The Future of CCFP-2010 and beyond
Q "Is the concept of a Family Medicine grouping of Caribbean doctors like the Caribbean College of Family Physicians (CCFP) still relevant in the 21st Century or should we dismantle and disband?"
I am starting with a quote from the Editorial of WONCA NewsDecember 2008 -- Professor Chris van Weel, WONCA President:
“The memory of the ALMA ATA Declaration in 1978, that primary health care be the designated approach to promote health is still fresh; and so is the disappointment of how today this grand design, despite all good intentions, turned into rhetoric. Vertical, single disease or issue programs with a specialist focus, remain the order of the day…….. Yet the world of 2008is essentially different from that of 1978. Substantially more countries are actively contributing to primary care development – through their healthcare policy, their universities, and their medical-professional organizations…… More importantly, and probably the most significant progressof family medicine and primary care of the past decades, is international unity in concepts and core valuesthat underlie the discipline; care directed at the determinants of healththat matter-‘Community oriented’- aiming to promote and preservehealth as much as to restore it when needed- ‘patient or person –centredness’- and built on a personal professional relation between patient and doctor over time- ‘continuity of care’."
All that CCFP has stood for from the beginning seems to remain therefore as relevant as ever. The College’s emphasis on commitment to lifelong continuing education, training and professional development; the personalization of the care that is expected from our doctors for our patients; the emphasis on being contextually and culturally relevant for our patients, dealing with them in the environment of family and community; building teams that encompass other disciplines related to medicine with the patient being the ‘centre’ ofthe care approachesthat are designed; empowerment of the patient to be more involved in his/her decisionmaking for care – all of this was enunciated from the beginningand continue to be the essence of what the College stands for.
The College has tried to bridge the gap between academiaat the University levelwith delivery of quality careon the ground at GP-Office and health centre-based level and encourages all of our members to become part of our fledging Research Arm- the Caribbean Primary care Research Group (CAPCRG)recently introduced by Drs. Rohan Maharaj (Trinidad) and Peter Adams (Barbados) . Additionally, in building partnerships with regional health institutions such as CHRC (The Caribbean Health Research Council), places are reserved for members of CCFP in training sessions in Research Principles carried out by the Council in all the Caribbean territories where it functions.
CCFP has bridged the gap between family medicine and public health, forging unity in health, by forming firm relationships with PAHO in every territory and with its agent CAREC - the Caribbean Regional Epidemiology Centre The pilot programme- the Physician-based Sentinel Surveillance Survey carried out in 1999 underscored the value of the good clinician - family practitioner based on the ground, in the community.
Use of the new technologies in communication are being encouraged on our Website and in our monthly CME teleconferences, organized out of Barbados by Dr. Colin Alert. Work is to begin on our College Curriculum, under Dr. Pauline Williams-Green (Jamaica), which will inform our final decisions relevant to the granting of the Membership in the College (MCCFP) and standardize what is required from our doctors as our members submit themselves voluntarily to recertification every three (3) years.
At this moment the College is gearing for its 4th triennial Pan-Caribbean Family Medicine Conference to be held in Barbados, the 1st held in Trinidad followed by a 2nd in Jamaica and a 3rdin Bahamas. Prior to that there have been smaller Conferences in Jamaica, Grenada and in Antigua.
In time, it is the dream of the Collegeto build a Regional Network of GP’s that will be able to share experiences,problemsand triumphs in a more meaningful and timely way, again utilizing information technology and informatics.
CCFP continues to advocate forexposure of undergraduate students to primary care and for primary care specialty training of young professionals in medicine and the allied health professions.Family Medicine has had to compete with Public Health and other disciplines for scarce funding at University and ministerial levelbut the College hopes that soon an established Chair in Family Medicine will bea feature of all the University Schools in the region.
Out of this pool of graduateswill come the doctorswho hopefully will see the continued need forsuch a grouping as the CCFP-a Group that the memberscanfashion into a force uniquely theirs,uniquely Caribbean .
Because this is something that belongs to us, the GPs and primary care practitioners, and because the political agendas may not necessarilyaccept that to deliver quality care throughout theregion ,it would be to their advantage to assist a group like CCFP to not only exist, but to flourish, it is important thatwe acknowledgethat the case for our continuance must be made by us. The strategic planning of the Collegefor 2010 and beyond must also take cognizance of the barriers that lie in our way, notably the barriers we face from the apathy and disinterest of the very same colleagues that CCFPcan assist.
We have been warned that "numbers talk" and it has always been the undoing of doctors that we are the last to realize even when our very life and livelihood is being threatened. In this regard, however CCFP neednot stand alone, being a member of the World body- WONCA, a body partnering with WHO and world universities and governmentsto make healthcare relevant to people’s and population needs.
The WHO in revisiting the Alma Ata Declaration has released a new Report in 2008 – entitled “Primary Care now More than ever”- placing the issue of primary care squarely on the medico political agenda.WONCAhas embarked on an international mission- the concept of the “Medical Home”- ‘every family a family doctor, a family physician in every community on the globe’ In our Caribbean arena two important Declarations have been signed in recent times by the governments and Prime Ministers in the region- the Nassau Declarationof 2001 – ‘The Health of the Region is the Wealth of the Region’ and the Port of Spain Declaration of 2007- uniting to stop the epidemic of chronic non-communicable diseases --- allunderscoring the key role that will need to be played by our primarycare teams.
Our members continue to have their personal and territorial problems, peculiar to each individual and to each jurisdiction, but it is evident from the responses receivedto the question“ Should CCFP dismantle or disband? Is CCFP still relevant?”, from almost every Caribbean territory, that the concensus opinion isthat the College should still exist, despite our very real problemsbecause it is bigger than the individual interests of our professionals, it is about the delivery of quality medical care, health and wellness to our Caribbean communities and its people and it is an institution that has been built on a foundation of sacrifice, good intentionsand core values that are timeless.
Somehow a way has to be found tomake us viable and sustainable and innovativeenough to attract and retain our very best.
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