Holistic approach is the characteristics of primary health care
LAHORE: Prof. Salman Rawaf from Imperial Medical College London who is also President of Interenational Association of Medical Colleges (IAMC) was one of the invited guest speakers at the 7th International Conference on Health Professions Education (ICHPE) organized by University of Lahore on November 2nd 2023. During the conference dinner held at the university campus, he spared some time to talk to Pulse International Chief Editor Mr. Shaukat Ali Jawaid and shared his views on functioning of the IAMC, working of National Health Service in UK, duties and responsibilities of healthcare professionals, importance of primary healthcare besides unethical medical practices by the medical profession. Given below are the excerpts from the conversation.
Prof. Salman Rawaf
“Basis of any health system in the world is primary healthcare delivered by trained doctors and health professionals. We have some superb models since 40s in UK, Sweden, In European countries where every citizen is registered with doctors. Doctors were trained in a structured training programme for two years after MBBS.
In 1978 WHO at its Alma Ata conference decided to provide “Sustainable Health for All by the Year 2000”. Every family in the world should have a family doctor? It was the starting point for the universal health coverage. Why we talk about primary health care because cost of consultation at PHC level will be much less than visit to the OPD in the hospital or Accidents and Emergency Department. At PHC they look after the patient in health and disease. Hospital they visit only when they have disease. It is good if people maintain health and prevent diseases.
Holistic approach is the characteristics of primary health care. When we develop disease which are chronic diseases, the GPs who are PHC specialists continue to follow up. The patients rarely visit hospitals as it is very expensive. Primary health care also provide convenient location for community care. PHC is the first contact of patient with health system. They do gate keeping preventing people to go to the hospital. In UK 90% of health problems are sorted out at Primary Healthcare level and only 10% go to Hospital in NHS which is extremely cost effective.
Medicine is no longer an attractive profession for young doctors as it is very demanding. There is pressure of technology and patient’s expectations has increased. The diseases the patients are suffering from are resulting in lot of pressure on junior doctors. Their pay is not comparable with the amount of time engaging them and the work they do while looking after the patients.
This generation discuss lot of fun while we did not had the computers. With Social Media now world is in their hand. They do not want to miss to be located in hospital. Pay remains a major factor. This problem is seen at global level. After Covid19 pandemic, things have changed. Medical profession finds itself under lot of pressure and unfortunately it reflects badly on residents all over the world.
Medical Education during Covid has also undergone enormous changes. Lot our history is affected and it has also broken our social fabric. People now prefer to work from home. Nobody is going to banks and post office in the developed world. Use of internet for virtual teaching is common. Human beings are social animals hence this situation may not last long. Isolation is very dangerous for elderly people.
Unethical practices by the healthcare professionals are seen worldwide. Cost of living continues to increase. My father said to me two things. You do not take money from any patient. You go and do PhD. I never took money from patient during my life. I am amazed at the devotion and dedication of people working in National Health Service. We need to prepare future generation of doctors trained in ethical practice. It should be taught in the curriculum and seniors should act as role models. Regulatory bodies like GMC in UIK and others in different countries should look at it and take action. In USA 10% deaths are attributed to medical errors. It is the duty of the government to protect doctors and provide treatment to patients.
They should ensure that healthcare professionals are happy and work under comfortable, conducive, secure environment. Once we have voice, and doctors should have voice Change their attitude and behavior to be more human. Pakistan is a great Muslim country. You have lot of good critical mass In Islamic world, you have fantastic work force, and your professionals are talented and well trained. They should have confidence in the Nation.
Prepare new generation in all fields who should be equipped with knowledge courage drive and commitment to Love of the country. Among those working in NHS we do not see any one leaving before he or she has completed their job. It is the commitment and dedication. They are doing more than expected. Only 5% not doing the job, hence why punish the 95% who come in time and leave much later in the evening. Society should give due respected to the medical profession. You have many beautiful places, take care of doctors, keep them happy and they will be more than happy to serve the country.”
