by Dr Neha Ahuja and Dr Bhakti Visani
As two GP trainees currently taking an OOPE to do a medical education fellowship, we were both extremely lucky to go to Kyoto, Japan for the WONCA Asia Pacific Region (APR) Conference 2019 in May this year to present our experiences and learning in this post.
Why were we there? South East Asia’s primary care systems are currently in their infancy, but there is a strong drive to improve its standing and recognition because, as has been consistently shown across the world, high-quality primary care is the bedrock of a high performing health system and has the ability to reduce all-cause mortality, increase life expectancy, lower health inequalities and reduce costs amongst many other benefits.
This was one of the biggest lessons that was reinforced for us. Do we truly appreciate what we have until its gone? Often forgotten in the UK, this shows why we should invest our time and energy into high quality primary care and create a passion for it in our students too.
Amongst talks about the benefits of Primary Care, we also learnt from a myriad of streams including mentorship, education, quality improvement and surviving in the profession as a young doctor.
Dr. Felicity Goodyear-Smith gave us examples of a patient and clinician engagement programme (PACE) with doctor-patient dyads co-creating research. This was a great insight into forward movement in social accountability where the key stakeholders have ownership of the studies, use the findings and assist in dissemination. This of course raises questions about the implications on the professional boundaries in the doctor-patient relationship, and this short BJGP article explores their thoughts. If you are interested in the project, you might find this paper on PaCE gives a good insight.
Another stark idea that was floated was about doing too much medicine. Dr. Iona Heath gave a powerful talk on the harms of overdiagnosis as well as our misconceptions on the benefits of multiple interventions. We already know that the burden of adverse drug reaction in the UK is high, with a report in 2006 showing that they result in 250, 000 UK admissions a year!
“So benumbed are we nowadays by electric lights that we have become utterly insensitive to the evils of excessive illumination.”
If you are as interested in this as us, you may find these links useful: Preventing Overdiagnosis and Choosing Wisely UK.
As an added bonus, we had an extra few days before the conference to try some local delicacies like Japanese curry, Ramen, Mochi and Melon-Pan! We dressed up in traditional kimonos and even came across geisha down an unsuspecting alley.
Despite the flaws in our UK primary care system, this opportunity reaffirmed our choice to be GPs and to be proponents for investing in a system that has the potential to truly have large scale health impacts when done in the right way.
Prior to a recent teaching session, I was discussing with a colleague about how we felt the session may go: “I suppose you have always got to be prepared for the gremlins” I said, and we chuckled. We repeated the same phrase a few days later, realising that our wireless clicker had inexplicably reversed left and right. I can’t count the various mishaps that occurred in sessions I have witnessed: computers failing, tutors disappearing, printers misprinting, and the list goes on. Our instinctual cognitive reaction to all these events probably protects us from curling up into sobbing balls of human anxiety:
schools from across the United Kingdom attended the day to share knowledge, experience and advice in running longitudinal attachments for their students.
