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December 2015

Dear Fellows and colleagues,

It is with sadness that I write this message during my trip with an Academy delegation to Chengdu of Sichuan, visiting some hospitals and institutions with disaster management experiences. With just several weeks before 2015 comes to an end, the global community has been stunned by the news of a series of devastating attacks across Paris on 13 November. Over hundreds of people have been killed and dozens injured. Our deepest sympathies go out to the victims and all the families affected.

Terrorist attacks are examples of human-instigated disasters that cause loss of life, create an impact on health, and stretch emergency services beyond their usual limits. While we cannot foresee when they strike, we should be able to ‘expect the unexpected’ and learn beforehand how to deal with disasters. As reported in previous issues, the Academy is committed to train health care professionals, NGO workers, as well as members of the public in disaster preparedness and response through the establishment of the Hong Kong Jockey Club Disaster Preparedness and Response Institute (HKJC DPRI). By making use of technology, such as simulators of our Hong Kong Jockey Club Innovative Learning Centre for Medicine (HKJC ILCM) and virtual reality to provide disaster scenarios, we hope to train disaster response professionals as well as increase public resilience.

The tragic loss of so many lives in an instant forces many of us to confront the meaning of mortality as we cling onto the precious gifts of life, family, friends, joy and health. How does one define a life well lived? None of the victims who died in the terrorist attacks could have been prepared for the sudden loss of lives. But for those patients living with a terminal illness, how can we help them as they prepare for the inevitable? Should we doctors, committed to saving lives, provide treatment or carry out procedures that might only extend suffering till the end?

Dr Atul Gawande, a renowned surgeon and writer, author of the best-selling novel titled “Being Mortal: Medicine and What Matters in the End”, visited our Academy and gave a lecture on the same topic. Dr Gawande, a practising surgeon himself, believes that for most people, wellbeing is more than mere survival. He asserts the audience that medicine can comfort and enhance life even towards the end, providing not only a good life, but also a good end. Having conversations and discussions with terminally ill patients about the progression of disease, treatment options and so on can be extremely challenging. The increasing demands that patients and families put on doctors add to the stress.

It is clear that times have changed. In the past, patients automatically looked up to doctors as wise figures of authority and power. Now, doctors have to work harder than ever before to gain and keep the trust of patients and their families. Training in communication and improving skills in expressing empathy have become pivotal. Putting patient-clinician relationship at the heart of health care helps achieve quality and safety goals.

The importance of quality and safety in health care delivery is well recognised. The British Medical Journal (BMJ) organised its first International Forum on Quality and Safety in Healthcare: Asia in Hong Kong jointly with the Institute for Healthcare Improvement. The Forum, titled “Improve, Innovate, Inspire”, featured keynote speakers from the US, UK, and Asian countries and showcased the very best of international and regional thinking and practice in quality and safety in health care. I participated in a WHO Summit: Policy Roundtable for Quality in Health Services, which brought together representatives, experts, and senior policy makers from across the Western Pacific region. There were constructive discussions on policy trend and critical issues in promoting actions for and assuring the quality of health services in countries worldwide. Participants discussed and identified strategies to overcome challenges by working in collaboration with the ultimate goal of improving quality in health services.

I met President of China Medical Board, Dr Lincoln Chen, while attending the International Medical Education forum in Vancouver organised by the Royal College of Physicians and Surgeons of Canada a few months ago. Dr Chen, who visited our Academy earlier in the year, presented at the forum in Vancouver his co-authored “2010 Lancet Commission Report - Health Professionals for a new century: transforming education to strengthen health systems in an interdependent world”. He provoked discussion amongst international medical leaders on how concerted effort of health care professionals and educators could strengthen health systems with a change in the mindset acknowledging challenges whilst seeking ways to solve associated problems. Participants agreed to embrace the imperative for reform through dialogue, open exchange and discussion about recommendations. The outcome would ultimately be an enlightened new professionalism that can lead to better services and consequent improvements in the health of patients and populations.

We are a profession of strong minds. We are also one with great hearts. Let us continue to be passionate, build mutual trust and rapport with our patients to enhance the quality of medical service.

Dr Donald Li

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