It is depressing to think about
primary care in Hong Kong. It seems
common consensus that primary care is all along not well taken care of by the government.
Resources allocated to primary care are
out of proportionally low as compared to secondary and tertiary healthcare. However, the outcome is not that bad. Hong Kong people might be unhappy, but they
are not in poor health. Statistics confirm
this fact. There exists a delicate
balance among the behavior of citizens, the hard working primary healthcare
workers and the government input.
It is not depressing to be a
general practitioner, provided that you don’t think too much. Do ignore the people who called you names out
of nothing when the Healthcare Voucher Scheme was first launched. Do not think about the stressed-to-be-overpaid
sum of $50 for vaccinating screaming kids, for explaining pros and cons, for
keeping records, and for looking after them for any adverse effects. Do not watch TV least you see the HMOs
promising everything to their potential clients while giving you $105 for each
consultation, plus medications, plus writing medical reports, and plus once in
a while harassment from them. Do not try
to explain when your learning-to-be-kind relatives or some newly met
friends-of-friends ask you “how come” you became a general practitioner rather
than a dermatologist. After twenty plus
years of practice, I find it OK to be a general practitioner. I can earn a living. I can study or do some reading in spare time
within the overtly long working hours. I,
sometimes, even, have a sense of job satisfaction by being able to help my
patients.
It was over joyous to learn that our
President had come up with an idea to form a College of Primary Care early this
year. I guessed it would not be an easy
job. But our President must have talked
to some big guns, pulled some strings and twisted some arms. Some colleagues feared that such College might
do more harm than good by imposing control rather than support. Frankly, this fear was also at the back of my
mind. However, when a risk was
identified, we could at least try to take care of it. Eventually, an “Ad Hoc Committee on a College
of Primary Care” was formed to work out how and when to set up a College of
Primary Care. Funny name, but some
support to general practice might be better than none.
It was sad to read what the President of the Hong Kong College of
Family Physicians
wrote in “Message of the President” of the Family
Physicians Links (March 2015 Edition). “While we welcome endeavours to promote Primary Care,
we cannot support the idea of establishing a new College of
Primary Care.” All supposed-to-be-big-guns stayed at home, rubbing their twisted arms.
I was at the verge of depression.
I remembered my psychiatrist friends
told me that learning something new might help to overcome depression. It was depressing, however, that I forgot to
ask them whether trying to promote primary care, or forming
a college of primary care could help. So,
I decided to put
down this college stuff for a while, and went to learn
drifting. From the almighty Wiki, “drifting is a driving
technique where the driver intentionally oversteers, causing loss of traction in
the rear wheels or all tires, while maintaining control from entry to exit of a
corner.”
I spent 24 hours, flying via
London to Arlanda of Stockholm, then changed for a propeller driven plane to
Arvidsjaur at the northern part of Sweden. There was a race course temporarily built on a
large frozen lake with 100cm thick ice. When
driving on ice, drifting was not something you learnt to do. It would happen anyway with even 30km/hr on
turning a corner. Drifting was something
to control, and to make use of so as to have fun, or to tackle a corner
skillfully. The instructor taught me to
brake hard before entering a corner. Then
entered slow. “Wait, wait, wait.” He said. “When you can see the end of the corner, then
gas.” When I got used to drifting, there
were racings on different courses. There
were “hot laps” where the instructors demonstrated what racings were supposed
to be. They practically drifted all the
way and the cars were moving side-way all along. I began to doubt whether cars were built to
travel forward in the “usual” sense.
Practicing and racing from 9 to 4
everyday in -12 degree celsius was fun to many. However, I was not the competitive made nor
the strike-for-perfection type. My mind
now and then began to drift. I forgot to
mention one important point. For such
dramatic drifting, you have to first turn off the Electronic Stabilizing
Program (ESP) of the car. People do not
slide or drift easily as in icy road because of the activation of this great
system. I tried driving a round with the
ESP on. Life was much easier.
Drifting is fascinating. In expert hands, it is the fastest way to cut
a slippery corner. However, in daily
lives, we need ESP instead of drifting. Do
we need a novel College before our primary care can function or flourish? Don’t read me as against the formation of the
College of Primary Care. I am more
concerned about the function of the body, whatever it is named. As mentioned, our system is now delicately
balanced. What we need is not a
disturbance of the balance. We have to
consolidate what we have. Give our
primary care workers a hand to stand against unequal terms and adverse
conditions. United in this sense,
whatever the body is named, we go for it.
(Source: HKMA News April 2015)
