From the President: The Art and Science of Medicine

President's Messages September 2024

September, 2024

Photo: Panel discussion from left to right - Dr Suraj Kumar (CFPS Vice President), WONCA President, Dr Brian Chang, (WONCA APR President) and Dr Wong Tien Hua (CFPS President)

WONCA APR Conference Singapore

The WONCA Asia Pacific Region conference held at the end of August in Singapore provided the chance to reflect on both the “art and the science of medicine” - the conference theme. I had the honour of participating in a panel on this theme chaired by the College of Family Physicians Singapore (CFPS) Vice President Dr Suraj Kumar who sums up the discussion: “The art and science of medicine has different meanings for different individuals. The 'science' of telemedicine and artificial intelligence have their advantages in advancing the practice of medicine. However, this must be balanced against the potential pitfalls such as the erosion of the doctor-patient relationship and compromise of medical ethics, which will put a damper on the 'art' of medicine. WONCA and its member organisations certainly have a role in the moderation of this delicate balance through education, engagement, and advocacy of the maintenance of the core values of family medicine.”

Planetary Health Keynote

Dr Catherine Pendrey delivered a keynote on planetary health. Three key points that she would highlight for actions GPs can take are:

Invest in high-quality preventative health, particularly focusing on healthy lifestyle interventions that result in 'co-benefit' emissions reductions - including promoting active transport and plant-forward diets.
Reduce low-value care. It is estimated that 40% of healthcare that is delivered is low value or harmful and that contributes to 30% of healthcare's emissions.
Promote green asthma and COPD care. Pressured metered dose inhalers (pMDI) are a carbon hotspot containing a propellant that is 1300-3350 times more potent than CO2 as a greenhouse gas. Ensuring adequate preventer therapy and changing individuals from a pMDI to a DPI where clinically appropriate can improve patient outcomes and reduce emissions.

The Rajakumar (Young Doctors) Movement Enthusiasm

Young Doctors Rajakumar Movement I was privileged to be invited to speak to the young doctors at the Rajakumar Movement preconference. I continued my planetary health theme and challenged our younger colleagues to consider what can be done in their prescribing and in their practices. Some very enthusiastic discussion resulted.

APR Awards

The Awards ceremony included acknowledgment of the 5 Star Doctor award winners (L to R) Dr Brian Chang (WONCA APR President), Dr Karin Estepa-Garcia (2024 winner from the Philippines), WONCA President, Prof Hwang Shinn-Jang (2023 winner from Taiwan), and his wife. Congratulations to both recipients for their dedicated work and for meeting the demanding criteria of a 5 Star Doctor.

More Conference Photos

Young Doctor Marshell Tomotius and his Family Medicine Resident Gabrielle Glenis from Pellita Harapan University Medical Faculty Tangerang, Indonesia.

With delegates from Mongolia: Drs Ulziikhutag Janchiv and Tsengelmaa Bayanzul.

With CFPS VIPs; President Wong Tien Hua and Immediate Past President Tan Tze Lee.

Practice visit to Raffles Medical Group

Before the conference in Singapore, I was lucky to do a practice visit to the Raffles Medical Group, which was certainly a fantastic example of both the art and science of medicine in action. This is a large multifaceted Private Health Service which was started as a small practice by previous WONCA CEO, Dr Alfred Loh (pictured). Alfred was CEO 2001 – 2012 – read his final report here. The practice is based on the principles of compassion, commitment, excellence, team-based care. It is a physician-led group of facilities with Evidence-Based Medicine (EBM) driving protocols and where case notes are electronic and can be shared between clinics and other integrated specialty services.

WONCA visitors were warmly greeted and then we split into groups for a facility tour followed by refreshments. I joined Director of the facility Dr CHNG Shih Kiat on a tour. The centre boasts a health screening unit which is unusual in that it operates an appointment system, a transitional care facility for those whose care level is between hospital and community – these began during the COVID pandemic but have an ongoing use. Perhaps the most interesting thing was that there was a private emergency facility, but one that is approved by the Singapore Government so Government ambulances do bring patients in. An interesting service fact is that during COVID, the centre operated a telemedicine service 24 hours a day, 7 days a week, and did 5000 to 6000 consultations per month. Practice Visit

Remembering the 70s in New Zealand

The 50th anniversary conference of the Royal New Zealand College of General Practitioners (RNZCGP), of which I am a Fellow, was in true 70s style. Geometric designs in orange, long-haired hippies, and sweet treats from the era. One of the formal aspects was the Fellowship and Awards ceremony – an affair for academic gowns and ceremonial chains. RNZCGP 50th anniversary

Photo: New fellows and award winners await their turn on stage.

Photo: WONCA President and RNZCGP President Dr Samantha Murton in ceremonial dress.

Wearing a traditional Māori korowai (cloak) was Fellowship recipient Dr Tipene Wairepo. Dr Wairepo started his medical journey in Orthopaedic surgery where he missed the opportunity to connect with people and their wider story. After a general practice placement, he found his place. He says, “I love working in the community amongst my people. These korowai (cloak) are worn traditionally by Māori and represent 'Mana,' which is power inherited from our forebears. With this Mana, I carry an obligation to care for my people. Dr Tipene Wairepo

To this end, I work full-time in the Māori health rural general practice and urgent care space. We have opened a clinic in Hamilton, New Zealand called Taakiri Tuu, which is a joint partnership with the secondary health system to ensure our patients' health needs are being met and that every possible barrier is removed. We have diagnostics and specialist clinics operating alongside general practice services to ensure our patients have the best chance of accessing the care they need.”