VOL 48 | NUMBER 3
NEWS
2022
A P R I L
WONCA PRESIDENT DR ANNA STAVDAL (NORWAY) EMAIL: PRESIDENT@WONCA.NET TWITTER: @ASTAVDAL WONCA IMMEDIATE PAST - PRESIDENT DR DONALD LI (HONG KONG) PRESIDENT-ELECT ASSOC PROF KAREN FLEGG (AUSTRALIA)
CONTENT
EXECUTIVE MEMBER AT LARGE & HONORARY TREASURER PROF VAL WASS (UK)
FROM THE PRESIDENT
PAGE 3
FROM THE EDITOR
PAGE 6
EXECUTIVE MEMBER AT LARGE DR MARÍA PILAR ASTIER PEÑA (SPAIN)
WORLD FAMILY DOCTOR DAY 2022 TEASER
PAGE 7
EXECUTIVE MEMBER AT LARGE PROF SHABIR MOOSA (SOUTH AFRICA)
SUPPORT FOR UKRAINE
PAGE 8
REGIONAL PRESIDENT, WONCA AFRICA DR DAN ABUBAKAR (NIGERIA) REGIONAL PRESIDENT, WONCA ASIA PACIFIC ASSOC PROF MOHAMMAD HUSNI JAMAL (MALAYSIA) REGIONAL PRESIDENT, WONCA EAST MEDITERRANEAN PROF TAGHREED MOHAMED FARAHAT (EGYPT) REGIONAL PRESIDENT, WONCA EUROPE PROF SHLOMO VINKER (ISRAEL) REGIONAL PRESIDENT, WONCA IBEROAMERICANACIMF ADJ/PROF JACQUELINE PONZO (URUGUAY)
MONTEGUT GLOBAL SCHOLAR PROGRAM
PAGE 11
WONCA REGIONS
PAGE 13
WONCA EUROPE A PRACTICAL GUIDE TO OBESITY MANAGEMENT: WEBINAR FOR EUROPEAN GPS
WONCA WP & SIGS NEWS WONCA SIG IN AGEING AND HEALTH LAUNCH OF ICOPE IMPLEMENTATION PILOT PROGRAMME WONCA SIG IN NON-COMMUNICABLE DISEASES CKD EARLY IDENTIFICATION AND INTERVENTION TOOLKIT
FEATURED STORIES
REGIONAL PRESIDENT, WONCA NORTH AMERICA DR JEFF MARKUNS (USA)
WORLD HEALTH DAY
REGIONAL PRESIDENT, WONCA SOUTH ASIA DR TARIQ AZIZ (PAKISTAN)
RELATIONSHIP AND TRUST, PREREQUISITES OF THE MEDICAL CONSULTATION
YOUNG DOCTORS' REPRESENTATIVE DR SANKHA RANDENIKUMARA (SRI LANKA) WONCA CHIEF EXECUTIVE OFFICER DR HARRIS LYGIDAKIS WONCA WORLD SECRETARIAT WORLD ORGANIZATION OF FAMILY DOCTORS AVENUE DES ARTS 7-8 1210 BRUSSELS BELGIUM EMAIL: SECRETARIAT@WONCA.NET PHONE: +32 (0) 2 329 00 75 WONCA EDITOR MARIA DOLORES ZAVALA EMAIL: EDITOR@WONCA.NET TRANSLATIONS DR JIE GU DR HUA YANG DR JULIEN ARTIGNY CREDIT COVER PHOTO: SIRIWANNAPATPHOTOS
PAGE 14
PAGE 16
ONE MINUTE FOR OUR PLANET
WONCA CONFERENCES
PAGE 22
ANNOUNCEMENTS AND UPDATES
PAGE 28
image credit: gettiyimages
FROM THE PRESIDENT A P R I L
2 0 2 2
“Life is not a problem to be solved, but a reality to be experienced.” Søren Kierkegaard
DIAGNOSING LIFE? A SNAPSHOT OF NOW
We are living through difficult times. The pandemic is not over; in some regions cases are at an all-time high. Military aggression, within and among states, is causing lasting harm. Mental health has always been a central concern in Family Doctors’ daily practice. As so many people suffer and die before our eyes, mental health must remain high on our agenda.
F R O M
Mental health is also a top Public Health priority, particularly given the reports of the deteriorating situation that the pandemic, social isolation, and shutdowns of social services seem to have triggered in those with chronic psychiatric conditions. We also observe rising rates of depression and anxiety, particularly among young people. In 2018, the WHO approved a new diagnosis, “Prolonged Grief”, and “Prolonged Grief Disorder” was recently added to the latest version of the DSM, the psychiatric classification system. VALUE AND POTENTIAL PITFALLS OF DIAGNOSES
T H E
Once a suitable diagnosis is assigned to a patient, the caregiver may be better situated to select treatments that respect the patient’s current needs, capacities, and limitations. Receiving a diagnosis may bring relief to both patient and family, helping to make sense of otherwise frightening and chaotic experiences.
P R E S I D E N T
This is where self-scrutiny helps.
However, the issue of diagnosing is not simple. Insurance companies use diagnoses to determine what they will pay to caregivers, making them crucial to the income of the entire medical profession. The economic survival of ‘BigPharma’ is dependent on physicians’ willingness to diagnose patients with the conditions for which the pharmaceutical companies manufacture treatments.
PAGE 3
WONCA NEWS
Diagnostic categories also lend themselves to being assessed using expensive technological equipment and to being evaluated digitally using binary algorithms. Clearly, such economic, corporate, and potentially depersonalizing forces exert pressure on medical practitioners to redefine their role as caregivers, making our person centered approach harder, if not impossible. We might find ourselves routinely applying diagnostic labels, defining as mental illness the ways our patients tackle the complex but normal situational crises of daily life. A caregiver might avoid feeling powerless by labelling as “Prolonged Grief Disorder” any lengthy period of mourning following the unbearable loss of a loved one. After all, a diagnosable dysfunction might be treatable.
F R O M
If such overdiagnosis takes hold, patients may run the risk of being overtreated. Also, once a diagnosis becomes a label, a patient may face such concrete consequences as diminished employment options, plus a range of emotional burdens, such as shame. Unfortunately, health literacy is not yet so widespread that insight into mental illness has eliminated judgmental, moral condemnation.
T H E P R E S I D E N T
Psychiatric labelling has seeped into our daily lives, our shared vocabularies, and popular cultures. Just look how the distinction is vanishing between ‘feeling down’ and having the medical condition of ‘depression’. An obvious cost of linking disease labels to caretaking is the decrease in what is considered ‘normal’, not just within the field of mental health, but in the entire field of medicine. A CHANGE OF DIRECTION
Providing person centered care, the Family Doctor plays a crucial role in counteracting the tendency to medicalize normal, daily life. Sometimes, of course, we can treat—provide concrete interventions that stop the symptoms and allow daily functioning to recommence. But some conditions can`t be ‘cured’, neither by medication nor psychotherapy.
image credit: gettiyimages
PAGE 4
WONCA NEWS
Then, continuity of care and support over time is the very best we have to offer—and ‘watchful waiting’, Family Medicine’s most powerful tool. It does, indeed, help. The power of the ‘healing relationship’ has now been validated; look, for example, at the evidence from epigenetic studies documenting that experiences of support, recognition, and belonging can help to strengthen or even restore a state of good health.
We need to help each other, wherever we are in the health system, to increase our awareness of when and how current trends and pressures are impacting our patient-care decisions. We can encourage other specialists to funnel their hardwon knowledge to Primary Caregivers so that we can fine-tune our decision-making about when medicalization is not only appropriate, but life saving.
Many of our patients’ leave our consulting room without having been diagnosed with a disease but, perhaps, with a view that many crises are experiences from which maturity may grow, and opportunities to hone strategies for meeting future problems.
In short, I wish all of us the wisdom to use diagnostic labels carefully, with insight into culture and context, and empathy for all our patients, and ourselves, as individual persons.
F R O M
As we’re woven into community life, we Family Doctors can play a central role in increasing health literacy. We might adapt a well-known phrase and say: “It takes a village to heal a depression.” Formal, and maybe even better, informal, education of close family members, teachers, and employers will strengthen their capacity to empower depressed patients and those who care for them.
DR ANNA STAVDAL WONCA PRESIDENT
Also available in: Español Français
中文
BOTTOM LINE
T H E P R E S I D E N T
We Primary Caregivers are well-positioned to slow, if not stop, the growing tendency toward the medicalization of daily life. We can resist the temptation to rush to diagnose, rush to medicate, rush to refer. We can continue striving to master the balancing act between ‘watchful waiting’ and ‘early detection’. As patients’ first point of contact with the health care system, we can help them to navigate within it, referring them when necessary to the best level of care. We can make sure that the doctor-patient relationship and the community base remain at the core of how we practice medicine, so that we individualize the treatment we offer while also recognizing and responding to trends as they appear. We need to help each other, wherever we are in the health system, to increase our awareness of when and how current trends and pressures are impacting our patient-care decisions.
PAGE 5
WONCA NEWS
F R O M T H E E D I T O R WELCOME TO WONCA NEWS APRIL!
In this edition, we maintain our call for solidarity and continue to promote multiple ways to support Ukraine. We call on members to support key humanitarian relief organisations, including the International Committee of the Red Cross, Médecins Sans Frontiers (MSF), and UNFPA. Read how you can help here. WONCA News April includes in our section From the President, a reflection by Dr Anna Stavdal on the importance of keeping mental health care as a priority in primary care agendas and on the value and potential pitfalls of diagnoses in this regard. You will also find an interesting article by Dr Bruno Kissling and Peter Ryser, “Relationship and trust as prerequisites of the medical consultation.”
In this issue, you can also find a teaser of our World Family Doctor Day 2022 campaign, “Family Doctors, Always there to Care”. We are on our way to this celebration, with new updates and materials coming very soon! We are also happy to announce that the applications deadline for the Montegut Global Scholar Program has been extended to 2 May 2022! Read all the details and requirements for application here. Are you planning to attend the WONCA Regional conferences for 2022 and 2023? In this edition, you will find more details, important dates, welcome messages and more! WONCA News April also includes information about the activities from our WONCA Regions and Special Interest Groups: the recent webinar A Practical Guide to Obesity Management: Webinar for European GPs; the ISN KDIGO - WONCA Joint Webinar about CKD Early Identification and Intervention Toolkit, with the participation of the WONCA SIG in Non-communicable diseases; and the upcoming launch of ICOPE implementation pilot programme, approach in which the WONCA Special Interest Group in Ageing and Health has contributed.
We dedicate this edition to World Health Day 2022, under the theme “Our Planet, Our Health”. On this occasion, the WONCA Working Party on Environment and Dr María Pilar Astier Peña share the article “One minute for our Planet”. I hope you enjoy this issue, and please remember that you can drop me a line (or an article!) at editor@wonca.net.
Happy reading, and stay safe! Sincerely, Maria Dolores Zavala, WONCA Editor
PAGE 6
RE
A
YS
CA
AL W
19 MAY 2022
DOCT ILY O M
RS
WORLD FAMILY DOCTOR DAY
FA
WONCA NEWS
THERE TO
JOIN OUR 2022
CAMPAIGN
THE ROAD TO
WFDD 2022 MARCH 11, 2022
We are now thrilled to announce this year’s theme: Family Doctors, Always there to Care!
Join World Family Doctor Day using the hasthags:
APRIL 20, 2022 TOOLKIT LAUNCH
#WFDD2022 #WORLDFAMILYDOCTORDAY #ALWAYSTHERE2CARE
DOCT ILY O M
AL W
RE
RS
We are officially ON THE ROAD to WFDD2022!
MAY 19, 2022
FA
On 20 APRIL 2022, we will share more information about #WFDD2022, and a media kit with the materials to join this campaign!
APRIL - MAY, 2022 ONE MONTH FOR WFDD CAMPAIGN AWARENESS
A
YS
JULY 15, 2022 REPORT OF ACTIVITIES WONCA NEWS JULY
CA
BE PART OF THE #WORLDFAMILYDOCTORDAY!
WFDD THEME ANNOUNCEMENT ON WONCA NEWS
THERE TO
PAGE 7
WONCA NEWS
SUPPORT
UKRAINE The scale of humanitarian crisis unfolding in Ukraine and the neighbouring countries is staggering. It becomes urgent to support humanitarian aid and provide assistance to vulnerable people and those taking care of them. We urge our members to take action and support key humanitarian relief organisations, including the International Committee of the Red Cross (ICRC), Medicines Sans Frontiers (MSF), and UNFPA. Due to the uncertainty of the situation, it is currently advisable to support such organisations, which have the experience and logistic infrastructure to deliver medicines and other material in a coordinated manner.
The World Medical Association (WMA) has set up a support structure to funnel medical help to Ukraine. To support this, WMA, the European Forum of Medical Associations (EFMA) and the Standing Committee of European Doctors (CPME) have set up the Ukraine Medical Help Fund. The account holder for donations is the WMA. The funds will be redistributed to WMA’s partners in Poland, Slovakia and other bordering countries in order to help Ukrainian colleagues or the medical help for refugees from Ukraine.
Inma Vazquez MSF, Médecins Sans Frontières: “MSF has already deployed local teams in Ukraine. In addition to the need to coordinate, it is crucial to prioritise needs and concentrate on the essential (what is to be shipped first). Establishing several safe corridors through which to send goods is very important — it will be difficult to manage otherwise. They see three main priority axes: mental health, women’s and children’s health care and Covid-19 high prevalence.” Read what MSF, ICRC, and UNFPA are doing in response to the humanitarian crisis.
1) WORLD MEDICAL ASSOCIATION: THE UKRAINE MEDICAL HELP FUND
image credit: inkdrop
PAGE 8
WONCA NEWS
SUPPORT
UKRAINE WMA, EFMA and CPME appeal to you to consider donating to the Ukraine Medical Help Fund to allow the medical community to coordinate and provide vital medical support to the humanitarian crisis. Please find here the official letter of appeal for donations.
2) UKRAINIAN RED CROSS
The Fund is governed by the Taskforce Ukraine, which is composed of representatives of the medical associations (int/national) involved in the execution of the project, i.e. the WMA, EFMA, CPME, the Polish Chamber of Doctors and Dentists the Slovakian Medical Association and the Slovakian Medical Chamber. The Taskforce will recommend the use of funds to the Steering Committee consisting of the Secretary Generals of CPME, WMA and EFMA and is chaired by WMA Past President Prof. Dr Leonid Eidelman.
DONATIONS CAN BE MADE TO THE FOLLOWING ACCOUNT:
The Ukrainian Red Cross has set up a call for donations. You can donate directly on this website: https://donate.redcrossredcrescent.org/ua/donate/
3) INTERNATIONAL COMMITTEE OF THE RED CROSS The International Committee of the Red Cross — together with its partners in the Red Cross and Red Crescent Movement — remains active in Ukraine, saving and protecting the lives of victims. You can donate directly here: https://www.icrc.org/en/donate/ukraine image credit: sketchify ukraine
Bank: SOCIETE GENERALE Domiciliation: ANNEMASSE ENTERPRISES (04335) IBAN: FR76 30003 04335 00050005353 78 BIC: SOGEFRPP Account Owner: ASSO MEDICALE MONDIALE 13A Chemin du Levant 01210 FERNEY-VOLTAIRE FRANCE
PAGE 9
WONCA NEWS
SUPPORT
UKRAINE 4) MÉDECINS SANS FRONTIÈRES Médecins Sans Frontières (MSF) is one of international organisations active in Ukraine, delivering medical supplies in Kyiv, Mariupol, Kramatorsk and Pokrovsk, and sending emergency and specialist medical staff. MSF is supporting hospitals and doctors remotely, including by providing training on trauma care, and through telemedicine, while also working in neighbouring countries offering support for displaced people. Click here to see how MSF is responding to the humanitarian crisis.
6) UNITED NATIONS POPULATION FUND An estimated 80,000 women will give birth in the next three months in Ukraine – many of them without access to critical maternal health care. For some, childbirth will be a life-threatening rather than a life-changing experience. The United Nations Population (UNFPA) remains on the ground to deliver life-saving sexual and reproductive health services and supplies. You can support UNFPA by donating here. Read more information on how UNFPA is responding to the humanitarian crisis here.
You can support their efforts with donations at: Beneficiary: ASBL MEDECINS SANS FRONTIERES BELGIUM Address: Rue de l’Arbre Bénit 46 IBAN: BE73 0000 0000 6060 BIC: BPOTBEB1 Reference: Corporate support Or by credit card here.
5) UNITED NATIONS HIGH COMMISSIONER FOR REFUGEES The United Nations High Commissioner for Refugees (UNHCR) has stepped up operations and capacity in Ukraine and neighbouring countries. You can support UNHCR by donating here.
7) COLLEGE OF FAMILY PHYSICIANS IN POLAND The College of Family Physicians in Poland can facilitate donations of funds to to the potential receivers in Poland who organise direct help (please contact the WONCA Secretariat for contact details).
8) FUNDACJA LEKARZE LEKARZOM – FOUNDATION DOCTORS FOR DOCTORS The charity is set up by the Polish Supreme Chamber of Physicians and Dentists; it coordinates deliveries of medical supplies. For information, please contact Dr Mariusz Janikowski, President of the Foundation, through https://fll.org.pl/kontakt/ or at fundacja@hipokrates.org
PAGE 10
WONCA NEWS
MONTEGUT S C H O L A R
A W A R D
SUPPORTED BY THE AMERICAN BOARD OF FAMILY MEDICINE FOUNDATION
We are happy to announce that applications for the Montegut Global Scholar Program, are now open! The Montegut Global Scholars Program (MGSP) was established by the American Board of Family Medicine Foundation (ABFM-F) in 2010. The American Board of Family Medicine (ABFM) is a member of the American Board of Medical Specialties (ABMS). The ABFM-F is a supporting organisation of the ABFM. Its primary mission is to support the ABFM’s research and scholarly activities.
ALAIN MONTEGUT MD The Montegut Global Scholars Program (MGSP) was established by the ABFM-F in April 2010. It was named in honor of Alain Montegut, M.D., a member of the Board of Directors of the American Board of Family Medicine (ABFM) from 2005-2010 and whose career has been devoted to developing high quality family medicine practice internationally, especially in underserved and/or undeveloped countries.
A PROGRAM FOR WONCA REGIONAL MEETING ATTENDANCE. The MGSP was established to foster international education, research, and collaboration in the specialty of family medicine. It will support the attendance of family physicians from Africa, Asia Pacific, East Mediterranean, Europe Iberoamericana, North America, and South Asia Regions of the international organization of family physicians (WONCA) to any WONCA regional conference of 2022.
For further information on the MGSP click here.
2022 INFORMATION The MGSP will provide a scholarship for the selectees from Africa, Asia Pacific, East Mediterranean, Europe, Iberoamericana, North America, and South Asia Regions to attend any WONCA regional conference of 2022. The application process depends on the region of origin of the candidates. To apply: 1. For WONCA Africa, please contact Elizabeth Reji. 2. For WONCA South Asia, please contact the South Asia Region President, presidentSAR@wonca.net 3. For WONCA Europe please contact Barbara Toplek, secretariateurope@wonca.net. 4. For WONCA Iberoamericana – CIMF, please contact Thomas Meoño Martín, ceo@cimfwonca.org 5. For Asia Pacific and East Mediterranean, please submit the application form and all relevant documents to the WONCA Secretariat at secretariat@wonca.net.
ELIGIBILITY The MGSP will provide a scholarship for the selectees from Africa, Asia Pacific, East Mediterranean, Europe, Iberoamericana, North America, and South Asia Regions to attend any WONCA regional conference of 2022. Criteria for all applicants:
PAGE 11
WONCA NEWS
M O N T E G U T
G L O B A L
S C H O L A R
- Must be a Family Physician/General Practitioner in good professional standing; - It is suggested that the selectee be a Physician involved with education, research, and/or committed to improving the quality of family medical care in his/her region; - The selectee chosen should be a person whom under ordinary circumstances would not have the financial means to attend the referenced conference; - The selectee should not be part of the WONCA leadership in his/her region; - It is suggested that the same individual not be chosen to attend more than one conference offered by this Scholars Program.
APPLICATION For the application form click here (or you can request an application from the WONCA Secretariat by emailing secretariat@wonca.net).
DEADLINE FOR 2022
For all Regions (except Europe): 2 MAY. For details on the application process and deadline for Asia Pacific and East Mediterranean, please contact the WONCA World Secretariat at secretariat@wonca.net.
P R O G R A M
1. Name, practice address, and WONCA region; 2. A brief report outlining ‘Lessons Learned’ from the designated conference that, going forward, could benefit that physician, his/her patients, residency training programs or trainees, or the specialty of family medicine in his/her region; 3. In the report reference above, the Scholar should list two (2) or three (3) action items that s/he will implement in their region, practice, or training program as a result of attending the conference. It is our hope that the scholarship recipient can meet with ABFM physician leaders who are attending the conferences. This report will be due to the ABFM-F office [President ABFM-F, 1648 McGrathiana Parkway, Suite 550, Lexington, Kentucky, 40511-1247, United States of America] or via email to: president@abfmfoundation.org no more than sixty (60) days after the conclusion of the respective conference. Any papers, lectures, or presentations by the Scholar containing information gained as a result of this scholarship should acknowledge the ABFM-F as a sponsor. WONCA wishes to formally acknowledge the generous sponsorship of the American Board of Family Medicine Foundation (ABFM-F) through the Montegut Global Scholars Program.
SCHOLAR RESPONSIBILITIES The selected scholars are expected to devote the entire amount funded toward expenses related to attending the WONCA conference for which s/he is chosen. Should additional funding be necessary for a selectee to attend any of the aforementioned meetings, the individual or his/her regional WONCA shall be responsible for the balance. In return for the scholarship, each scholar is required to submit a brief report (in English) after the selected conference to the President of the ABFM-F containing the following information:
PAGE 12
WONCA NEWS
W O N C A
E U R O P E
A PRACTICAL GUIDE TO OBESITY MANAGEMENT: WEBINAR FOR EUROPEAN GPS On World Obesity Day on 4th March, the World Organization of Family Doctors (WONCA), in conjunction with the European Association for Study of Obesity, EASO, held a webinar for General Practitioners and other healthcare professionals on Practical Tips for Obesity Management
WONCA REGIONS
The recording of this webinar can be watched here: https://woday.eu/events/wonca-webinarfor-healthcare-professionals/
The event was initiated by Dr Dominique Durrer. The webinar speakers included world renowned experts in the field of Bariatrics who covered a diverse range of topics including diagnosis of obesity, avoiding stigmatizing language while speaking with patients, treatment targets and how to treat post bariatric surgery patients.
With information of WONCA Europe
WONCA sent invitations to 10,000 European GPs and more than 700 medical professionals signed up for the event. EASO also publicised the event to more than 17,000 recipients of the EASO newsletter.
PAGE 13
WONCA NEWS
W O N C A
W P
&
S I G S
N E W S
WONCA SIG IN AGEING AND HEALTH
WONCA WP & SIGS NEWS
LAUNCH OF ICOPE IMPLEMENTATION PILOT PROGRAMME The Special Interest Group in Ageing and Health has contributed to the development of the World Health Organisation Integrated Care for Older People (ICOPE) approach over the last few years. The SIG recognises that it is important to optimise the health of older people, and that an important part of that is to support the person’s ability to function while recognising that there will be some inevitable decline in health and functional ability with age. This shift towards optimising function is sometimes a difficult one for family doctors, who may have been educated that only cure, or at best, optimal physical health management is worthwhile. Often it is necessary to work with other primary care practitioners and social care providers to achieve the best possible functional ability for older people. Such a shift can only be possible if the person’s own preferences and unique abilities are taken into account. The World Health Organisation has developed a series of helpful resources for family doctors and for countries that are looking to expand the vision of healthy ageing to include optimising function. This includes for example a guidance booklet which incorporates pathways of care (Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care. Geneva: World Health Organization; 2019 (WHO/FWC/ALC/19.1). Licence: CC BY-NC-SA 3.0 IGO).
The findings can support governments, health and care workers and other service providers to implement ICOPE as part of efforts towards universal health coverage. The online launch of ‘ICOPE implementation pilot programme: findings from the ‘ready’ phase,’ a new WHO report on the integrated care for older people (ICOPE) approach. Date and time: Monday 25 April, 13.00-14.30 CEST via zoom. Registration is required for the event at https://bit.ly/3NOj95b Interpretation will be available in French. A recording of the event will be made available.
PROFESSOR DIMITY POND CHAIR - SIG ON AGEING & HEALTH
JOIN THE THIS SIG
The Implementation Pilot Program report will be launched on April 25th The new report summarizes the findings of the first phase of a pilot research programme, from the implementation experiences across nominated Member States. It focuses on enablers, barriers, and strengths for implementation. image credit: Getty Images, Yamini Ganga
PAGE 14
WONCA NEWS
W O N C A
W P
&
S I G S
N E W S
WONCA SIG IN NON-COMMUNICABLE DISEASES
WONCA WP & SIGS NEWS
CKD EARLY IDENTIFICATION AND INTERVENTION TOOLKIT ISN - KDIGO - WONCA JOINT WEBINAR With the global burden of kidney disease increasing, early identification and treatment is a worldwide imperative. Therefore, the International Society of Nephrology (ISN), KDIGO a global non-profit foundation dedicated to improving the care and outcomes of patients with kidney disease worldwide- carried out a webinar to explore the CKD Early Identification and Intervention Toolkit, launched in 2021, through the perspective of the PCP, discussing CKD identification and risk stratification in the primary care environment. Panelists also discussed how to increase collaboration between PCPs and nephrologists. In this session, WONCA was present through the participation of Dr Ana Cebrián, Chair of the WONCA Special Interest Group on Noncommunicable diseases, who highlighted the crucial role of Primary care physicians in detecting chronic kidney disease on its early stages.
WONCA was also represented with the participation of Dr Domingo Orozco Beltrán, Past Chair of WONCA Special Interest Group: Noncommunicable disease, who emphasised primary care as the first point of contact and screening for CKD.
"Screening is a term that should be commonly used, not stigmatize patients, but to be able to detect and treat them earlier" noted Dr Domingo Orozco- Beltrán. DR DOMINGO OROZCO BELTRÁN PAST CHAIR - WONCA SIG NONCOMMUNICABLE DISEASES
"As a primary care physician, checking the albuminuria and GFR in patients should be considered as a must when we approach patients. Then we can move forward into treatment" DR ANA CEBRIÁN CHAIR - WONCA SIG NONCOMMUNICABLE DISEASES
PAGE 15
WONCA NEWS
W O N C A
W P
&
S I G S
N E W S WONCA WP & SIGS NEWS
ISN - KDIGO - WONCA JOINT WEBINAR The session also featured presentations by Dr Vivekanand Jha, Past-President of the International Society of Nephrology (ISN) and Dr Magdalena Madero, Chair of the ISN Latin American Regional Board.
"The importance of primary care for CKD management is key. It's critical that the international nephrology community join efforts with other societies, like KDIGO and WONCA to better care for patients" DR VIVEKANAND JHA
PAST-PRESIDENT OF ISN
ISN-KDIGO CKD EARLY IDENTIFICATION AND INTERVENTION TOOLKIT Chronic kidney disease (CKD) causes substantial global morbidity and increases cardiovascular and all-cause mortality, so identifying and treating it at the earliest stages is a worldwide imperative. To this end, the ISN and KDIGO launched a series of tools for CKD early identification and intervention aimed at kidney health professionals, primary care physicians and nurses working in primary care settings. The website includes a series of resources for CKD early identification, including: Quick guides and infographics Teaching tools for health teams Resources for patients Conference report and articles Webinars and webcasts
According to ISN, there are 850 million people living with kidney disease worldwide. “The number of Chronic kidney disease is highest in lowincome countries and lower, middle-income country, however, a consensus to treat it is needed”
Discover and access these tools:
CKD Early Identification and Intervention Toolkit
JOIN THE THIS SIG
PAGE 16
WONCA NEWS
WORLD HEALTH DAY 2022
FEATURED STORIES
Our Planet, Our Health
#HealthierTomorrow
image credit: WHO.ORG
Every year on 7 April, we celebrate World Health Day, a date focused on raising awareness about the importance of health as a fundamental right, drawing attention to a specific health topic of concern to people worldwide. This year, WHO focus global attention on the interconnectedness between the planet and our health. In the midst of a pandemic, a polluted planet, and increasing diseases like cancer, asthma and heart disease, WHO highlights urgent actions to keep humans and the planet healthy and foster a movement to create societies focused on well-being. According to WHO, more than 13 million deaths around the world each year are due to avoidable environmental causes. This includes the climate crisis which is the single biggest health threat facing humanity.
image credit: WHO.ORG
"The climate crisis is also a health crisis. Breaking these cycles of destruction for the planet and human health requires legislative action, corporate reform and individuals to be supported and incentivized to make healthy choices." Through this year’s campaign: “Our planet, our health ”, WHO urge governments and the public to share stories of steps they are taking to protect the planet and their health and prioritize well-being societies.
image credit: WHO.ORG
PAGE 17
WONCA NEWS
WORLD HEALTH DAY 2022
ONE MINUTE FOR OUR PLANET NET
FEATURED STORIES
The theme of World Health Day 2022 "Our Planet, Our Health" makes us aware of the importance of caring for our planet as an essential habit in caring for our own health and the community. We, as family physicians, have a crucial role to play in sharing with our patients and the community the close relationship between personal health and the health of the planet. Proximity, longitudinality, and comprehensiveness are crucial values of family medicine in the care of citizens and are also essential values to improve the health of the planet. Our job is to explain and share the close connection between personal and planetary health. From our practice, we can raise awareness and promote caring behaviours for the planet. Small gestures count every day to achieve this. We are many family doctors worldwide, visiting many patients every day, and we participate in health promotion activities in the communities we serve. These are crucial opportunities to raise awareness about caring for the planet: start a conversation with our patients about the impact of our habits on planetary health; give concrete examples such as recycling materials, equipment and technology, consuming local food, reducing meat consumption, walking or cycling versus using the personal car, promoting public or collective transport, reducing the use of paper in consultations, reducing the use of medicines in pressurized containers, recycling medicines in pharmacies. All these efforts count to avoiding high concentrations of pharmaceuticals in the water we drink, our rivers, vegetables and fruit crops; reducing microplastics in our seas; lowering the
As family physicians, we have a crucial role to play in sharing with our patients and the community the close relationship between personal health and the health of the planet WONCA WP on Environment
pollutant particles in the air, preventing an increase or worsening of respiratory problems. The central question for reflection is are “producing” health if we are not looking for the environmental consequences of our actions. In 2020, England’s National Health Service became the world’s first health service to commit to net-zero emissions. By this year’s World Health Day, there are now over 50 countries committed to being Sustainable Low Carbon Health Systems and 18 countries with net-zero healthcare targets. Interventions to get the NHS to Net Zero range from improving energy efficiency in hospitals, to installing solar panels, to developing the world’s first hydrogen-electric ambulance, to working with its 80,000 suppliers to ensure they have carbon reduction plans with the NHS’s own targets. Primary care is leading the way in terms of implementing net zero interventions. PAGE 18
WONCA NEWS
WORLD HEALTH DAY 2022 ONE MINUTE FOR OUR PLANET The Green Impact for Health Toolkit provides practical tips for general practices to reduce their environmental footprint across 13 different areas, with the opportunity to reach a Bronze, Silver, Gold or Carbon rating. Metered-dose inhalers contribute a substantial proportion of primary care emissions. The Greener Practice guide, How to reduce the carbon footprint of inhaler prescribing? A guide for healthcare professionals supports better patient management of asthma and COPD alongside patient-focussed prescribing to switch to dry powder inhalers where appropriate. General practices can also estimate their non-clinical emissions from energy, travel, IT, waste, business services and procurement, using this calculator from SEE Sustainability. If every family doctor spends one minute communicating the close relationship between personal and planetary health, the action will multiply for the benefit of humanity and our planet. Start sharing messages about the health of the planet and our health with your patients today! To get more ideas, you can join the online course about Planetary Health of the WONCA WP on Environment.
FEATURED STORIES
DR MARÍA PILAR ASTIER PEÑA WONCA EXCUTIVE MEMBER AT LARGE
In collaboration with:
WONCA WP on Environment
DR ÖZDEN GÖKDEMIR CHAIR -WP ON ENVIRONMENT
DR ENRIQUE FACETO DE BARROS
DR MAYARA FLOSS
DR ALICE MCGUSHIN
We believe that evidence-based medicine and planetary health knowledge can promote a minute for the planet in the clinical encounter.
Our Planet, Our Health
#HealthierTomorrow
JOIN THE THIS WP
PAGE 19
WONCA NEWS
F E A T U R E D
S T O R I E S
RELATIONSHIP AND TRUST
FEATURED STORIES
PREREQUISITES OF THE MEDICAL CONSULTATION Anna Stavdal’s article “From the President: On Family Doctors’ Vaccine Dilemmas” addresses the dilemma of what happens when a patient rejects the Covid vaccination despite the doctor’s science-based recommendation, and despite the resulting risk of serious consequences, not only for the patient’s health but also for the health of others.
Authors Dr Bruno Kissling, family doctor, former Teaching Doctor Peter Ryser, specialist in Systemic Counselling, Teacher and Supervisor in Solution-Oriented Medicine
Anna Stavdal invites family doctors to reflect on how we can cope with such dilemmas. With its far-reaching uncertainties Covid reveals and amplifies pre-existing problems on all, relational, medical, epidemiological and societal issues and the complex interactions between them on their micro, meso and macro levels – going far beyond Covid. Dilemmas are subliminally present in each medical encounter and they affect both, the doctor and the patient. This is true because of the complexity, uncertainty and ambivalence. These three factors are at work in all the patient’s diseases / illnesses and healing processes. Dilemmas are also inherent to the scientific medical knowledge and therefore to all medical interventions from analysis to diagnosis, therapy and prevention. And let’s not forget, they are present in each interaction between doctor and patient and influence their relationship and trust. To be aware of this circumstance is crucial for each medical decision-making process.
Dr. Bruno Kissling
This awareness allows the doctor to have a self critical attitude and to meet the patient on an equal footing - like two experts: the patient being the expert of their unique disease / illness, their psycho-socio-economical context, targets, values, beliefs, experiences and resources. The doctor as an expert of medical knowledge, their professional experiences and, not to forget, personal convictions. Peter Ryser
PAGE 20
WONCA NEWS
F E A T U R E D
S T O R I E S FEATURED STORIES
This mutual respect leads to a sustainable relationship, to trust and to a feeling of safety. Relationship and trust are recognised as the foundation of any collaboration. A reliable collaboration finally leads to mutual understanding and the clarification of different views and interests. It leads to good solutions which are appropriate and acceptable for the patient and the doctor and to more satisfaction for both. This makes dilemmas easier to bear for both, doctor and patient. We have been dealing with precisely all these issues around the highly sensitive interactive encounter of doctor and patient for over 30 years. Bruno as a family doctor and Peter as a specialist in systemic, solution-oriented counselling and as a supervisor of family doctors. ogether we have summarized all our experiences in the book “Mastering the Medical Consultation”. Using practical examples, we discuss in seven steps, how the doctor can structure the consultation and how they can communicate with the patient. We reflect on why these approaches are useful. We show, how the doctor can build up and maintain a creative relationship. How they can ask questions which lead to the required clinical answers plus have the potential to make the patient widen their perspective on their problem. We reflect on how, together, they can create a common reality out of the patient’s and doctor’s realities. How they can reveal, what the patient really wants from the encounter with the doctor. How they can negotiate a reliable cooperation for an open-ended shared decisionmaking process. How they can deal with each other when there is a disagreement. And finally, how they decide on the next steps of an ongoing therapeutic process and how they conclude a treatment. We also address how they can terminate their relationship when they cannot find a constructive level at all. We end with questions which help the doctor to reflect on the consultation on a medical but also interpersonal and intrapersonal level.
The book also contains chapters on topics which are part of all steps of the consultation, such as active listening, physical proximity and contact, ambivalence, discussing therapeutic options, dealing with errors… Unfortunately, all these basic communication skills and organizational competences are not or only insufficiently taught at most medical schools. In our longstanding cooperation with experienced doctors, we have learned that there is a real need for repeated reflection on their own professional attitude and for training of their communication skills. Preferably in supervised peer group meetings. The participants share positive and negative clinical examples they experienced. They discuss which interactions have been helpful and which have not. Beyond the medical topics they can also discuss their emotional experiences. As a further benefit these peer-group encounters help the participants to look after their own personal wellbeing. We all agree: We can only be good doctors, when we also care for ourselves. ‣ Prefaces by Iona Heath and Susanne ‣ Rabady Free Association Books, London, 2021 ‣ Book Prize of the European Society for PatientCentered Healthcare ESPCH 2020 ‣ Original in German: «Die ärztliche Konsultation – systemisch-lösungsorientiert», Vandenhoeck & Ruprecht, 2019
Dr. Bruno Kissling, family doctor, former Teaching Doctor Peter Ryser, specialist in Systemic Counselling, Teacher and Supervisor in Solution-Oriented Medicine
PAGE 21
WONCA NEWS
W O N C A
C O N F E R E N C E S
WONCA RURAL HEALTH CONFERENCE 2022
WONCA CONFERENCES
LIMERICK, IRELAND
DUE TO POPULAR DEMAND, WONCA WORLD RURAL HEALTH CONFERENCE HAS EXTENDED ITS EARLY BIRD REGISTRATION DEADLINE TO MONDAY 18TH APRIL A reminder to get your registration submitted before the early bird deadline, now extended to 18 April. A number of packages are available, including special rates for WONCA Direct members, allied health professionals, lower income country-of-origin attendees and retirees. All details can be found on the website www.woncarhc2022.com
Both the Rural WONCA and WONCA Europe 2022 conferences are conveniently timed just one week apart with the latter taking place from 28th June to 1st July in London. Many conference participants are interested in attending both and there are convenient air links between the two host cities. Shannon Airport {located 3omins from the University of Limerick) has multiple daily flig hts on offer with flig ht times of just 1hr, 3Omins. Visit www.shannonairport.com for details or click here.
PODCAST: GP WORKS Two senior members of th organising committee, Professor Liam Glynn and Dr. Jerry Cowley, recently recorded a episode of the GP Works podcast, produced by Practitioners. In it, they explore a range of our host partner, the Irish College of General issues affecting Irish general practice and community healthcare. You can download the episode whereever you get your podcasts, or alternatively, click here to listen online.
PAGE 22
WONCA NEWS
W O N C A
C O N F E R E N C E S
27TH WONCA EUROPE CONFERENCE
WONCA CONFERENCES
LONDON, UK
SECURE YOUR SPOT AND REGISTER NOW TO WONCA EUROPE 2022! Spaces are quickly filling up! Let´s meet, discuss and share new knowledge in the leading global city of London. London is a natural meeting point for the world’s business networks. It is a leading city in the global economy and a center of international trade and finance. We think, that it is the perfect place for this year´s WONCA Europe conference. Find out more about London here.
WONCA & RCGP RUN Join us this year for WONCA & RCGP Run. We have teamed up with Run Talk Run to provided attendees with a lovely morning 3km walk or 5km run by the Excel centre. The run and walk will be led by Dr Hussain Al-Zubaidi (RCGP Lifestyle & Physical Activity Champion, Triathlete & Running coach) and an amazing team of volunteers. The event is FREE & open to all abilities. Come and run & walk together!
VGM PRECONFERENCE As part of #woncaeurope2022, we are delighted to announce that the Vasco da Gama Preconference will take place from 27th to 28th of June. Tickets are limited, so be sure to book your place soon! Find out what does keynote speakers, representatives from VdGM, Junior International Committee and RCGP are most excited about the pre-conference and conference in 2022
PAGE 23
WONCA NEWS
W O N C A
C O N F E R E N C E S
7TH WONCA AFRICA REGION CONFERENCE 2022
WONCA CONFERENCES
ABUJA, NIGERIA
WELCOME MESSAGE My dear Friends and Colleagues, I am Dr Dan Abubakar, the WONCA Africa Region President and the Chairman of the Host Organising Committee for the 7th WONCA Africa Region conference taking place in Abuja, Nigeria from 24th to 26th November 2022 at the NAF Conference Centre. The conference is tagged “WONCA Abuja 2022” I welcome you all to the event which promises to be very exciting and afford us the opportunity to meet physically, network, discuss and implement positive changes. It will be the second time Nigeria is hosting this event, the first was held here in Abuja 21 years ago. The conference will be [HYBRID] both physical and virtual and will afford colleagues who are unable to travel to Nigeria, the opportunity to fully participate in the event. The theme of the conference is: Africa’s Health Systems and Preparedness for Global Health Emergencies. The Sub-themes of the Conference are: 1. Psychosocial and economic burden of global health emergencies: The African perspective. 2. Challenges to providing effective frontline healthcare in Africa. 3. Ensuring health personnel safety during epidemics and pandemics. 4. Sustaining health professionals’ mentorship and education during epidemics and pandemics. The topics were painstakingly selected to reflect and address the present day healthcare challenges facing African family physicians. I invite you all to register for the conference and join us in Abuja in November 2022. Abuja is the administrative and political capital of the Federal Republic of Nigeria, a serene city with modern facilities for learning and a city known for culture and hospitality. A city with many monuments, historical sites and attractions.
Abuja is defined by Aso Rock, a 400 metre monolith left by water erosion. The Presidential Complex, National Assembly, Supreme Court and much of the city extend to the south of the rock. Zuma Rock, a 792 metre monolith, lies just north of the city. We look forward to welcoming you and hundreds of family doctors from around the world to the conference 24-26 NOV 2022. We promise to make the event exciting, interesting and educationally rewarding.
DR DAN ABUBAKAR Chairman, LOC woncaafricaregion@gmail.com
PAGE 24
WONCA NEWS
W O N C A
C O N F E R E N C E S
7TH WONCA EMR REGIONAL CONFERENCE
WONCA CONFERENCES
MUSCAT, OMAN
JOIN US IN OMAN THIS NOVEMBER AS WE DISCUS THE FUTURE OF FAMILY MEDICINE IN THE EASTERN MEDITERRANEAN REGION: CONNECT WITH SOME OF THE GREATEST MINDS IN FAMILY MEDICINE. We invite you all to share the results of your scientific research with us by submitting an abstract of your work and by joining us in sharing our vision at the 7th Wonca EMR Family Medicine Congress 2022: a vision to provide high-quality educational resources and enable Family Practitioners to provide optimal care for patients. We welcome you to the beautiful country of Oman, and wish you three days of education, knowledge sharing and unforgettable experiences.
VISIT WONCAEMR2022.COM FOR MORE INFORMATION
PAGE 25
WONCA NEWS
W O N C A
C O N F E R E N C E S
28TH WONCA EUROPE CONFERENCE
WONCA CONFERENCES
7 - 10 JUN 2023, BRUSSELS, BELGIUM
WONCA 2023 WORLD CONFERENCE SYDNEY, AUSTRALIA
Family doctors and GPs from around the globe will come together in Sydney to share research and discuss best practice, keeping communities healthy on an international level. WONCA 2023 is also about having fun, with many social activities planned for delegates, and their families and travel companions. Why not plan for the travel experience of a lifetime? Sydney Harbour is one of the world's most beautiful natural harbours, and there’s other iconic Australian destinations both near and far. From the Outback in Uluru to the Great Barrier Reef, the tropical terrain of Kakadu National Park, and much more.
PAGE 26
WONCA NEWS
W O N C A
C O N F E R E N C E S WONCA CONFERENCES
WONCA 2023 WORLD CONFERENCE SYDNEY, AUSTRALIA
DR MARK MORGAN, CHAIR OF THE WONCA 2023 CONFERENCE SCIENTIFIC COMMITTEE
A/PROF KAREN FLEGG WONCA PRESIDENT-ELECT
A MESSAGE FROM THE CONFERENCE SCIENTIFIC CHAIR
A MESSAGE FROM THE INTERNATIONAL ADVISORY CHAIR
As chair of the Scientific Committee for WONCA 2023 I am honoured to work with the members of the committee to design a program that has thought provoking and informative content that will be delivered in exciting and innovative ways. I hope you will come away from the conference with new global perspectives of primary care, new skills and new knowledge. Above all, I hope you will gain a sense of connection. The title of WONCA 2023, “Recovery, reconnection and revival. A celebration of primary care” is front of mind as we work through this global pandemic. The Scientific Committee will be working hard to ensure that WONCA 2023 lives up to this title.
We look forward to welcoming you to Sydney, in October 2023. Recovery, reconnection and revival - a celebration of primary care is our theme. How appropriate this is for 2023! Our program is sure to have something for everyone. It will be a celebration of primary care. The past years have been tough – with hard work and with COVID affecting our work, our homes, our friends and families. I was born in Sydney, and still think it is one of the world’s cities worth visiting and a great place in which to recover. You will be greeted with the well known Aussie friendliness! This may be the first opportunity, since 2019, for many of us to see our Australian and International friends, so be assured we are aware that time for reconnection both academically and socially is important. We aim to revive personally, and in our passion for primary care.
VISIT WONCA2023.COM.AU FOR MORE INFORMATION
PAGE 27
A N N O U N C E M E N T S &
U P D A T E S
ANNOUNCEMENTS & UPDATES
MCGILL FMER: INTERNATIONAL AWARDS IN FAMILY MEDICINE EDUCATION RESEARCH The McGill Family Medicine Education Research Group (FMER) is proud to announce the sponsorship of ‘The Pierre Pluye International Mixed Methods Thesis and Dissertations Awards in Family Medicine Education’ to celebrate the original and influential contribution of Dr. Pierre Pluye, founding member of the FMER, to the advancement of mixed methods research and mixed studies reviews in general, and of the family medicine education field of inquiry in particular. These awards are aimed to distinguish the work of promising new researchers committed to the advancement of science in family medicine education research around the world. As of the academic year 2021-2022, two academic awards – one for the best MSc thesis, and one for the best PhD dissertation – will therefore be granted by an Award FMER Evaluation Committee chaired by Dr. Pluye. The committee will include at least two other FMER researchers, and two FMER-affiliated graduate students (one MSc student and one PhD student or candidate). ELIGIBILITY
Submission period: May 1st to August 31st, 2022. Candidates must have completed their thesis or dissertation no earlier than two academic years prior submission, i.e., before August 31st, 2020. The thesis or dissertation must meet 3 criteria: a)be related to research in family medicine education; b)must uses mixed methods in empirical research and/or literature review; c)be written in English or French.
APPLICATION – PROCEDURE
Applications must include the five documents detailed below. Incomplete applications will be disregarded: • A cover letter in which the candidate clearly indicates the award s/he is applying for (thesis or dissertation);introduces him/herself, the program and institution in which s/he graduated, as well as his/her research supervisors; and briefly describes the investigation conducted. • An abstract of maximum 500 words that summarizes the thesis/dissertation. Particular attention should be given to the description and justification of the mixed methods (empirical research and/or review) adopted in accordance with GRAMMS (Good Reporting of Mixed Methods Studies), and of the major theoretical, empirical, methodological, and practical contributions to the sciences of family medicine education. • A copy of the thesis in PDF format. • An updated version of the candidate’s Curriculum Vitae. • A letter of support from the candidate’s principal research supervisor (specifying that the thesis has been approved to obtein a PHD Degree. Read the complete information here.
PAGE 28
WONCA NEWS
A N N O U N C E M E N T S &
U P D A T E S
ANNOUNCEMENTS & UPDATES
ISTAMBUL - TURKEY
94TH EGPRN MEETING We cordially invite you to attend the 94th EGPRN meeting that will be held in İstanbul, Turkey between 12 - 15 May 2022. The theme of this meeting is "Optimizing the organization of family medicine practice". Last day to submit your abstract is January 30th. Find more information and register HERE. 12 - 15 MAY 2022 REGISTER NOW
DIGITAL CONFERENCE HONG KONG PRIMARY CARE CONFERENCE 2022 CHAIRLADY’S MESSAGE On behalf of the Hong Kong College of Family Physicians, the members of the Organizing Committee and myself, we are very proud to announce the “13th Hong Kong Primary Care Conference” under the overarching theme of: “Committed. Versatile. Ever-growing: Primary Health Care in the Time of COVID” which will be held online from 17th to 19th of June 2022. As always, our hallmark conference, held online for the past 2 years, has continue to enthral our participants with its well-curated program. Our program will retain the wellreceived structure with various theme-based seminars, plenary sessions, interactive workshops and interesting discussion forum.
Last but not least, I cordially invite you to submit cases to our signature clinical case competition, as well as abstracts to our full and free paper competitions. So please stay tuned for further details I strongly believe that you will undoubtedly have a fruitful and enjoyable learning experience in the forthcoming conference. Dr. Lorna Ng Chairlady, Organizing Committee Hong Kong Primary Care Conference 2022 17 - 19 JUNE 2022 REGISTER NOW
This annual event offers an inspiring platform for bringing together international and local experts, family physicians, nurses and primary care professionals to promote collaborative and networking opportunities in addressing present and future challenges. PAGE 29