Wonca News - August 2005

From the Wonca President

Understanding our Patients –

Can it be Taught?

From the CEO’s Desk

Highlights from the Kyoto Wonca

Executive Committee Meeting

From the Editor

Wonca’s Journey Told Through the

Stories of its Family Doctors

FEATURE STORIES

•Kyoto’s Asia Pacific Regional Conference Sets a Global Standard

•Wonca Welcomes Five New Member Organizations into the ‘Family’

Wonca REGIONAL NEWS

•The Greek Island of Kos to Host September 2005 Europe Regional

Conference

•Come to Colombo, Sri Lanka for the 2005 Wonca MESAR Conference

HEALTH AND HEALTH SYSTEM NEWS

•ICPC Global Popularity Growing in 2005

•A Letter from Banda Aceh, Indonesia

MEMBER AND ORGANIZATIONAL NEWS

•Meet Professor Igor Svab: Wonca Europe Region President

•Celebrating the Life of Scotland’s Alastair Donald

•Calvin Lucas Wilson, MD: July 2005 Global Family Doctor of the Month

RESOURCES FOR THE FAMILY DOCTOR

•Special Interest Group on “Ethics in General Practice”

•Wonca SIG in Psychiatry and Mental Health

•Wonca Special Interest Group in Travel Medicine

WONCA CONFERENCES 2005-2010 AT A GLANCE

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

VOLUME 31

NUMBER 4

AUGUST 2005

CONTENTS

Wonca website:

http://www.GlobalFamilyDoctor.com

Wonca President

Prof Bruce Sparks, South Africa

2 Cruden Bay Road

Greenside

Johannesburg 2193

South Africa

Tel: 27 11 646 2140

Fax: 27 11 717 2558

Email: brucespa@global.co.za

Wonca Chief Executive Officer

Dr Alfred W T Loh

Wonca Administrative Manager

Ms Yvonne Chung

World Organization of Family Doctors

College of Medicine Building

16 College Road # 01-02

Singapore 169854

Tel: 65 6224 2886

Fax: 65 6324 2029

Email: admin@wonca.com.sg

Wonca President-Elect

Prof Chris van Weel, Netherlands

Wonca Immediate Past President

Dr Michael Boland, Ireland

Honorary Treasurer

Richard Roberts, MD, USA

Wonca Regional Presidents

Dr Abra T Fransch, Africa

Warren A Heffron, MD, Americas

A/Prof Goh Lee Gan, Asia Pacific

Prof Igor Svab, Europe

Dr Shatendra K Gupta, Middle East

South Asia

Dr Adolfo Rubinstein,

Iberoamericana-CIMF

Wonca Executive Members at Large

Dr Javier Dominguez del Olmo, Mexico

Prof Michael Kidd, Australia

Richard Roberts, MD, USA

Chair, Bylaws and Regulations

Dan Ostergaard, MD, USA

Chair, Publications & Communications

Dr Geoffrey D Martin, Australia

Editor, Wonca News and Editorial Office

Marc L Rivo, MD

4566 Prairie Avenue

Miami Beach, Florida 33140, USA

Tel: 305 671 7327

Fax: 305 674 8839

Email: marcrivo@aol.com

WONCA GLOBAL SPONSORS

FROM THE WONCA PRESIDENT:

UNDERSTANDING OUR PATIENTS -

CAN IT BE TAUGHT?

“Be sure that you go to the author to get at his

meaning, not to find yours.”

John Ruskin 1819-1900

It was Wednesday morning at a community-based

primary health care centre in Northeastern

Johannesburg. Alexandra clinic caters to the lower socio-

economic community living in humble dwellings and

shacks of the ‘black-only’ township established in 1914.

I was sitting in a consulting room, observing con-

sultations conducted by a young family medicine

resident in my department. The morning was literally a

cornucopia of educational gems and examples of every

aspect of our discipline. One theme which developed

was that of cross-cultural barriers in the patient

encounter and the importance of effective listening.

Many of the residents are from foreign African states

and do not speak the local languages, but use either

sophisticated West-African English or a heavily accented

‘French-English’. Most patients can understand some

English.

The first patient was a 36 year-old man who had

been referred back to the clinic by the local hospital. He

had diabetes which appeared to be totally out of

control. He had been admitted regularly to the hospital

with marked hyperglycaemia. While he claimed to be

taking his drugs regularly his HBA1C indicated poor

control. The doctor, after examining him chastised him

for his dietary control and indicated that without

compliance his condition could affect other vital organs.

His record card indicated similar, regular admonish-

ments. As he was leaving I asked him about his sources

of income and where he lived. He was in fact

unemployed, lived on the streets with friends, ‘wherever

he found a place’ and apart from drinking large amounts

of alcohol, ate whatever came his way in handouts.

On further questioning he admitted that he purposely

induced hyperglycaemia, to escape from the cold streets

of winter, preferring the warm beds and regular meals of

the hospital wards. To him being healthy was associated

with misery, hunger and cold winter nights. Adherence

to our protocols did not feature in his explanatory

model of health and disease!

The next patient was a 4 year-old girl brought in by

her 20 year-old mother, Martha. Martha seemed typical

WONCA

News

FROM THE WONCA PRESIDENT

of the poor disadvantaged people of the township with

limited schooling. But, she said, “Lucy has tonsillitis and

I think she needs amoxicillin!” Missing the obvious

cues, the doctor took a brief focused history, examined

the child and confirmed the mother’s diagnosis but

stated that he didn’t think she needed an antibiotic

because it didn’t look infectious! He proceeded to write

a prescription for paracetamol and was about to dismiss

them, when the other resident struck by the incongruity

between the mother’s appearance and background, and

her clinical knowledge, asked Martha where she worked.

She said, “No I have never worked.” “How do you know

about amoxicillin” she was asked. The consulting

resident was visible stunned when she replied, “I have

HIV, you know. I am on ARV (antiretroviral therapy), my

CD4 is 320 and my viral load has decreased since being

on ARV. I know about infections, PCP, TB and strep. I

am well now but if I can only live to see Lucy start

school then I will be happy.” The language, nature,

content and outcome of the consultation changed

dramatically with discussion of the mother’s health and

the need to prevent complications to her health. Her

frequent visits to the HIV clinic and community

counselling had totally altered her understanding of

health and disease.

Many of the patients visiting the clinic are HIV

positive. Having now been sensitised to HIV the

resident diagnosed the next patient, a 52 year-old thin

man with a persistent mild cough, as a patient with

possible TB and HIV, and referred him for a chest x-ray

and sputum analysis, with verbal advise on the

necessity for ‘safe-sex’. As the patient was about to

leave I asked the resident about the patient’s dark

pigmentation on the face, around the neck, and on the

hands. Further history (in Zulu) and examination

confirmed pellagra as a result of heavy drinking and

poor diet. This man lived alone in a backyard shack, ate

a limited diet of porridge and occasional meat which he

cooked on a paraffin stove. His main daily activity was

drinking with his pals and doing ‘odd handyman jobs’

when he could get them. He did not have TB nor HIV.

He had been celibate for years since he became

impotent. His main reason for encounter today was to

obtain assistance with his alcohol problem. He did not

understand the resident’s “French-English” and nodded

confidently when asked questions he did not

understand.

Other patients that morning demonstrated similar

missed or confused diagnoses. Regretfully the resident

had also failed to communicate adequately, possible for

many reasons – foreign language, missed cues, poor

basic medical training, failure to explore the social

context, poor clinical reasoning, biased index of

WONCA

News

FROM THE WONCA PRESIDENT / FROM THE CEO’S DESK

FROM THE CEO’S DESK:

HIGHLIGHTS FROM THE KYOTO WONCA

EXECUTIVE COMMITTEE MEETING

The first full business meeting of the new Wonca

Executive for this 2005 to 2007 triennium was held in

Kyoto, Japan from Wednesday, 25th–27th May 2005 just

before the Asia-Pacific Regional Conference held at the

same venue. All Executive Members attended with the

additional presence of the Chairs of the Wonca Bylaws

& Regulations Committee and the Wonca Communi-

cations and Publications Committee in ex-officio roles.

At the start of the meeting the Wonca President

informed the Executive of the passing of one of Wonca’s

Past Presidents, Dr Donald Rice from Canada. Dr Rice

was Wonca’s 2nd President from 1974-76. He was

awarded the Wonca Fellowship and Honorary Life

Membership in 1980. Executive stood for a minute’s

silence in his memory.

The agenda items took the full two-and-half days set

aside for the meeting with several significant issues

discussed and important decisions made on behalf of

Wonca’s Member Organisations and Direct Members. I

hope to cover just a few of these issues in this column.

Implementation of Standardised Dues

Wonca Executive was informed that the

standardization of both the Direct Members’ and

Member Organization’s membership dues have been

implemented beginning in 2005 following Wonca World

Council’s acceptance of the CEO’s recommendations to

have a more structured policy.

New Direct Member applicants pay a once off

processing fee of US$40 with annual membership dues

of US$25 per year, or $75 for three years. In addition to

these scheduled Direct Member dues, regional dues of

the different Regions would be added. Currently, this

applied to the European and Asia Pacific Regions only.

Member Organizations (MOs) are now categorized

into three broad groups based on their GDP per capita

from World Bank figures. The following discounts are

applicable to the amount of organizational membership

dues payable:

suspicion towards HIV and TB, or even a lack of cultural

and social understanding of the community, to name a

few. Korin and Lebensohn wrote “The differences in the

meaning of suffering and disability in many ethnic and

socio-cultural groups often conflict with the traditional

model in which physicians operate. Most doctors think

that treatment should include intervention and that

biological anomalies should be corrected. However,

some ethnic and socio-cultural groups view disability as

a spiritual rather than a physical phenomenon, and

might believe that disability itself is a blessing or

reward for ancestral tribulations.”

Those foreign doctors attending the family medicine

programmes in South Africa are probably fortunate to be

part of a formal training programme, and we are more

than willing to assist. But most of the over 50 states in

Africa have no family medicine / primary care training

beyond their basic ‘inoculation’ as medical students.

Wonca is mindful of this hiatus in the training and

expertise of this region’s primary care practitioners,

particularly if one considers the high prevalence of HIV

related illness, TB, and the high burden of disease and

childhood deaths rates from infective and preventable

conditions. To this end Wonca is developing major

projects in collaboration with many organisations,

international pharmaceutical companies and funders to

attempt to establish and nuture educational pro-

grammes based on local needs and priorites. The

Flemish Departments of Family Medicine have assisted.

Recent meetings with GAME (Global Alliance for Medical

Education) and Project GLOBE for Global Education of

Family Doctors look very promising. The focus of such

programmes must be on improving the quality of health

care through optimising practitioner expertise and not

by purely rolling out and reprocessing CME from

developed countries. We must not encourage Academic

Neo-Colonialism!

But such programmes must address not only the

numerous clinical issues and challenges of the

developing world, but also the cultural diversity of the

continent. Korin and Lebensohn ask, “But how can

physicians promote and focus on such dialogue? Self-

awareness and reflection about their cultural values,

beliefs, and social location is a first requisite, plus a

posture of genuine curiosity and ‘cultural humility’ vis-a-

vis the patient’s/family’s culture”.

Bruce Sparks, M.D.

President

World Organization of Family Doctors

WONCA

News

FROM THE CEO’S DESK

(1)MOs with GDP per capita above the world’s

average. They pay the full MO dues.

(2)MOs with GDP per capita between the world

average and 50% of that average. They receive a

33% discount on the dues payable.

(3)MOs with GDP per capita less than 50% of world

average. They receive a 50% discount.

Members of Executive felt a need to consider

extending the 3 categories discount policy. A motion

was adopted to add a 4th category to include member

organizations in countries with GDP per capita of less

than 75% of the world average. These members would

receive a 75% discount. This proposal would take into

account countries with US$2000 GDP per capita or less,

and of which currently 7 Member Organizations exist.

This additional category will be implemented

immediately.

Standardising the National Licensing Royalties

for ICPC-2

The CEO proposed to Wonca Executive to

standardize the approach in the royalties payable for

national licenses for ICPC-2. The old method of

calculation was based solely on GDP, the economic

output indicator or wealth of a country, but did not take

into account the GDP per capita, or the average

economic output per person. The GDP per capita was

felt to be a better measure of the average earning of

the population, and therefore, would give a better

gauge of the affordability of the average citizen. This

should be reflected in the calculation for the national

ICPC-2 license.

The new approach would use the GDP and GDP per

capita of all countries listed by the World Bank. Using

these figures from the World Bank would ensure

impartiality. Also, the figures provided were updated

annually to reflect the current status of the economies

of the various countries. The initial step would be to

categorize the GDP per capita of all countries into three

broad groups (as for the calculation of the Wonca

organizational membership dues):

(1)Countries with above world average GDP per capita.

The baseline for the calculation for the national

license would be US$1,000,000.

(2)Countries with below world average GDP per capita.

The baseline would be US $670,000, a 33%

discount.

(3)Countries with 50% or less below world average

GFD per capita. The baseline would be US$500,000,

a 50% discount.

The quantum for the national license for a country X

would then be calculated using the ratio of the GDP of

Country X over that of the USA, (the USA being the

leading world economy) multiplied by the baseline to

which Country X belongs, ie:

Total GDP of

Baseline or

Country X

Discounted Baseline

Total GDP of USA

of Country X

As countries at the lower ends of the three groups

(1), (2) and (3) would need to pay extremely low prices

for ICPC-2 national license, it was suggested that a

minimum sum be set for each group as follows:

(1) Countries with above world average GDP per capita:

Minimum sum for national license of ICPC-2 is

US$8,000

(2) Countries with below world average GDP per capita:

Minimum sum for national license of ICPC-2 is

US$5,000

(3) Countries with 50% or less below world average GFD

per capita: Minimum sum for national license of

ICPC-2 is US$3,000

For Wonca Member Organizations purchasing the

national license, there would be a discount of 20% to

the royalties calculated above.

Wonca Executive agreed to the proposal to

encourage the widespread use of ICPC-2 without making

cost an obstacle for obtaining a license, yet receive

some revenue to cover the administrative costs for

Wonca and WICC. The Wonca Executive requested that

this be implemented with immediate effect for all new

purchasers of ICPC-2.

Standardised Conference Contract

At the Wonca World Council in Orlando, the CEO

gave background regarding a contractual document to

be signed between Wonca World and the Member

Organization hosting a Wonca conference.

WONCA

News

FROM THE CEO’S DESK / FROM THE EDITOR

The contract document stated

the obligations of the Host Member

Organization and that of Wonca

World. The document was meant to

serve as a guide for those

organizations who wished to bid to

host a Wonca conference. The

document would help that

organization to understand the

seriousness of the bid it had

undertaken to meet the obligations

of hosting a Wonca conference.

This initial contract document

was presented to the 2004 Wonca

World Council Meeting in Orlando.

Following comments and

suggestions from Wonca World

Council, further changes were made.

This revised document was

discussed in detail by Executive at

this meeting in Kyoto.

The document would spell out

clearly the various responsibilities of

the Host Organising Committee, the

Host Organisation and also Wonca.

With the increasing interest shown

by member organisations in hosting

Wonca World and Regional

Conferences, this document was felt

by Executive to be timely and

necessary.

As agreed at the Orlando World

Council, all Wonca conferences to be

held after year 2007 will be covered

by the terms in the document. But

conferences being organised

between now and 2007 itself will

abide by the spirit of the document

as well.

Wonca Welcomes its Newest

Member Organisations

During the Kyoto meeting, Wonca

Executive agreed to accept the

membership applications of five

organisations. With these five new

Member Organisations, Wonca now

has a total membership of 105

FROM THE EDITOR:

WONCA’S JOURNEY TOLD

THROUGH THE STORIES

OF ITS FAMILY DOCTORS

“Since history has no properly

scientific value, its only purpose is

educative. And if historians neglect

to educate the public, if they fail to

interest it intelligently in the past,

then all their historical learning is

valueless except in so far as it

educates themselves.” George M.

Trevelyan, 1876-1962, British

historian. People, organizations,

nations, and our global community.

We learn through our individual and

collective experiences. Those

experiences, once recorded, become

the sum total of our history.

Learning from the lessons of history

is of immense value to our

individual and collective success.

Wonca is a learning community

of family doctors made up of its

component organization parts. At its

core, Wonca represents the sum

total of its knowledge experienced

daily through the senses of its

family doctors. Those shared

experiences help us learn and grow

as individual family doctors and as

an organization.

The stories in this issue of

Wonca News illustrate the richness

organisations in 88 countries

globally that cover over 80% of the

world’s total population.

Dr Alfred Loh

Chief Executive Officer

World Organization of Family

Doctors

of our global organization. At one

end of the spectrum, stories

describe the organizational

complexity of Wonca and the

collective work of our members,

from the recent Asia Pacific Regional

Conference in Kyoto, Japan attended

by more than 2300 family doctors

and others from more than 50

countries; to the highlights of

Wonca’s Executive Committee

Meeting held in Kyoto; to the work

of Wonca’s International Classi-

fication Committee members in

numerous countries throughout the

world, and to the work of Wonca’s

Special Interest Group members.

At other end of the spectrum,

the August 2005 issue of Wonca

News chronicles the stories of

individual family doctors. In this

issue, we read moving stories

of Slovenia’s Igor Svab, Scotland’s

Alastair Donald, the USA’s Calvin

Lucas Wilson and Canada’s Lynda

Redwood-Campbell.

Through these stories, both the

individual and the collective, we

celebrate our accomplishments,

identify our challenges and learn

from each other.

Please help us chronicle our

Wonca journey and learn from one

another by sharing with me your

collective and individual stories.

Marc L. Rivo, M.D, M.P.H.

Editor, Wonca News

marcrivo@aol.com

4566 Prairie Avenue

Miami Beach, FL 33140 USA

1-305-674-8839 (fax)

WONCA

News

FEATURE STORIES

KYOTO’S ASIA PACIFIC REGIONAL

CONFERENCE SETS A GLOBAL STANDARD

Kyoto, the enchanting ancient capital of Japan and

site of the 1997 Kyoto Protocol standards to control

global warming, served as an ideal venue for more than

2,300 family doctors from over 50 countries in the Asia

Pacific region and around the world to network together

and share their views on a global standard for family

medicine.

Their Imperial Highnesses Prince and Princess

Akishino graciously hosted the opening reception and

lent a dignified presence to the opening plenary

performances and a series of warm welcome addresses

by the Host Organizing Committee, including Honorary

Chairperson Dr Makoto Komatsu and Chairperson,

Professor Tsukasa Tsuda, from The Japanese Academy of

Primary Care Physicians. Greetings from the Wonca

Executive, who met in Kyoto in conjunction with the

conference, were given by Professors Goh Lee Gan,

Wonca Asia Pacific Regional President, and Bruce

Sparks, Wonca World President.

Plenary speakers expounded upon the conference

theme, “Family/General Practice as a Global Standard”.

Kiyoshi Kurokawa, President of the host Science Council

of Japan, opened with an expansive plenary address on

“Global Healthcare Challenges and Opportunities”.

Jonathan Rodnick, past Chair of Family and Community

Medicine at University of California, San Francisco, then

directly addressed the conference theme. He suggested

that a unified set of global standards for family

medicine is possible and proposed a set of standards

for consideration.

In the special Invited Symposium, enlightening

national perspectives on family/general practice as a

global standard from the Asia-Pacific Region were

presented from Hong Kong by Tai-Pong Lam, Associate

Professor of the Family Medicine Unit, Hong Kong

University; from Korea by Bong Yul Huh, Chairman of

the Department of Family Medicine, Seoul National

University Hospital; from Australia by Michael Kidd,

President, the Royal Australian College of General

Practitioners; and from Japan by Tomoyuki Kido, Clinical

Professor, Osaka Medical College and Kyoto University.

In addition, recent developments in the United Kingdom

were presented by Neil Jackson, Dean of Postgraduate

General Practice Education, the London Deanery; and in

the United States by Jonathan Rodnick.

Their Imperial Highnesses Prince and Princess Akishino at the opening

plenary

From left to right: Miss Jace Phang (CFPS Secretariat, Singapore),

Dr Chng Woei (Singapore HOC 2007 Committee), A/Prof Goh Lee Gan

(Regional President, Asia Pacific), Dr Tan Sze Wee(Singapore HOC 2007

Committee), Dr Tsukasa Tsuda (Chairperson, HOC Wonca Kyoto 2005),

Dr Makoto Komatasu (Honorary Chairperson, HOC Wonca Kyoto 2005),

Miss Mariko Sunaba (Conference Organiser, Wonca Kyoto 2005)

The magnificent Kyoto International Conference Hall

WONCA

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FEATURE STORIES

A rich set of daily plenary perspectives were offered on Japanese spiritual health care by Tetsuo Yamaori from the

International Research Center for Japanese Studies; on global health challenges for family physicians by Shigeru

Omi, WHO Regional Director for the Western Pacific; on equity, health and primary care by MK Rajakumar, President

of the Family Physicians of Malaysia; and on the International Classification of Primary Care (ICPC) as a global

standard for Family Medicine, by Henk Lamberts, Professor at the University of Amsterdam.

Conference participants enjoyed a brisk and diverse choice of excellent workshops organized by the Scientific

Program Committee and its Chairperson, Professor Nobutaro Ban, Chairman of the Department of General Medicine,

Nagoya University Hospital. The exhibit hall was full of informative poster sessions and booths, organized by the

Exhibition Committee and its Chairperson, Takashi Yamada, Director of the Institute of Community Medicine with the

Japanese Association for Development of Community Medicine.

In addition, Kyoto was the site of a preconference meeting of Wonca’s International Classification Committee,

organized by Committee Chair Neils Bentzen and hosted by Japan’s Institute of Community Medicine under the

leadership of its Director, Takashi Yamada. During the conference, Wonca’s Working Party on Women and Family

Medicine met under the leaders of Executive Committee members Sorayda Leopando from the Phillipines and

Amanda Barnard from Australia.

A 3-day post-conference workshop on family medicine teaching, organized by Dr Ryuki Kassai was held in

Ranzan. The theme was Clinical Education: making our teaching more humane and learner-centered. There were 54

participants including the resource persons. A highlight of this Workshop was cinemeducation, the use of clips from

the movies for learning and reflection of various topics: Akahige for the topic of mentorship; The Mighty for

narrative based medicine; and Good Will Hunting for trainee safety. The workshop consisted of plenary lectures on

mentorship, formative assessment, communication, and safety for trainees, each with an accompanying workshop.

There was even the experience of Zen in visiting a Zen temple in Kyoto. For the participants, it was an enriching

workshop on learning and teaching family medicine.

Family Doctors at one of Kyoto’s beautiful outdoor receptions

WONCA

News

FEATURE STORIES

Wonca CEO Alfred and Yiau Leng Loh and their daughter, Abigail with the Japanese Geisha

Wonca Executive Committee Members and accompanying persons in Kyoto

The Host Organizing Committee’s welcome night, opening ceremony,

culture night party, closing ceremony and farewell party highlighted the

warmth of Kyoto’s citizens, its beautiful culture and illustrious history of

Japan’s ancient capital for over a thousand years. The conference excursions

and tours displayed Japanese traditional art, architecture, crafts and

gardening carefully preserved in its breathtaking Buddhist temples, Shinto

Shrines, gardens, ponds and scenic areas, including 17 UNESCO World

Cultural Heritage sites designated as National Treasures.

The inviting and informal conference structure and its warm surroundings

helped nurture the renewal of old friendships and the development of new

ones among the participants from the Asia Pacific and around the world.

The beauty of Kyoto, the scientific rigor of the conference and the

hospitality of the Japanese hosts made for a memorable Asia Pacific

Regional Conference.

Wonca Welcomes Five New Member Organizations into

the ‘Family’

We have been gratified that new organizations from new and existing

member countries continue to recognize Wonca as the leader in this

worldwide movement of family

medicine.

We are excited to see that many

new family medicine organizations

are being established across the

globe in countries with significant

health care needs from El Salvador

to Iraq to Myanmar.

At the June Executive meeting in

Kyoto Japan, five new member

organizations from four different

Wonca Regions were admitted as

full members of Wonca. This brings

us to 105 member organizations

from 88 different countries. The new

members (pending approval where

incidated) are

*Asociacion de Medicina Familiar

El Salvador. (AMEFAES) The

Family Medicine Association of El

Salvador, joining the

Iberoamericana-CIMF Region

The Iraqi Family Physicians

Society, joining the Middle East

South Asia Region

*Societe Scientifique

Luxumbourgeoise de Medicine

Generale. (SSLMG) Luxemburgish

Scientific Society for General

Practice, joining the Europe

Region

The General Practitioners’

Society, Myanmar Medical

Association, joining the Asia

Pacific Region; and

The Vietnam Association of

Family Physicians, joining the

Asia Pacific Region

*El Salvador and Luxembourg

were approved pending

completion of some final

administrative details.

Warren Heffron

Chair, Wonca Membership

Committee

WONCA

News

REGIONAL NEWS

WONCA REGIONAL NEWS

THE GREEK ISLAND OF KOS TO HOST

SEPTEMBER 2005 EUROPE REGIONAL

CONFERENCE

It is an honour and a privilege to invite you to the

11th Conference of the European Society of General

Practice/Family Medicine-WONCA Region Europe, which

will be held in Greece from the 3rd to the 7th of

September 2005.

The overall theme of the Conference has been

determined to be “From Hippocrates to the Human

Genome: The Past, Present and Future of General

Practice/Family Medicine.”

It is time to reexamine the Hippocratic principles,

taking into consideration the large and recent scientific

breakthroughs and to test, in terms of time endurance,

our classical values in order to reassure them. As far as

Greece is concerned, the country that has invented

Family Medicine in the past, it will have the chance to

reinvent it once more in the Conference, as well as to

reform any basic principles while monitoring the

evolution of General Practice along with its challenges.

We believe that the concept of Family Medicine is a

classical one. Nevertheless, we strongly feel that it is

our duty to argue on our belief and to prove that our

specialty is the actual core of Medicine itself; to such an

extend this is, that the later cannot evolve as a science

and a function in the absence of the former.

Bodossakis Merkouris

HOC Chairman

The Conference will be organized in the island Kos,

the birthplace of Hippocrates. Kos is a place where

antiquity and modern civilisation find themselves in

unison. The island of Kos is situated in the southeastern

region of the Aegean Sea and is the third largest

(295 sq. m.) of the Dodecanese Islands. Kos is an island

of magni-ficent beauty also described as the jewel of

the Greek Islands. Besides its breath taking golden

sandy beaches, Kos is also full of ancient monuments,

remnants from its glorious past. Kos is the site of the

famous Hippocrates’ Plane tree, where the father of

modern Medicine used to teach and practice medicine.

This is considered to be the oldest tree in Europe. It is

also home to the Asclepion of Kos, a temple dedicated

to the Asclepios, the god protector of health in ancient

Greece. The island’s mild climate, among the finest in

the Mediterranean, is the primary reason for the island’s

abundant green and other physical charms. No wonder

that people call it “the garden of the Aegean”.

To learn more about the 2005 European Regional

Conference and to register online, please visit our web

site at http://www.woncaeurope2005.org/. Additional

contact information is available in this issue under

“Global Meetings for the Family Doctor”.

We are waiting to welcome you to our beautiful

country so that we could offer our hospitality, always

under the gaze of Zeus, protector of guests according to

the ancient Greek tradition.

Bodossakis-Prodromos R.Merkouris

Chairman, Host Organizing Committee

Greek Association of General Practitioners

Come to Colombo, Sri Lanka for the

2005 Wonca MESAR Conference

The College of General Practitioners of Sri Lanka is

organizing a Wonca Middle East South Asia Regional

(MESAR) Conference from the 12th to 16th October 2005

in Colombo on the theme Family Physician in Health

Care – the Way Forward. There seems to be a great deal

of enthusiasm among family physicians from the

member countries of Wonca and I have had a number of

inquiries from those who are interested in attending.

Family medicine as a speciality is well established in

many parts of the world, and is now gaining momentum

in the Middle East South Asia Region. Therefore, it is

our duty as family physicians in the region to convince

governments and universities to recognize it as such.

We are at a crucial stage in the process of recognition in

our region. The World Health Organization and other

world bodies concerned with the health status of our

region, have had several discussions on this subject and

they strongly support the view that family physicians

should play a pivotal role in primary health care of a

country, and that a proper referral system should be

established. The Sri Lankan College has taken many

steps in this direction and this conference will be an

ideal forum for all of us to express our views and speak

in one voice. Many leaders and decision makers in

health care in this region are expected to participate

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REGIONAL NEWS / HEALTH AND HEALTH SYSTEM NEWS

and therefore it is vitally important

that as many of you as possible

should attend this conference.

Dr Preethi

Wijegoonawardene

President

College of General

Practitioners of Sri

Lanka

A stimulating scientific

programme is being planned and we

will dedicate a session to the

tsunami affected people, where

presentations will be made to

inform the delegates at the

conference on the role of the

College in rebuilding and

rehabilitating tsunami affected

families. Preliminary studies on the

tsunami, and its impact on the

health system of the country will

also be presented for discussion at

a seminar. There will be an

interesting social programme with

much interaction and we also plan

to have a day excursion to some of

the tsunami affected areas on the

coast line, for the foreign delegates

to see for themselves. The Host

College of General Practitioners of

Sri Lanka has decided to donate

part of the proceeds of the

Conference to the Tsunami Relief

Fund.

Do not miss an opportunity to

combine the benefits of a good

scientific programme with enjoying

one of the best destinations in the

world. Sri Lanka, a tropical island

situated at the southern tip of India,

has been appropriately described as

a paradise. Its sunny beaches, palm

fringed coastline, abundance of

rivers, streams cascading waterfalls,

and its heartland of cool misty

mountains, forests containing a

variety of exotic flora and fauna are

some of its major attractions. Sri

Lanka has a colourful history of an

advanced civilization that dates

back to the Pre-Christian era. The ruins of palaces, irrigation systems and

places of worship, which still can be viewed, bear eloquent testimony to the

advances the ancient Sri Lankans made.

Please circulate this message to all your colleagues in your organization,

keep the dates free and make your travel arrangements accordingly. You

could communicate with us on our e-mail cgpsl@sltnet.lk as early as

possible.

I welcome you all to Sri Lanka in the month of October for this great

event.

Dr Preethi Wijegoonawardene

President, College of General Practitioners,

Sri Lanka

Professor W A Ferdinand

Secretary General

Wonca MESAR Conference 2005

HEALTH AND HEALTH SYSTEM NEWS

ICPC GLOBAL POPULARITY GROWING IN 2005

Use of ICPC, developed by the Wonca International Classification

Committee, continues to expand worldwide, with exciting new developments

in 2005 in a number of countries. While this article highlights what is

happening in the economically developed world, ICPC’s application in

developing countries will be of particular importance in the future.

In Argentina, ICPC is still used only in selected private sector institutions.

In the Hospital Italiano de Buenos Aires a Terminology Server has been

developed and is used in the Ambulatory Electronic Patient Record. This

allows doctors to create the problem list of each patient using a Local

Interface Terminology that maps to ICPC-2e, ICD-10 and SNOMED CT. Part of

the Interface Terminology is available as a thesaurus in a test web site

(http://ciap.hospitalitaliano.org.ar). This is the follow up of a paper

presented in Spanish at the 2002 MedNet meeting

(http://www.latinmednet.com.ar/Trabajos/D2.pdf).

In Australia, ICPC is used in BEACH (Bettering the Evaluation and Care of

Health), the Australian national continuous study of general practice activity.

Data is collected in 400 GP practices (1600 GPs) using the Plus terminology

and classified for reporting in ICPC. Now in its 8th year, over 700,000

encounters have been secondarily classified in BEACH. ICPC was also used

for classification of co-morbidity reported by 30,000 adult respondents in

the 2004 Australian National Drug Strategy Household Survey.

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HEALTH AND HEALTH SYSTEM NEWS

communicating reports to GPs and in retrieving data for

scientific use.

Using evidence based medicine guidelines from

Duodecimo, Finland 946 topics have been indexed by

ICPC-2 codes. By using the bilingual Dutch French

thesaurus to find the ICPC-2 code, GPs have easy on-

line access to a short-list of the guidelines.

In Denmark, an Extended Danish ICPC-1 has been

updated twice and is now incorporated in the national

health portal, and is used in all electronic medical

record systems. ICPC coding in general practice is not

mandatory, but an ICPC coding network group is

working on promoting and optimising the daily use of

ICPC in electronic medical record systems. Work

continues on the Link Portal Project, in which entering

the ICPC code activates an internet call to a module on

the health portal, giving direct access to relevant and

updated information on the health problem in question.

In Finland, the translation of ICPC-2 Chapter 10 into

Finnish and Swedish was completed in June 2005, and

is available in an electronic format on the website of the

Norwegian Centre for Health Informatics (KITH),

www.kith.no. Ten bigger municipalities are preparing to

start to use ICPC-2 as soon as the classification has

been integrated in electronic medical record software

used in primary health care. Plans are advanced to

make ICPC-2 a national coding standard for Reason for

Encounter with a formal decision awaited by the

Ministry of Health and Social Affairs. The Social

Insurance Institution of Finland is also considering using

ICPC-2 as a standard for coding of diagnosis.

In France, the CISP-Club is active in promoting ICPC

in France and French-speaking countries. Its last

workshop was held in Annecy, France in October 2004

with eight French-speaking countries represented,

including four colleagues from Africa. The CISP-Club is

currently collaborating with the non-government

organisation “Médecins du Monde” for pilot testing of

ICPC in collecting data on homeless patients seen in

community health centres in France and other European

countries.

In 2003-2004, a field study was conducted in the

Lyon area, to test the process of structuring consultation

data in overweight patients (reasons for encounter, co-

morbidity, and process of care), and was classified with

ICPC. This initiative was supported through grants for

dedicated projects by the French regional organisations

of private-practising physicians and a fund of the French

Health Insurance System, is uncertain.

WICC Chair Neils and Inga Bentzen and fellow WICC members relax

after their meeting in Kyoto during the Asia Pacific Regional

Conference to enjoy dinner, Japanese style

WICC members Henk Lamberts and Inge Okkes at the beautiful

Kinkakuji, Golden Pavilion in Kyoto, Japan during the Asia Pacific

Regional Conference

As part of a Commonwealth Fund project led by the

University of California, San Francisco comparing general

practice data from the US, UK, New Zealand and

Australia, ICPC-2 has been mapped to the Johns Hopkins

University’s Expanded Diagnostic Clusters, a higher-level

diagnostic classification applicable across all health

sectors, and to Major Expanded Diagnostic Clusters,

another higher-level classification.

In Belgium, the government gives incentives for GPs

to use labeled electronic patient record (EPR) systems,

and ICPC as an encoding system in the EPR is now

mandatory in software systems. ICPC is increasing being

used in the EPR for communication, reporting and as

part of expert system tools.

An improved bilingual (Dutch and French) thesaurus

has been developed, which links to a list of about

65,000 clinical labels mapped to an ICPC-2/ICD10 code.

These are used in notification systems in the EPR, for

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In Germany, with support of the German Ministry of

Education and Research, a general practice morbidity

registration network, using ICPC-2E in an episode based

electronic patient record, is being developed by the

Department of General Practice and Health Services

Research at Heidelberg University. The German

translation of ICPC-2E, mapping between the German

version of ICD10 and ICPC-2E, and a German thesaurus

have been integrated into registration software for GPs.

Import and export interfaces as well as a central

database and web-based analysis tools are functional.

In order to set standards for further GP software

solutions a manual for programmers has been

developed and may serve as a basis for an accreditation

process. GPs are being recruited to participate in the

CONTENT registration network, with first analyses of

data expected at the end of 2005.

In Greece, translation of ICPC-2 is in progress.

Chapter 10 is in use in a selected group of practices to

check cultural adaptation and local needs for codes and

labels. ICPC-2 is being considered as the national

standard for electronic medical records in Greece, but no

formal decision has yet been taken by the Greek

Ministry of Health. A process to adopt Health Level

Seven (HL7) for the Greek setting has began and ICPC-2

is being proposed as a standard classification for

connecting different health software in primary health

care.

In Malta, interest in ICPC is growing steadily, with

interest is being shown in incorporating ICPC in a

variety of primary health care settings, including

Government Health Centres. The Maltese Transition

Project, using the software tool TRANSHIS donated by

the Dutch Transition Project, has completed four years

of data collection from eight family practices. The

database contains data on more than 55,000

encounters including prescribing data using the ATC

codes and the defined daily dose prescribed. Morbidity

data from the Maltese Transition Project has been used

to support the Malta College of Family Doctor’s policy

document on Vocational Training. ICPC was used to

collect data for a study of sickness certification in Malta,

and was published in the June 2004 issue of the

European Journal of General Practice.

In The Netherlands, ICPC-1 continues to be the

engine of electronic patient records (EPRs) in Dutch

general practice, as it has a core role in the mandatory

prescribing software. From January 2006, the health

insurance system in the Netherlands will be changed.

The establishment of a countrywide system for out-of-

hours care means that most patients will have no

access their own GP during evenings, nights and

weekends. These changes could lead to the

development of software, which will allow access to

patient data on episode and medications by the doctors

who will provide these out-of-hours services.

In New Zealand, the Royal New Zealand College of

General Practitioners IT Working Party has discussed

ICPC. At the government level, the Health Information

Standards Organization has flagged the topic of Primary

Care classification systems standards, but not discussed

it to date. Currently the Read Codes are used for all

primary care reporting and are incorporated in all

Practice Management Systems. A change to ICPC use in

general practice computer systems may not come about

until government dispenses with use of the Read Codes.

In Spain, the most important recent development has

being the translation of ICPC-2-e into Spanish, with the

joint cooperation of the two associations of general

practitioners/family physicians, SEMFYC (family

physicians) and SEMERGEN (rural doctors). Both

associations are also supporting the translation of the

Wonca Dictionary of General Practice.

In the United Kingdom, ICPC is being actively used in

academic research projects in several universities in

England and Scotland. The English National Programme

for IT is adopting SNOMED-CT as a common terminology

standard, and implementation and deployment are now

underway. With the proposed mapping between

SNOMED-CT and ICPC, the prospect of future use of

ICPC as a research and audit tool as well as a primary

care classification is a distinct possibility.

In the United States, primary care is at the center of

the movement to transform the health care system with

developments in a number of areas. The US Department

of Health and Human Services has purchased rights to

use SNOMED-CT as the core terminology for US

electronic health records. A comprehensive National

Health Informatics Infrastructure is being developed, and

the American Academy of Family Physicians is

implementing recommendations from the Future of

Family Medicine report on the New Model of Family

Medicine. Work has intensified on the creation of a

Patient Safety Taxonomy that will advance clinical and

research efforts to improve health care safety and

quality. WHO has created a blueprint for a “family of

international classifications” that will include a patient

safety classification.

It is increasingly clear that the information

technology that will support these initiatives is of

international scope. Much of the experience and

expertise in this area is outside the US. Primary care

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HEALTH AND HEALTH SYSTEM NEWS

policy leaders in the US now

recognize that these activities offer

an unprecedented opportunity to

create a primary care information

infrastructure that will support a

new clinical model of primary care

while conforming to emerging

national and international

standards.

A conference, or series of

conferences on primary care

classification will be held over the

next 18 to 24 months. These will

serve to engage the international

primary care community in the task

of creating a common infrastructure

that will support the interoperable

primary care electronic health

record. The expected outcomes are

the publication of Data Standards

for Primary Care, completion of a

SNOMED-CT to ICPC-2 map,

development and testing of a

primary care-based patient safety

taxonomy and integration of

selected classifications,

terminologies, and taxonomies

considered essential to primary care

into a “Primary Care Data Model” or

basic data set. These activities will

feed directly into the development

of ICPC-3 and will involve many

WICC members.

Dr Ian Marshall

Member

Wonca International Classification

Committee

ianm@ocea.es

A Letter from Banda Aceh,

Indonesia

As I step up onto the stairs of

my airplane, I look back once more

and say thank you to Banda Aceh.

Thank you for the experience. Thank

you for sharing your stories, your

pain, and your strength with me. I

have just spent 6 weeks doing

humanitarian medical work in

tsunami-devastated Banda Aceh. I

feel very privileged and honoured to

have worked there. I am sad to

leave, but it is my time to go.

I worked in a tent field hospital.

The helicopter landing pad was right

beside the food tent, and the tent

would shake when the helicopters

landed. The days were very, very

hot, and by the time we finished

ward rounds at 9 AM, rivers of

sweat poured down our backs.

Dr Lynda Redwood-Campbell treating a

Tsunami victim with her health care team

Keeping hope alive among the endless

devastation in Banda Aceh

The devastation was more than

any television camera could capture.

It just goes on and on ... kilometers

and kilometers of devastation. On

the second day, we took a tour of

city. After an hour, I had had

enough....body bags, piles of

rubble, kids scavenging, looking for

anything recognizable. How much

suffering could they endure? When I

left Canada to go to Banda Aceh, I

asked myself why do I do this kind

of work? It involves some of the

most difficult challenges that I have

ever had to face.

As a general practitioner, I was

in charge of the outpatient and

emergency department, and covered

for those in the hospital. I wondered

whether I would have the skills to

do a good job. I soon found out

that I was doing a lot of what I

normally do as a family doctor in

Canada, but also a lot more. My

tropical training was very helpful,

but so was my trauma training.

The richest part of the

experience was the people, the

people of Banda Aceh. They were

grateful, respectful, and when they

were ready, they had stories. Oh,

what stories they had to tell. The

story of one new friend was heart-

breaking. He saw his wife and 2

year old daughter wash away with

the first tsunami wave, then found

himself 3 km from his home on a

mountain (after clutching a piece of

the kitchen cupboard) where he

lived for 3 days, eating coconuts.

Finally, he sifted through the rubble

to find the bodies of his wife, his

parents, and his siblings; he never

found his little daughter. He lost his

home, his store, his entire family.

But he keeps going. He has faith,

and that is what keeps him going.

Another friend lost her husband,

her dear father, and her home, and

now lives on a dirt floor with a

friend trying to feed her 6 year old

son. There are many stories about

how people struggled in the water

to survive and many stories of very

complicated aspiration pneumonias

as a result of it. We saw numerous

infected wounds and fractures that

had never been treated. In some

ways it was very difficult to hear

these stories that I was able to lend

WONCA

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HEALTH AND HEALTH SYSTEM NEWS / MEMBER AND ORGANIZATIONAL NEWS

MEMBER AND

ORGANIZATIONAL NEWS

MEET PROFESSOR IGOR

SVAB: WONCA EUROPE

REGION PRESIDENT

My name is Igor Svab and I am

the new Regional President for

Wonca Europe.

Even if I still work part time in

practice, my main job is to work as

a professor of family medicine in at

the medical faculty in Ljubljana, the

capital of Slovenia. Slovenia is a

small and very beautiful country on

the sunny side of the Alps,

bordering to Austria, Italy, Croatia

and Hungary. The country joined

European Union in May 2004.

Professor Igor Svab, Wonca Europe Region

President

I started my medical career after

graduating from the same medical

faculty in 1981. From 1983 to 1991, I

have been working as a rural GP in

a rural health centre. During this

time I have come in contact with the

first international organisations of

family medicine that has influenced

my career, the European General

Practice Research Workshop

(EGPRW). I have always been

interested in difficult patients, and I

have completed my Masters degree

in medicine on a topic of frequent

a therapeutic ear, and I sometimes

felt that just acknowledging their

feelings was even more helpful than

any other intervention I could offer.

Why do I do this work? First, I

feel proud that as a Canadian family

doctor I have the skills to make a

difference. My international

colleagues commented on how

many Canadian family doctors are

very well trained for this work.

I think that when I know that

someone appreciates even a little

thing that I do for them, I will work

to move the sky for them. When I

hear a story about how patients

struggled to survive, lost an entire

family, after such hardship, I feel

honoured to help them. It isn’t just

the tsunami that affected these

people; like many people in the

world, it is poverty. It is the

discrepancy between rich and poor

and the inequitable distribution of

the world’s resources. This is why I

want to continue to be involved in

raising awareness of global health

issues, and to ask others to look at

the big picture when we think about

health.

Will I do this again? Absolutely.

For all these reasons, I will keep

helping with disaster relief for as

long as I possibly can, and probably

even longer.

(Editor’s note: Dr Lynda

Redwood-Campbell is a family

physician and Associate Professor in

the Department of Family Medicine

at McMaster University in Hamilton,

Ontario. This article, which was

excerpted, and the photos were

published in the May, 2005 edition

of Canadian Family Physician)

attenders in general practice.

In 1991, I moved to the National

Institute of Public Health to

Ljubljana in order to help in running

the vocational training scheme for

general practitioners in the country.

During this time I begun working on

my PhD in medicine, which I have

completed in 1993 on the subject of

multivariate analysis of the reasons

for referral from General practice.

During my work at the institute, I

joined the European Academy of

General Practice Teachers (EURACT)

as the first representative for

Slovenia. Joining EURACT helped me

much in my task of overseeing the

development of the Department of

Family Medicine at the Universuity of

Ljubljana. Together with a group of

colleagues we were able to

establish an innovative programme

for community-based teaching. One

of the biggest successes of my

career was to participate in the

creation and the development of the

Department of Family Medicine. Over

the years, the department has

become the key factor in the

development of Family Medicine in

Slovenia and is still continuing to

grow. The undergraduate curriculum

for family medicine has become the

most popular of all the curricula at

the medical faculty. This is the

reason that I am currently over-

seeing the curriculum review

programme for the whole of the

faculty. Recently, we have

established an independent research

unit which is very successful in

researching topics, relevant for

family medicine.

The development of family

medicine as a discipline has been

successful in Slovenia. The most

prominent success was probably the

obligatory vocational training for

family medicine, which has been

officially accepted in 2000 and has

replaced the old programme that

was in place since 1962.

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MEMBER AND ORGANIZATIONAL NEWS

I joined WONCA as the

representative of researchers in

general practice on the board of

WONCA Europe. Over the last three

years I have been the Vice President

of WONCA Europe. My biggest task

was to chair the scientific committee

of the WONCA Europe conference in

Ljubljana in June 2003. I am also

one of the authors of the European

definition of generalpractice/family

medicine, which was accepted in

2002.

In the last few years, I am

increasingly involved in family

medicine development projects,

especially in the countries of Central

and Eastern Europe, where there is

a great need for family medicine

development. I have been working

on World Bank projects in relation

to the development of family

medicine in Estonia and have

advised the development of family

medicine in Turkey. I am also very

much involved in the development

of family medicine in Montenegro

and Macedonia.

In autumn 2004 I was awarded

an honorary fellowship of the Royal

College of General Practitioners in

London.

As most doctors, I have interests

outside medicine as well. I enjoy

reading a good book and hiking in

the mountains. I try to exercise

regularly. If I have time, I spend

some time in my garden. And I have

introduced slow food philosophy to

many of my friends. I believe life is

beautiful.

Professor Igor Svab

igor.svab@mf.uni-lj.si

CELEBRATING THE LIFE

OF SCOTLAND’S ALASTAIR

DONALD

A general practitioner in Leith

and Cramond, Edinburgh, Scotland

for almost forty years, Dr. Alastair

Donald was a family doctor par

excellence. During his lifetime,

Alastair contributed to the growth of

general practice/family medicine

within Wonca.

After graduation from the

University of Cambridge, Alastair

qualified as a doctor at Edinburgh

University in 1951. After National

Service in the Medical Branch of the

RAF he joined his father’s practice in

Leith which his grandfather had

established. Under Alastair’s

leadership and vision the practice

rapidly became one of the largest

and most progressive in Edinburgh.

He was proud when his daughter,

Patricia, became a fourth generation

partner in the same practice.

Alastair Donald,

Honorary Life Direct

Member of Wonca

He was associated with the

Royal College of General

Practitioners from its foundation and

he never forgot its motto Caritas.

Like most outstanding general

practitioners he related to patients

as individuals, both in the surgery

and at home. He was elected to

Fellowship of the Royal College of

General Practitioners in 1972 and in

1997 received the Foundation

Council Award. For many years he

was a Member of Council of the

College, Chairman from 1979 until

1982, and President from 1992 until

1994, acting for the first year as

Deputy to HRH the Prince of Wales.

Alastair’s particular interest was

GP education, both of aspiring and

established general practitioners.

He was a part time lecturer in the

Department of General Practice in

Edinburgh and later he was

appointed Regional Adviser in

General Practice for South East

Scotland where he had a consider-

able influence in the development

of Vocational Training. He was

elected to Fellowship of the Royal

College of Physicians of Edinburgh

in 1981, and of Glasgow in 1993. He

was appointed OBE in 1982 and CBE

in 1993.

Alastair always believed that the

core principles of general practice/

family medicine were international,

shaped and modified by local

culture. He was an early exponent of

the MRCGP (International), even

although he met considerable initial

resistance! His contribution to the

development of general/family

practice extended overseas. One of

his most influential visits was to

Kuwait resulting in the RCGP/Kuwait

Fellowship. The model of family

practice education and assessment

developed by Professor Robin

Fraser, the RCGP/Kuwait Fellow has

been replicated in many other

countries both in the Middle East

and elsewhere. Alastair also made

educational visits to Malta and

Portugal. He had discussions with

Nick Pisicano and the American

Board of Family Practice remutual

recognition of membership/

certification. He maintained that one

of the most enjoyable visits he ever

made was to Lexington, Kentucky,

where he was impressed both by

the Boardroom of the ABFP and the

opportunity for a game of golf!

He served for six years as the

RCGP representative on WONCA

Council, bringing his considerable

educational expertise and his

political skills to the work of that

organisation. His interventions were

always apposite and, although he

did not speak very often, his views

were usually persuasive. With others

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MEMBER AND ORGANIZATIONAL NEWS

he supported a close relationship

with SIMG (Societas Internationalis

Medicinae Generalis) recognising

that it was a waste of resources to

have two competing European

Family Practice organisations. He

was delighted that during Lotte

Newman’s time as President of

SIMG, it became an ‘Organisation in

Collaborative Relations’ with

WONCA.

In recognition of his international

work Alastair was awarded the

Hippocratic Medal of SIMG in 1994

and made an Honorary Life Direct

Member of WONCA in 1998.

Dr Alastair Geoffrey Donald CBE

was born on November 24, 1926

and died on June 5, 2005. Although

he had been ill for a number of

years before he died, he remained

passionate about golf and it was

entirely appropriate that his sudden

death, took place in the clubhouse

of one of the three golf courses of

which he was a member.

Dr Douglas G Garvie, OBE FRCGP

douglas@garvie52.freeserve.co.uk

Calvin Lucas Wilson, MD:

July 2005 Global Family

Doctor of the Month

Dr. Wilson is a member of the

American Academy of Family

Physicians, Society of Teachers of

Family Medicine and certified by the

American Board of Family Practice.

Dr. Wilson started his career in

the Denver Colorado area as a

private practicing family doctor and

has been a long-standing member

of the faculty at the University of

Colorado. He has been evaluated as

an excellent teacher and innovator

in family medicine education and

has published appropriately. He has

been a recipient of the prestigious

Gabe Smilkstein international

educator award of the Society of

Teachers of Family Medicine.

Calvin Lucas

Wilson MD,

July 2005 Global

Family Doctor of

the Month

While he has made multiple

significant international contri-

butions on behalf of family medicine

there are a couple of significant

contributions that deserve special

mention. He left the University of

Colorado for nearly 10 years to start

a new family medicine residency at

Hospital Vozandes in Quito, Ecuador.

This was a small residency in a

small mission hospital, yet when the

Ministry of Health saw what he was

doing they realized that he was

training the kind of doctors that

their country needed. Many of his

graduates are now teaching in that

program as well as universities and

leading other new residency

programs. His work clearly has

impacted family medicine in Ecuador

and some of his work has been

exported to other South and Central

American countries. After about 10

years he turned leadership of the

program over to Ecuadorian

physicians and it has continued to

thrive.

After several years back at CU he

left for Jordan where he spent 5

years developing new educational

programs with an emphasis on

training GP’s into family physicians,

continuing education and retraining

of other specialists into family

doctors. After completion of his time

there again he was able to leave the

program in well-trained local hands.

In addition to these large

projects he has done educational

consulting and teaching in

developing family medicine and

Iraq, Kyrgyzstan and is currently

involved in a project in West Africa.

In summary, Dr Wilson is the

kind if physician educator,

consultant, leader and innovator

that Wonca is proud to be

associated with, and a deserved

winner of the Wonca Global Family

Doctor of the Month Award for July

2005.

(Editor’s Note; The “Global

Family Doctor of the Month” Award

is an award to encourage

philanthropy among primary care

practitioners and to honour doctors

giving their time and expertise to

their global colleagues and their

patients. The award is given to

doctors who are recognised by their

colleagues as having contributed

significantly to the community in

which they work by way of their

practice, community involvement,

charity work or other humanitarian

acts.

Each Award winner is given a

letter of congratulations from the

Wonca CEO, an award certificate and

a complete office diagnostic set

from Welch Allyn worth

approximately $400.

Submission Requirements

include:

1.Title and Full Name of nominee.

2.Photo of nominee. The winner

and his/her photo would be

featured on Wonca’s website

www.GlobalFamilyDoctor.com

3.Postal address of nominee.

4.Reasons for nomination for the

Award.

5.Brief resume or CV of the

nominee

6.Any other relevant information

that would assist Wonca in the

selection process.

Please submit nominations for

this monthly Award to Dr Alfred Loh,

CEO of Wonca at the Wonca

Secretariat via email to

admin@wonca.com.sg)

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

SPECIAL INTEREST GROUP ON “ETHICS

IN GENERAL PRACTICE”

During the Wonca Europe 2000 conference in Vienna,

the Special Interest Group (SIG) “Ethics in General

Practice” was proposed by Dr. Lotte Newman at the

occasion of the special symposium “Challenges to our

Professional Attitudes”. During the first four years of

existence the group has approached interested

colleagues globally, has held conference workshops

during the Conferences in Durban, Ljubljana and

Orlando – all with very good attendance. During the

London meeting the terms of reference agreed upon

were “to attempt to illustrate the nature of ethical

issues encountered by WONCA and its members (both

Organisations and Individuals) and to explore the

principles, values and beliefs which inform decisions”.

The group has established a list of interested

colleagues worldwide and has identified colleges,

academies or other general practice groups which have

working groups on ethical issues. The teaching situation

for professional attitudes in different countries was

reviewed and a forum to collect and discuss situations

which produce ethical dilemmas to colleagues world-

wide has been established; based on these collections,

the group has started to set up a database for ethical

dilemmas in general practice. Groups and individuals

were encouraged to develop similar activities back

home in their countries; as an example, the Austrian

Society for General Practice and Family Medicine has

now established a special working group for ethical

dilemmas.

Upon initiative of Prof. Igor Svab and EURACT, the

12th international course on “Learning and Teaching in

General Practice and Family Medicine” (September 2003

in Bled) dealt with the topic “Ethical Problems in

General Practice”; a complete teaching program

including recommendations for appropriate didactic

methods, a list of resources required and strategies for

implementation at the University level was developed by

the participants.

During the open forum held in Ljubljana the topic of

medical errors and errors in general practice in

particular was discussed. It was agreed that this is an

important issue for the field and for GPs worldwide

which should be included in the agenda for the group.

In particular, the attitude of the medical community and

of GP colleagues towards medical errors and the way

how to prevent or how to handle such situations are in

fact based on ethical considerations. Since then, the

topic of medical errors has been integrated into the new

medical curriculum at the University of Vienna: during

the 4th year medical students now have an introductory

lecture on the topic of medical errors followed by small

group work; here, two real situations are presented by

an interdisciplinary group of teachers – one from the

hospital sector and one from primary health care.

During the 2004 WONCA World Council Meeting in

Orlando, Dr Hava Tabenkin, the representative from

Israel, reported about a project to collect ethical

dilemmas in clinical practice to be published in a book.

Interest was expressed in this project. It was agreed that

the respective colleagues involved should collaborate

closely with the SIG and their existing collection of

ethical dilemmas in general practice.

The last workshop so far on ethical dilemmas

organized by the SIG was held during the Orlando

conference in October 2004. Seventeen colleagues from

around the globe presented recent ethical dilemmas

which occurred to them; two where selected for detailed

discussion. At the end the group agreed to stay in

contact and to exchange information and situations

causing an ethical dilemma to them. The open forum,

also held during the Orlando Meeting, was attended by

12 colleagues from 10 different countries. After the

presentation of the group, its history and aims several

issues where brought up and discussed: among them

were recent developments in the Netherlands regarding

the assessment of medical students and their attitudes

and a similar initiative from the USA. At the end of the

open forum the participants agreed that medical ethics

should be taught and integrated into a variety of

medical and clinical courses instead of being taught in

blocks by philosophers and ethicists. Further, ethical

issues should be included in every type of medical

student test because examinations drive the learning

needs of the students.

In early 2005, Dr. Lotte Newman announced her

retirement as Co-Convenor of this SIG. Dr. Lotte Newman

not only put forward the idea of the SIG in 2000 but

she promoted the ideas behind it at every occasion and

contributed invaluably to its organisation and spirit. It is

with great respect and appreciation that I have to thank

Dr Newman for all her efforts and contributions to the

development of the group. In speaking for all colleagues

around the world I think we have to accept her decision

and will work hard to continue what she started.

The next workshop to discuss

ethical dilemmas will be held during

the WONCA Europe Conference in

Kos, Greece; further, an open forum

for a get together of interested

colleagues will be organized for

presentation of the goals and

achievements of the Special Interest

Group.

Manfred Maier

manfred.maier@meduniwien.ac.at

Wonca Special Interest

Group in Travel Medicine

A most successful launch of the

SIG took place at the last WONCA

Congress held in Orlando. There

were twenty attendees, all of whom

expressed interest in participating in

the SIG. The following talks were

presented during the Orlando SIG

meeting:

*Welcome and Introduction -

B Sparks (South Africa)

*Travel Medicine: The Role of the

Family Doctor - G Brink (South

Africa)

*The Child as Traveler - D Hyams

(South Africa)

*Refugee Medicine - J Sulaiman

(USA)

*Preventive Accidents - H Yaman

(Turkey)

*Emerging Diseases - T Kemple

(United Kingdom)

*Malaria - G Ogunbanjo

(South Africa)

I attended the International

Society of Travel Medicine (ISTM)

Congress held in Lisbon from 1 - 5

May this year. The meeting stressed

the importance of providing pre-

travel advice, particularly in the field

of malaria. As a result, the first

educational material that the SIG

will prepare will be on advising

those traveling to malaria areas and

the importance of follow-up on their

return. The International Society of

Travel Medicine will be approached

to request special membership for

Wonca Direct Members of the SIG.

The South African Society of

Travel Medicine will be holding

various courses throughout Africa

during the next two years and

specific invitations will be sent to

the Wonca regions and the SIG

members inviting their attendance.

The South African Society of Travel

Medicine is also currently producing

a guide on the practice of travel

medicine and this will be made

available to all those interested.

I will be attending the Northern

European Congress of Travel

Medicine in Edinburgh in June 2006

and members will be encouraged to

attend this Congress. The SIG will

be planning a workshop during the

2007 Wonca World Conference in

Singapore.

Contact is to be made with the

Wonca regions inviting interested

persons to participate in the SIG.

Those who are interested in

participating in Wonca’s Travel

Medicine SIG may contact me

directly.

Garth Brink

gkb@brink.za.net

WONCA SIG IN

PSYCHIATRY AND

MENTAL HEALTH

At the upcoming Wonca Europe

Regional Conference in Kos, Greece,

the Wonca SIG In Psychiatry and

Neurology will be leading a

workshop on the Management of

Headache including cultural

considerations upon presentation

and on Mental State Assessment.

Facilitators will include Dr Hakan

Yaman, Dr Henk Parmentier, Dr Eleni

Palazidou, Dr Mike Grenville and

Dr Gabby Ivbijaro. Details of the

exact time, place and date should

be available on the WONCA Europe

website.

The SIG plans to produce a

quarterly e-mail newsletter which

will allow us to share views and

information about what is

happening in our countries, colleges

and localities. It will also be an

opportunity to share information

about ongoing projects and

publications from members. Dr Henk

Parmentier has kindly agreed to

co-ordinate this for us. Any other

members of our group with the

necessary skills and an interest in

this new development should let me

know. Henk’s e-mail address is:

henk.parmentier@gmail.com

The Primary Care Mental Health

Journal is a new, peer reviewed

journal with similar aims and

objectives to the SIG in Psychiatry &

Neurology and is indexed in

EMBASE/Excerpta Medica,

SwetsWise, Zetoc, EBSCOhost

Electronic Journals Service and

Ulrich’s Periodicals Directory. I would

like to recommend this publication

to you all and I hope that we can

support it by individual

subscriptions, by recommending it

to our institutional libraries so that

they can subscribe and by

submitting original work. The

journal has a multidisciplinary focus

and brings research and evidence

into the management of mental

health in everyday clinical practice.

Individual members of our group are

already involved in this journal and

I hope others will get involved. The

web site is:

http://www.radcliffe-oxford.com/

journals/

J14_Primary_Care_Mental_Health/

default.htm

Following KOS, our next

international business meeting will

be in the United Arab Emirates. We

have agreed to be co-sponsors of

an international Primary Care

Conference in the Emirates in

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

collaboration with the General Authority for Health

Services for the Emirate of Abu Dhabi. A member of our

SIG, Dr Abyad, has kindly agreed to be our host for the

three day conference. Our business meeting will take

place on Sunday 22nd January 2006. Those of you who

wish to attend or present at this conference should

contact Dr Abyad directly at aabyad@ghas.ae copying

Henk Parmentier (henk.parmentier@gmail.com) into the

e-mail so that he can plan to include this information

into the news letter. I attach further information about

this conference to this e-mail.

The SIG’s Culturally Sensitive Depression Guideline

has been found to be very useful worldwide. The

guideline was distributed in Pakistan and GP’s in Karachi

are freely using it. It was printed and reviewed in

Australian Doctor and recommended to GP’s by

Professor Ian Hickie. Feedback from Chile and other

South American countries is that it is very useful and we

have received similar feedback from Israel and Nigeria. It

has been praised as a very useful tool by East London

GP’s and medical students. The success of this first

project demonstrates the capability of the SIG to deliver

practical tools of high academic quality to general

practitioners worldwide.

The Primary Care Programme of the National Institute

of Mental Health (NIMHE) in England has referenced the

guideline and commended it to GP’s in England. The SIG

has also been commissioned to provide three articles

looking at mental health issues from the cultural and

global perspective by the Primary Care Mental Health

Journal (Radcliffe Oxford). This guideline is available for

free on the Wonca web at:

http://www.globalfamilydoctor.com/aboutWonca/sig/

FinalguidelinedepressionSIG_Version1.0.pdf

Gabby Ivbijaro

Convenor Wonca SIG in Psychiatry & Neurology

GABLUC@aol.com

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

MEET IN SRI LANKA

Wonca MESAR 2005 Conference

***********

12 – 16 October 2005

Colombo, Sri Lanka

Theme:

FAMILY PHYSICIAN IN HEALTH CARE –

THE WAY FORWARD

Venue:

Hotel Galadari

***********

For more information, please contact

Conference Secretariat

Prof W A Ferdinand

Secretary General

College of General Practitioners of Sri Lanka

Wijerama House

6 Wijerama Mawatha

Colombo 7

Sri Lanka

Tel: 0094 011 2698894 / 2688775

Fax: 0094 011 2695188

Email cgpsl@sltnet.lk / genprac@sltnet.lk

Website www.wonca-mesar.com

WONCA

News

CONFERENCES 2005 – 2010

Information correct as at June 2005.

May be subject to change.

WONCA CONFERENCES 2005 – 2010 AT A GLANCE

See Wonca Website www.GlobalFamilyDoctor.com for upates

2005

Region

Venue

Theme

3 – 7 Sept

European

Kos Island

GREECE

From Hippocrates to the Human

Regional Conference

Genome: The Past, Present and Future

of General Practice/Family Medicine

12 – 16 Oct

Middle East South

Colombo

Family Physician in Health Care –

Asia Regional

SRI LANKA

The Way Forward

Conference

2006

27 – 31 Aug

European

Florence

ITALY

Towards Medical Renaissance

Regional Conference

8 – 15 Sept

7th Rural

Seattle

Transforming Rural Practice

Health

Washington

Through Education

Conference

USA

11 – 14 Oct

Iberoamericana -

Buenos Aires

Pursuing Equity and Efficiency in

CIMF Regional

ARGENTINA

Healthcare: the Role of the Family Doctor

Conference

4 – 9 Nov

Asia Pacific

Bangkok

THAILAND

Happy and Healthy Family

Regional Conference

11 – 15 Oct

Americas Regional

Vancouver,

Preparing for Tomorrow

Conference

CANADA

2007

24 – 28 July

18th WONCA

SINGAPORE

Human Genomics and its Impact on

World Conference

Family Physicians

17 – 21 Oct

European

Paris

Re-Thinking Primary Care in the European

Regional

FRANCE

Context: A New Challenge for General

Conference

Practice

2008

1 – 5 Oct

Asia Pacific

Melbourne

Theme to be confirmed

Regional

AUSTRALIA

Conference

2009

Date to

Asia Pacific

Hong Kong

Building Bridges

be confirmed

Regional

Conference

2010

19 – 23 May

WONCA

Cancun

Millennium Development Goals:

World Conference

MEXICO

The Contribution of Family Medicine

WONCA

News

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

WONCA WORLD AND REGIONAL

CONFERENCE CALENDAR

Wonca Europe Regional Conference, Kos Island 2005

Host:Greek Association of General Practitioners

Theme:From Hippocrates to the Human Genome:

The Past, Present and Future of General

Practice/Family Medicine

Date:3-7 September, 2005

Venue:Island of Kos, Greece

Contact:The Greek Association of GPs (Elegeia)

Mr. Raoul Merkouris

21, N. Kountourioti Str. (5th floor)

54625 – Thessaloniki

Greece

Tel:30 2310 550048, +30 2310 539995

Fax:30 2310 539995

Email:elegeia@woncaeurope2005.org

Web:http://www.woncaeurope2005.org

Wonca Europe Regional Conference, Florence 2006

Host:CSERMEG

Theme:Towards Medical Renaissance

Date:27-30 August, 2006

Venue:Florence, Italy

Contact:OICsrl

Viale Matteotti 7

50121 Florence, Italy

Tel:+39 0555 0351

Fax:+39 0555 001912

Email:wonca2006@oic.it

Web:http://www.woncaeurope2006.org

Wonca 7th Rural Health Conference, Seattle-Anchorage

2006

Host:Wonca Rural Health Working Party

Theme:Transforming Rural Practice Through Education

Date:8-15 September, 2006

Venue:8 -10 September – Wonca Rural Conference

University of Washington campus

11-13 September, 34th Annual Advances in

Family Practice

University of Washington campus

13-15 September, Post Conference

Talkeetna Alaskan Lodge

Anchorage, Alaska

Contact:Tom E Norris, MD

Chair, Host Organizing Committee

Department of Family Medicine

University of Washington School of Medicine

Box 356390

Seattle, WA 98195-6390

Fax:206-543-3101

Email:tnorris@u.washington.edu

Web:http://www.ruralwonca2006.org/

Wonca Iberoamericana-CIMF Region, Buenos Aires, 2006

Host:Federacion Argentina De Medicina Familiar y

General

Theme:Pursing Equity and Efficiency in Healthcare:

The Role of the Family Doctor

Date:11-15 October, 2006

Venue:Sheraton Hotel, Buenos Aires

Contact:Federacion Argentina De Medicina Familiar y

General

Tel:54 11 4958 5071

Email:aamf@lvd.com.ar

Web:www.aamf.org.ar

15th Wonca Asia Pacific Regional Conference, Bangkok

2006

Host:General Practitioners/Family Physicians Assoc,

Thailand

College of Family Physicians, Singapore

Theme:Happy and Healthy Family

Date:5-9 November, 2006

Venue:Miracle Grand Convention Hotel, Bangkok

Contact:Dr Kachit Choopanya, Chairman, Host

Organizing Committee

10th Floor, Royal Golden Jubilee Building

2 Soi Soonvijai

New Petchaburi Road

Bangkok, Thailand 10320

Tel:66(0) 2716 6651

Fax:66(0) 2716 6651

Web:www.thaifammed.org

Wonca Americas Region/Family Medicine Forum 2005,

WONCA

News

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

Vancouver, 2006

Host:College of Family Physicians of Canada (CFPC)

Theme:Preparing for Tomorrow

Date:11-15 December, 2006

Venue:Vancouver Exhibition and Convention Centre

Vancouver, British Columbia, Canada

Contact:Joanne Langevin; Meetings Manager

Cheryl Selig, Registration Coordinator

2630 Avenue Skymark

Mississauga, Ontario, Canada L4W 5A4

Tel:905 629 0900 /1-800-387-6197

Fax:905 629 0893

Email:info@cfpc.ca

Web:www.cfpc.ca

18th Wonca World Conference, Singapore 2007

Host:College of Family Physicians, Singapore

Theme:Human Genomics and its Impact on Family

Physicians

Date:24-27 July, 2007

Venue:Singapore International Convention and

Exhibition Centre

Contact:Dr Tan See Leng, Chairman,

Host Organizing Committee

College of Family Physicians, Singapore

College of Medicine Building

16 College Road #01-02

Singapore 169854

Tel:65 6223 0606

Fax:65 6222 0204

Email:contact@cfps.org.sg

Web:www.wonca2007.com

Wonca Europe Regional Conference, Paris, 2007

Host:French National College of Teachers in General

Practice

Theme:Rethinking Primary Care in the European

Context

Date:17-21 October, 2007

Venue:Palais des Congres

Paris, France

Contact:French National College of Teachers in General

Practice

6 rue des 2 communes

94300 Vincennes

Tel:33-153 669 180

Emailcnge@cnge.fr

Web:www.cnge.fr

19th Wonca World Conference, Cancun 2010

Host:Mexican College of Family Medicine

Theme:Millennium Develop Goals:

The Contribution of Family Medicine

Date:26-30 May, 2010

Venue:Cancun Conventions and Exhibition Center,

Cancun Mexico

Contact:Mexican College of Family Medicine

Anahuac #60

Colonia Roma Sur

06760 Mexico, D.F.

Tel:52-55 5574

Fax:52-55 5387

Email:javierdominguez14@hotmail.com

MEMBER ORGANIZATION AND RELATED MEETINGS

Association of Health Care Professionals (AHCP)

16th Conference, London 2005

Theme:Advances in Family Medicine/General Practice

Date:20-23 August, 2005

Venue:London, England, UK.

Contact:Secretariat,

AHCP

P. O Box 18265

London EC2A 3TT

England, UK

Tel:44 20 7749 7243

Fax:44 20 7739 8683

Email:info@ahcp.org.uk

American Academy of Family Physicians (AAFP)

Annual Scientific Assembly, San Francisco 2005

Date:28 Sept - 2 October, 2005

Venue:San Francisco, California

Contact:AAFP

11400 Tomahawk Creek Parkway

Leawood, Kansas 66211-2672, USA

Tel:1 913 906 6000

Fax:1 913 906 6075

Email:international@aafp.org

Web:http://www.aafp.org

The Royal Australian College of General Practitioners

48th Annual Scientific Conference, Darwin, Australia

2005

Date:29 September - 2 October 2005

Theme:Unity and Care

Venue:Holiday Inn Esplanade Darwin

Contact:Tania Ormiston

Phone:(613) 8699 0427

Email: tania.ormiston@racgp.org.au

Web: www.racgp.org.au

North American Primary Care Research Group (NAPCRG),

Quebec City Canada 2005

Date:15-18 October 2005

Theme:Primary Palliative Care Research: Current State

and Future Agenda

Contact:Dr Geoff Mitchell

University of Queensland,

Brisbane, Australia

Phone:61 (0)7 3365 5504

Fax:61 (0)7 3365 5130

Mobile:0412 775 117

Email:g.mitchell@uq.edu.au

Web:www.NAPCRG.org

International Society for Quality in Health Care

22nd International Conference, Vancouver 2005

Date:25-28 October, 2005

Venue:Vancouver, British Columbia, Canada

Contact:ISQua Secretariat

212 Clarendon Street

East Melbourne 3002 AUSTRALIA

Phone:+61 3 9417 6971 ..

Fax:+61 3 9417 6851

Email: isqua@isqua.org

Web: http://www.isqua.org

WONCA

News

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

Network: Toward Unity for Health International

Conference

Ho Chi Minh City, Vietnam 2005

Date:12 - 17 November, 2005

Theme:On Making Primary Health Care Work:

Challenges for the

Education and Practice of the Health Workforce

Venue:Ho Chi Minh City, Vietnam

Contact:Ms. Yoka J.H. Cerfontaine

P.O. Box 616

6200 MD Maastricht

The Netherlands

Tel:31-43-3885638/3881524

Fax:31-43-3885639

Email:secretariat@network.unimaas.nl

Web:http://www.the-networktufh.org/conference/

College of Family Physicians of Canada (CFPC)

Family Medicine Forum, Vancouver 2005

Date:8-11 December, 2005

Venue:Vancouver, British Columbia, Canada

Contact:Joanne Langevin; Meetings Manager

Cheryl Selig, Registration Coordinator

Address:2630 Skymark Avenue, Mississauga, Ontario,

Canada L4W 5A4

Tel: (905) 629-0900 / 1-800-387-6197

Fax: (905) 629-0893

Email: info@cfpc.ca

Web: www.cfpc.ca

13th World Conference on Smoking or Health,

Washington, DC 2006

Theme:Building Capacity for a Tobacco-Free World

Date:12-15 July, 2006

Venue:Renaissance DC Hotel

Washington, D.C., USA

Contact:John Seffrin, PhD

Chief Executive Officer

American Cancer Society

Email:secretariat2006@cancer.org

Web:http://www.2006conferences.org/

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