Disclaimer: The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.
by Dr. Colin V. Alert
The Theme for the World Family Doctor Day 2022, due to be celebrated on May 19th 2022, is “Family Doctors, Always There To Care”. This is a day to highlight the role and contribution of family and primary care doctors in health care.
This celebration is the perfect opportunity to acknowledge the important role of family doctors and general practitioners in the delivery of personal, comprehensive and continuing health care for all patients.
It’s also a chance to celebrate the progress being made in family medicine and the special contributions of primary care physicians locally, regionally and globally.
But even though the University of the West Indies, including the Faculty of Medical Sciences at the Cave Hill Campus, has a postgraduate program in place to produce specialists family physicians, and has been doing so for over three decades now, the Ministry of Health and Wellness (MOHW) in Barbados has failed to create any sort of job opportunity for these graduates.
While the health of the nation is being decimated by the non-communicable diseases (NCDs), and now COVID-19, and while it is acknowledged that, in spite of escalating (and unsustainable) spending on health, the health of the nation seems to be deteriorating; the rationale for not including individuals with specific ‘specialist’ training is baffling.
[Fortunately, some of our Caribbean neighbours, specifically those that host UWI campuses, have attempted to include trained family physicians in their primary care services.] Over the last 50 years, the Ministry of Health has employed young doctors in its primary care services
(‘Health Centers’) and encouraged them to seek post graduate training in Public Health.
While there is still a need for practitioners of public health, they seem unable to cope with the clinical challenges posed by the NCD pandemic, to a communicable disease pandemic like covid-19, and to future infectious pandemics projected to accompany global warming. Our health planners need to re-focus their health planning decisions now.
The MOHW is not attempting to optimise available resources in primary care in Barbados, even to effectively battle the NCDs, and now covid-19 as well.
Perhaps, when the MOHW restarts producing the annual Chief Medical Officers reports (CMO reports), absent since 2012, they will have the actual data to convince them on the poor state of health in Barbados, and the need for this island’s health care services to change its current trajectory.
While the MOHW focuses on sugar sweetened beverages (SSBs) and legalising marijuana, perhaps the increased taxes the government hopes to collect from the sale of SSBs and marijuana will be channeled to turn around the deteriorating health situation.
One local Barbadian family physician has produced over 200 short educational videos on covid; another family physician occasionally writes articles in the local newspapers on covid and/or the NCDs.
While the MOHW repeatedly stresses the importance of patient education, they seem to be unable or unwilling to contribute in any effective way to this task that they have attached such high importance to. Fortunately a couple of family physicians have stepped up to the plate to partially fill the void created by the MOHW officials. The 2022 theme for World Family Doctor Day: Always there to Care.
Even in this era of Emergency Clinics, family doctors are available at all times, and continuity is a fundamental feature of their work. They continuously provide care in all stages of patients’ lives, from the womb to the tomb. They provide care to all members of the family.
Continuity is also present in care through the ongoing follow-up carried out to patients, where coordination with other levels of care and health care professionals is crucial. Lastly, continuity represents a commitment to keep up to date with the rapidly evolving medical science through continuing medical education, CME.
Family doctors are there, wherever and whenever needed. They are present in normal times and in times of emergency. During the lockdown phases of the pandemic, and at other stages since covid came to town, while there was significantly limited access to the government’s primary care services, i.e. the local polyclinics (a.k.a. health centers), and even the hospital, the majority of family physicians and general practitioners kept their offices open.
After all, when covid appeared all the other illnesses, including the NCDs, didn’t just suddenly disappear. [In “Building Back Better”, one hopes the MOHW considers the impact on the physical and mental health of individuals, families and communities that this abandonment caused (and in many cases is still causing), and identifies new strategies for dealing with situations now and in the future.]
Family physicians and general practitioners are part of the communities they work in, creating a unique connection with their patients and their families. In Barbados, family physicians are members of the Sports Medicine Association, accompanying our athletes locally and internationally.
They serve on the Heart and Stroke Foundation, and the Diabetic and Hypertension Association, offering various levels of their time and expertise outside of the walls of their clinics. They participate in television and radio programs, to educate the general public.
They volunteer to help in government’s covid programs, including the immunisation program. Family physicians have joined the Emergency Response team, a group of individuals who join with the Barbados Defence Force (BDF) to form a Caribbean-wide rescue team should a major catastrophic event, like a hurricane, earthquake, floods or other, decimate any Caribbean community.
This team is trained and equipped to go into a disaster site and set up emergency medical services, even an emergency field hospital. Bringing accessible, equitable, sustainable, high-quality care is a family doctor’s motivation.
Being a family doctor is both a privilege and a responsibility, always looking after people and providing what is necessary for their welfare and protection, identifying their patients’ needs to guarantee the fundamental right to health and wellness.
On May 19th 2022 local family physicians stand with WONCA, the World Organization of Family Doctors, and the CCFP, the Caribbean College of Family Physicians, in highlighting the role that family physicians and general practitioners can, and should play, in improving the health and wellness of our community.
Dr. Colin V. Alert, MB BS, DM. is a family physician and associate UWI family medicine lecturer.