A ‘shared vocabulary’ needed in uncertain times: WONCA President

WONCA 2023’s first keynote address came from the organisation’s President and Oslo-based family doctor of 35 years, Dr Anna Stavdal, who reflected on the many challenges facing family medicine across the globe and how these can be overcome with collective reflection and action.
 
Speaking to a packed Darling Harbour Theatre at Sydney’s International Convention Centre, Dr Stavdal offered delegates insights into how the future of family medicine can be shaped by unity and cohesion at a time where many feel ‘paralysed by polarisation’.
 
According to Dr Stavdal, the unique shared knowledge and experience of family doctors is a binding force that can be utilised to develop a considered path forward that results in high-value healthcare for patients and a fulfilling vocation for clinicians.
 
‘As we warn our teenagers, hoping they won’t learn it the hard way, you will be far better off if you reflect before you act,’ the WONCA President told delegates during her keynote address. 
 
Geopolitical stress, environmental disasters, healthcare workforce shortages, commercialisation of medical care and the digitisation and dehumanising of person-centred care were all cited as the key problematic forces affecting global health and by extension family medicine.
 
Dr Stavdal argues that a broadening of the core values in family medicine and a values-based action plan is needed in response to these challenges.   
 
She also believes stability is required more than ever and that this can be enabled through the care provided by family doctors.  
 
‘We provide competent, personal, continuous, comprehensive care close to home and as required, which increases health and thereby increases stability,’ she said.
 
Citing research published in the British Journal of General Practice in 2022, Dr Stavdal highlighted the importance of the doctor–patient relationship and continuity of care.
 
The Norway-based study showed that longer doctor–patient relationships are associated with reduced hospitalisations, lower mortality rates and less use of out-of-hours medical services – all of which meant reduced healthcare costs.
 
‘Doctor–patient relationships that were established by 15 years or more, the benefits were amplified,’ Dr Stavdal said.
 
‘The fact that continuity of care is such a potent force, obligates us to protect the continuity of our own care, giving itself a professional ethical duty of take good care of our own emotional and physical health.’
 
Reflecting on the potential harms of the digitisation of healthcare, Dr Stavdal warned that artificial intelligence may disproportionately affect vulnerable groups.
 
‘Until now, accessibility was deemed as a prerequisite for healthcare to be equitable,’ she said.
 
‘How are we to respond if digitalisation turns out to exploit accessibility to feed market forces?
 
‘Crucially, how can we avoid structuring a system that offers cheap digital health services to the poor while reserving personal human care for the risk?’
 
While conceding that she does not yet have the answer, Dr Stavdal believes the solution lies in distinguishing the benefits from the threats of the digitisation of healthcare in consultation with experts in artificial intelligence.
 
And despite the threats facing global health and the pressures experience by family medicine, Dr Stavdal left the audience with a sense of optimism.
 
‘Even in such uncertain, polarised times, or maybe because of them, what might emerge?’ she queried.
 
‘With hearts and minds connected we can develop a common language, one that embraces and transcends science and research.
 
‘We need a shared vocabulary of our humanity enabling us to reach out to our colleagues throughout the world, enriched rather than hindered by our differences.’
 
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