GP Supervisor Dr Sue Masel recently travelled to India for the World Rural Health Conference – Rural WONCA 2018. As part of the conference Sue spent time in the Agra District Hospital outpatient clinic where she was shown how primary health care is done in India.
“I went to meet a local doctor in the city of Agra at his district hospital and spent the afternoon with him in the outpatient clinic being shown around the hospital, introduced to the doctors and given a description on how it all worked.
The patients turned up at outpatient clinic, paid one rupee and were given a registration paper. There were thousands of people everywhere.
Patients queued down a long corridor towards to mouth of the door and inside the door the doctor sat at a desk with an assistant on his right, a social worker on his left and pharmacist sitting next to the social worker.
Whoever got to the head of the queue, would walk into the room, stand in front of the desk where the doctor was sitting and tell their story. He would ask them questions, and scribble on the piece of paper which they were holding. The paper was the one-rupee registration paper for today’s episode of care that they would then add to their other health records because the hospital didn’t keep any records. If the patient didn’t have their own bits of paper with them there were no past medical records available for them.
The patient presented their story while standing up (and sometimes second hand if it was a child through a parent or if it was an elderly person through a child), in front of four people and whoever could stick their head through the door – because they were next in the line.
The doctor would pass the registration paper to his assistant who would process the request for pharmacy or radiology and sometimes the person would be directed to the social worker to help organise something and sometimes the pharmacist if there was a medication issue.
Then the next person would come through the door. They came through every few minutes. Hundreds and hundreds of people came through this system every day. And that was primary care medicine being done pretty well in his part of the country.
It is important Australian registrars hear the message from people who have been outside of Australia, been to world conferences and maybe done exchange in other countries that the Australian general practice system is world class primary care medicine and they are being trained in one of the best systems in the world.
This is something that I think we should take some time to be proud of at a certain point and celebrate that although it is difficult to get through those exams and learn the big curriculum, once you are there, it is a world class achievement that is transportable not only within Australian but anywhere in world”.