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蔡 堅醫生 香港醫學會會長 Dr. CHOI Kin President, Hong Kong Medical Association The Hong Kong Medical Association welcomes delegates from Beijing and Macau as well as colleagues in Hong Kong to this Beijing/ Hong Kong Medical Exchange Forum. This is the eighth time we hold this exchange to foster academic relationship and knowledge exchange and transfer between China and Hong Kong. The forum was first initiated in 1997 to discuss pediatric problems and since then have proceed to look into Obstetrics & Gynaecology, Cardiology, Diabetes, Orthopaedics, the Climacteric and AID & Sexual Health in China and Hong Kong. Useful dialogues have emerged and we decided on our topic in Community and Family Medicine this year. Family medicine is provided by primary care physicians and provided at the first point of contact. It is undifferentiated medicine, holistic in nature, and requires the doctor to look at the physical, psychological and social aspect of the patient. The family physician acts as a gate keeper to help minimize unnecessary investigations and hospital admissions. He treats the person instead of an organ and looks after and supports the family instead of just a single patient. He uses evidence-based medicine to treat his patient and offers preventive care for his patients. Numerous studies in various countries have confirmed that the family medicine approach is the most cost-effective way to provide medical care to the population. We have witnessed a shift in emphasis in Hong Kong in the last few years with government providing more resources for Family Medicine. More training opportunities in this field have been opened up for young graduates to ensure a safe practicing standard in the community when they finish their contract. But have we looked at the market requirement? Have we looked at their training program and see if it really helps the young trainees to survive in the community? Have we followed their post- training course, their job opportunities since departure from the Hospital Authority and their salary scale since? Have we monitored their standards after they left their training post in the Hospital Authority? All these unanswered questions have implications on the content of the training program. In China, we have heard and witnessed a determination for change. We know that it is difficult for the vast population in rural China to get good medical care. We know about red packets and rebates and saw it on television reports. We have our doubts on some of the standard practices in China including the intravenous drips for almost all attendance. We read about the false and fatal medications and drugs created by the pharmaceutical industry. We can appreciate that the Health Minister demanded changes. The linkage between China and Hong Kong in collaborating to standardize specialist program and examination has been hailed as a success. However, most specialist service is out of bound to the majority of rural population in China. We learned that China may wish to model itself after NHS in health care. But NHS can only foster in a welfare state, in a country where taxation is high, and although at one time was a pride of the United Kingdom, is fast collapsing because of colossal demand despite huge financial support. China and Hong Kong must have its own way forward. We may look for guidance in the way that primary care is provided in other countries, but in the end, we must have our own way based on our own doctors’ training, standard, our own taxation system, and our own vision of how much basic care should be provided to citizens that will satisfy their demand for health care. I hope we have a fruitful discussion. Thank you.
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