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Stabroek News

GPs are alive and well
published: Monday | November 19, 2007

Garth Rattray, Contributor

In his piece, 'No GP's around anymore', published Saturday, November 10, erudite and respected veteran Gleaner columnist, Hartley Neita, reminisced as he lamented the perceived virtual disappearance of the venerated general (medical) practitioner (GP).

I, too, remember a time when the GP did almost everything for his/her patients. However, with scientific advancement, specialisation, changing social environments and the emergence of ethical and legal issues, the GP has evolved and taken on names (family practitioner, family doctor or primary care physician) more befitting their new role in the medical panorama.

I want to assure everyone that GPs are alive and well. In fact, we have some 2,000 registered GPs still filling multiple roles for their patients. These front-line warriors against disease must deal with social problems and medical conditions afflicting patients. They must treat everything from head to toe (including the mind). For many years now, they have sought to improve their skills in order to keep pace with international standards of good medical care. Organisations like the Association of General Practitioners of Jamaica (AGP) and the Caribbean College of Family Physicians (CCFP) are dedicated to equipping family doctors to provide optimum service to those entrusting their health needs to them.

Continuing medical education

GPs are so alive and well that they took it upon themselves to participate in continuing medical educational (CME) activities many years before the Government stipulated the need for a minimum number of CME hours for annual recertification. The CCFP (the only organisation that exists solely for CME purposes) has attained full-member status in the prestigious World Organisation of National Colleges, Academies (WONCA) - also called the World Organisation of Family Doctors.

GPs of long ago not only saw their patients through childhood, adole-scence, adulthood, pregnancies and into their golden years; they did home visits, hospital visits, deliveries, emergency calls (at all hours of day or night) and played the role of everything from family friend to counsellor. However, as the 1964 Bob Dylan song says, 'the times they are a-changin'; we now have specialists, sub-specialists and even sub-sub-specialists working in every conceivable field of medicine - almost 50 separate fields in all. For the sake of good patient care, the GP relinquished several hats and stuck to the role of general manager.

A good history

Because medical science has been making advances in leaps and bounds, it is impossible for any one individual to deliver adequate, modern medical care in several areas. If, for example, a doctor is called to see a patient that is very ill at home; unless that patient is chronically and severely infirm or known to be moribund, it would be unethical, and perhaps actionable, for him/her to cause the patient to wait on his/her arrival when there are so many well-equipped and manned emergency rooms across the island.

Medical science has revealed several new diseases and discovered new aspects to many old ones. Several require the use of very expensive imaging apparatuses and techniques. The mainstay of accurate diagnosis remains a good history. The physical examination ('looking under the lids of your eyes, by tapping your chest and back and listening to the echoes through their stethoscopes, pressing various spots on your belly, and peering down your throat' - as the esteemed writer puts it) serves to confirm or deny suspicions, and are sometimes non-contributory - hence the need for 'computers and other electronic gadgets'.

The GPs of old were one-man (or one-woman) bands. The GPs of today now operate as the conductors of highly-specialised, well-trained, life-saving orchestras.

Dr. Garth A. Rattray is a medical doctor with a family practice.

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