Career,Leadership
• 9 minute read
Talking to CEO: Dr. Donald Li, SBS, JP
In the era of information explosion, doctors need to be updated on new knowledge and keep learning to gain the trust of patients
By China Business Knowledge @ CUHK
In this episode of Talking to CEO, hosted by Prof. Andrew Chan Chi-fai, Director of CUHK Business School’s Executive MBA Program, Dr. Donald Li shares his passion in family medicine and how continuous learning helps doctors to treat their patients better.
Dr. Li is a specialist in family medicine in private practice, and the sole proprietor of Family Medical Practice in Hong Kong. He is the President of the Hong Kong Academy of Medicine, President Elect of the World Organization of Family Doctors (WONCA) and Censor of the Hong Kong College of Family Physicians.
Back to Hong Kong
Prof. Chan: Your undergraduate degree was in the U.S. and had many options upon graduation. Why did you decide to return to Hong Kong in 1975?
Dr. Li: I have always hoped to practice medicine in Hong Kong and serve Hong Kong people. I also wanted to do that with my father, who is also a doctor. The medical culture, systems and patient expectations differ from place to place, and I thought it best to receive my training and accumulate experience in Hong Kong if I wanted to practice here in the long run.
Prof. Chan: After graduation, you started working at the Queen Mary Hospital. How long were you there? How was the experience like?
Dr. Li: I worked at the Accident and Emergency Department for about a year, which was a very good experience. I saw all kinds of ailments and patients’ anxieties and emotions. It is a valuable experience for anyone who wants to be a family doctor or general practitioner in future.
I had considered training to be a surgeon as I was an intern in surgery and paediatrics. My professor knew I could be a surgeon. However, he still suggested I should pursue in family medicine because of my personality. As a family doctor, you need to provide patients with extra care besides just medical treatment. And he thinks that I’m someone who is willing to take these extra steps for my patients.
Prof. Chan: What is the difference between a doctor in a neighbourhood clinic and a family doctor?
Dr. Li: In the past, there was only one doctor in each housing estate, and doctors had to draw lots to get the job. The doctors were so busy that they would rather see more patients than giving them extra time during consultation, so patients requiring any more than simple treatment would be referred to the hospital accident and emergency departments, which eventually became overloaded. To deal with the workload, the Hong Kong Hospital Authority began to train family doctors to treat not only minor illnesses such as coughs and colds, but also to manage chronic diseases, and even handle common mental illnesses. Patients started to appreciate these doctors who were offering more comprehensive care.
As pharmacies started providing more over the counter medication, patients with minor ailments would not need to visit the doctor as often. They would visit the doctors to seek advice, such as to find out whether or not they actually have a certain illness and whether that illness requires treatment by the family doctor or need to be referred to other specialists. Doctors also began to provide anticipatory and preventive care such as taking patients’ blood pressure and checking if they had smoking and drinking habits. The more established the doctor-patient relationship, the more willing the patients will consult their family doctors.
The Disadvantage of Standard Health Check Packages
Prof. Chan: Do patients come for regular health checks? How is that different from taking a standard health check package in the market?
Dr. Li: Once a trusting doctor-patient relationship is established, patients will come to see the family doctor regularly. However, many standard health check packages available in the market are not suitable for all as the plans are not tailored-made for the individual patient’s needs.
Prof. Chan: We often see on television how people who neither smoke nor drink would discover they have some medical issues following regular health checks. Isn’t it better to go for regular body examination and discover such ailments earlier?
Dr. Li: Ailments discovered in those health checks could be hereditary or due to other factors he or she is exposed to. During consultation with the family doctor, a patient will reveal his or her family’s medical history, as well as personal habits and environmental factors he or she is exposed to. The doctor can then assess whether the patient has any particular risk factors for certain diseases and then suggest appropriate tests. It would be a waste of resources for someone to blindly take all the tests without input from the family doctor.
Also, those standard health check packages tend to give people a false sense of security. For example, a patient who underwent a HK$20,000 worth of ‘Premium Health Check’ might feel he or she is in good health. However, after two months, the patient coughs up blood. He or she might not seek consultation from a doctor after paying for such an expensive health check because they have a false sense of security from the ‘Premium Health Check’. But a family doctor with an established long-term relationship with the patient will be able to help in advising whether further investigation is needed. That’s the value offered by family doctors – to provide continuous comprehensive care.
“At the end of the day, family medicine is about caring and treating people, not just relieving symptoms.” – Dr. Donald Li
Never Stop Learning
Prof. Chan: We can easily understand the work of specialties such as those in the field of Ear Nose Throat (ENTs) or oncology. But people would often still wonder what the specialty of family medicine is about.
Dr. Li: Specialist doctors in Hong Kong need to undergo training and assessment by examination to be certified. Just like all other specialists, six years of structured training is required. Family doctors require breadth and not depth of knowledge. During the training period, they need to rotate through different specialties and learn about many things such as surgery, internal medicine, obstetrics and gynaecology, paediatrics, ENTs, ophthalmology, etc. In addition, family doctors need to be competent in communication and consultation skills, as well as possess the proper empathy and appropriate attitude to gain the trust of patients.
Prof. Chan: To promote family medicine, you joined the Hong Kong College of Family Physicians and, after that, the Hong Kong Academy of Medicine. Why?
Dr. Li: The Hong Kong College of Family Physicians used to be the Hong Kong College of General Practitioners. I decided to join because there is only so much we could learn during undergraduate medical school. The field of medicine is evolving and changing constantly. It is crucial to keep learning and improving oneself. Hence, more than 30 years ago, I got together with a group of colleagues practising family medicine and we set up an academic college to provide colleagues with continuous learning opportunities in family medicine. The College of Family Physicians was the first organisation amongst different specialties to provide such a programme.
We would regularly invite specialists in different fields to share updates in technology and knowledge, and conduct new courses for practitioners to raise the standard of family medicine. Over the years this has given me a lot of satisfaction.
To be elected President of the Hong Kong Academy of Medicine has been an honour. The previous Presidents were prominent specialists of other disciplines but I believe that a President being a family doctor actually has an advantage of being knowledgeable about all specialties.
When Doctors Are Being Challenged
Prof. Chan: Doctors have always been respected by patients. But in the era of information explosion, people can read all kinds of medical information online; some even regard themselves as medical experts and they begin to challenge the opinions of doctors. What do you think of that?
Dr. Li: This is precisely why we must keep learning and improving. Only through attending seminars and continuous learning about new technology and medical advancement can we continue to gain the trust of patients. We need to be updated with the relevant new data and evidence, including side effects of new medicines, etc.
At the end of the day, family medicine is about caring and treating people, not just relieving symptoms. The internet has a lot of information about diseases; it allows people to find out about causes of diseases and possible treatments. But in real life no two patients are the same. Doctors cannot and do not make the same diagnosis for all patients with the same complaints. They do not use the same method or prescriptions for all. We must understand the patient’s cultural background and match their expectations, then apply the most appropriate treatment for the individual.
Learning from Chinese and Alternative Medicine
Prof. Chan: How do you combine traditional Western medicine with alternative medicine? Patients not only get information from many sources, they also have their own views on health management. For example, a cancer patient may favour an alternative treatment over chemotherapy. How do we help patients make better decisions?
Dr. Li: The ultimate goal is to make a patient well and feel better. Therefore, we must adopt an open mind. Nowadays, there are already treatment protocol integrating Traditional Chinese and Western medicine, as well as other alternative medical treatments. In fact, Western medicine has its deficiencies and cannot treat all illnesses including those caused by hormonal imbalances and many painful conditions.
The most important thing is to treat patients based on medical evidence and to ensure the treatment is safe. Doctors need to understand and balance the risks involved before administrating any treatment. They must inform the patient of the risks.
Being a doctor, having a good attitude is also very important. In this regard, Western doctors have a lot to learn from Traditional Chinese practitioners. More than ten years ago, The Times (the British National newspaper) interviewed me on my views on Chinese medicine. I said Chinese medicine doctors are more empathetic – they take your pulse for a couple of minutes, hold your hand and pay attention to your reaction. This already makes you feel cared for. In contrast, Western doctors sometimes just ask you to open your mouth, look into your throat then send you to get your prescription medicine.
We must learn from one another. We must learn more about different types of alternative treatments. I must emphasize again however, patient safety is the most important. For example, some patients with diabetes could really die from not taking prescribed western medicine such as insulin and we must remind patients of such risks when they seek alternative treatments.
About Talking to CEO
Since 2002, CUHK EMBA has been running the Talking to CEO TV/radio program with Radio Television Hong Kong. Distinguished business leaders, academics and government officials have been invited to share their experiences and insights with CUHK alumni and students.
