lanka, Bangladesh, Nepal and Pakistan. The conference was  organised by AKU's Department of Family Medicine in collaboration with the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA); Royal College of General Practitioners (RCGP), UK, and the College of Family Medicine, Pakistan. It also celebrated the first and very successful decade of AKU's  four-year residency programme in Family Medicine.

Professor Sultan M. Farooqui, President, College of Physicians and Surgeons, Pakistan, and member of AKU Board of Trustees, who was chief guest on the occasion, highlighted the multitude of health care problems afflicting the developing world, especially Pakistan. He said that at 2.8 per cent, Pakistan had the sixth fastest population growth rate in the world, but a very poor health services network. Professor Farooqui added that 80 per cent of the diseases reported to doctors were preventable in nature. "These diseases are either totally preventable or such that their course can be positively altered if properly dealt with at the first level of care by a trained family physician," he said.

Dr. Michael Boland, President of WONCA, said the practice of family medicine is required most in countries where it is weak, or non-existent. He emphasised that expenditure on the health sector both in developing and developed countries did not meet the demand. "This trend needs to be reversed, and this aim can be achieved if we attach due importance to the discipline of family medicine," he said. WONCA is the largest organisation of family physicians in the world, with 180,000 members from North America to the Far East.

Dr. Garth Manning, Medical Director, International Development Programme, RCGP, UK, discussed the successful partnership between this organisation and AKU over the past 10 years. He suggested that where a country's health care system is family practice care orientated, the results are lower costs, higher satisfaction levels of its health care services, a more healthy population and lower medication usage. Dr. Azhar Faruqui, Professor and Executive Director, National Institute of Cardiovascular Diseases, highlighted the central role of family medicine in prevention of cardiovascular diseases including hypertension.

"There is world-wide recognition that trained family physicians combine knowledge and skills from various medical specialities with a holistic approach, offering accessible, high quality and cost-effective care to individuals, family and the community," said Dr. Riaz Qureshi, Chair of the Department of Family Medicine, AKU. He said that the challenges ahead were, amongst others, a paltry budget of less than one per cent of GNP for the health sector in Pakistan, and a lack of structured training programmes in family medicine.  It was for this reason that AKU started its four-year Family Medicine training programme, which later gained recognition for MRCGP, UK  and FCPS.

Challenges in family medicine identified for the next decade included a proactive, joint approach by regional parties in collaboration with international organisations to promote the awareness and recognition of family medicine as an important speciality.