WONCA inauguration speech 2013

Author: Michael R Kidd

Med J Aust 2013; 199 (7): 439. || doi: 10.5694/mja13.10871
Published online: 7 October 2013

New president of the World Organization of Family Doctors, Australian professor Michael Kidd AM, recently spoke about leading the response to the health and wellbeing needs of communities around the world.

Download PDF (78 KB)

This editorial is based on edited excerpts from World Organization of Family Doctors (WONCA) president Michael Kidd’s address “Family medicine and WONCA — the challenges ahead” given in Prague, 29 June 2013*

T his week, I asked some young Czech family doctors who they thought was the most famous Czech person ever. The name I was seeking wasn’t Kafka, Dvorak or Navratilova. Rather, it was Vaclav Havel, the first president of the Czech Republic, a playwright as well as a global political figure and a voice for world peace and my Czech hero. It was Havel who once wrote,

The salvation of this human world lies nowhere else than in the human heart, in the human power to reflect, in human meekness and human responsibility.

I think this is a wonderful message for family doctors, as with our combination of compassion and intellect, humility and responsibility, we have within us the power to do great good — to make a real difference in the world.

Further, the evidence is now clear that health systems based on strong primary care, which includes strong family medicine, are the most efficient, equitable and cost-effective systems. I last met with Barbara Starfield, the researcher who contributed much of this evidence, a few months before she died in 2011. Barbara was keen to talk about the biggest challenges she saw for family medicine in the future, and what WONCA, and I, Michael Kidd, as your incoming president, should be doing. I wrote it all down. Barbara’s last message for WONCA was:

Here are the three challenges I think you should focus on. How do we develop primary care research to address the challenges of care for people with comorbidities? How do we truly adopt patient-centredness into family medicine? How do we use the information from primary care to improve population health?

Barbara recognised the failure of guidelines to accommodate comorbidity and multimorbidity and the need to turn our evidence base upside down.

We need to build our own evidence base from primary care. And where do we get this evidence from? The answer is right in front of us. It is from our encounters with our patients. In the words of immediate past WONCA president, Rich Roberts, “If we want evidence-based practice, we need practice-based evidence”.

Barbara also recognised the power of the information that we are starting to collect through digital means in primary care and how this can be used to improve population health. The potential of e-health, especially the aggregation of patient data from electronic medical records, is extraordinary. It will assist us in identifying the health care needs of populations and highlight those areas where we can work together to make improvements. In the words of Sir Muir Gray, Chief Knowledge Officer for the National Health Service in the United Kingdom, “In the 19th century we needed clear, clean water; in the 21st century, we need clear, clean information”.

I believe this is the beginning of a new Golden Age for family medicine. Why do I say so? Because in countries all around the world, the message is getting through about the importance of strong primary care and the role of family doctors in ensuring universal access to health care and equitable health care outcomes. The global policy pendulum is now swinging back to a focus on universal coverage. And for good reasons.

WONCA, like me, was born in Melbourne many years ago. It started with a small group of family medicine colleges and academies that banded together to create a world body that shared an ideal of training and education for family medicine and high standards for clinical care in all nations of the world. WONCA now has 118 member organisations representing over 400 000 family doctors in over 130 countries and territories around the world.

The 400 000 family doctors represented by WONCA have over 2 billion consultations with patients each year. Two billion: that’s the scope of our current work and our influence. But we need to do more. We need to expand our commitment to the education and training of family doctors, quality care and primary care research to the 80 nations of the world where WONCA does not yet have a presence.

There are 7 billion people on this planet. The WHO (World Health Organization) tells us that 1 billion have no access to any health care services. We need to work with our global partners, the WHO, the World Bank and others to bring high-quality primary care to the 1 billion who currently have no access to any health care at all.

Are you familiar with the term “a fair go”? It is an Australian expression meaning that we treat everyone equally. I want to be known as the WONCA president who called for a fair go for every person in this world. And how will we meet this challenge of meeting the health and wellbeing needs of the many diverse communities around the world? We will do so by continuing to adapt to changing health needs and expectations.