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An international meeting highlights domestic health care

From the November ACP Internist, copyright 2010 by the American College of Physicians

By J. Fred Ralston, FACP

I am glad to live in a country that offers the latest specialty services, particularly cutting-edge procedures should those I care for need them. I often note that the U.S. is clearly one of the best places in the world to get high-quality intervention if you have a heart attack. Sadly, however, it may also be the most likely place in the world to have that heart attack because of our unhealthy lifestyles and lack of easy access to affordable primary care—or to health coverage at all. While the U.S. has much to offer the world, we also have much to learn.

On the suggestion of ACP’s international office, I accepted an invitation to keynote the meeting of the Association of Consultant Physicians of Jamaica (ACPJ). My host for the entire visit was ACPJ President Amza Ali, MBBS, DM, who took me to grand rounds at the University of the West Indies, followed by a talk from a distinguished visiting lecturer. I met many of the internal medicine faculty there during a reception that followed.

The ACPJ’s meeting took place on a Sunday, and on the preceding Saturday, I attended a regular lunch group composed of physicians, business leaders and the president of the Jamaican Senate. There was a robust discussion on a variety of topics, and I learned a great deal about the Jamaican perspective on health care reform.

At a black tie banquet that evening, I spoke on the history of health care reform efforts in the U.S. and the challenges ahead. This was a festive affair and my message was well-received by the audience, which included leading physicians, civic leaders and a former prime minister and his wife, who were quite interested in health care and in moving toward a system focused more on primary care. This was not an ACP meeting, but I saw it as a sign of tremendous respect for the organization when Masters and Fellows of ACP were asked to stand and be recognized during the official program.

On Sunday, I keynoted the ACPJ Annual Symposium. I ended my speech by outlining what I was learning during my visit to Jamaica. I pointed out the remarkable similarities in the goals I heard outlined for Jamaica by the chief medical officer of the Jamaican Ministry of Health and the goals on which ACP has been focusing. We agree on the need for strong, patient-centered care based on strong primary care, improved lifestyles and careful, evidence-based use of more expensive diagnostic tools and therapeutic modalities.

I advised the principal of the University of the West Indies to do everything in his power to make the electronic health record they are contemplating interoperable with all systems being considered by others in Jamaica. I also reminded him of the need for physicians in both universities and private practice to be involved in the selection of a system that meets a variety of needs. I pointed out ACP resources that may help in this selection process.

On Monday, I paid a courtesy call on Owen Morgan, MACP, the only living ACP Master in the West Indies. I also met with the chair of internal medicine, Michael Lee, FACP, and other faculty members, and learned a great deal about the needs of the University of the West Indies and potential areas where ACP can help. Many faculty members pointed out the need for closer ties with ACP, since many graduates and faculty do part of their training in the U.S. and Canada. They also noted that their medical school graduates and residency graduates normally perform quite well in American and Canadian programs.

The people I met with asked many questions about how ACP can help Jamaica and the University of the West Indies, which I will share with ACP leadership and staff. This leads me to ask other international members reading this column: How can ACP, with its many resources such as education, professional recognition, electronic health records and practice transformation, help members in your area of the world?

In 2010-2011, ACP attained membership of 130,000. It was the 10th consecutive year of overall growth, and included a 14% growth in international membership. Currently, ACP has 8,730 members outside the U.S. We have international chapters in Brazil, Canada, Central America, Chile, Mexico, Japan and Venezuela. We are in the process of approving a new chapter in Saudi Arabia and are looking at other countries that would like to have chapters.

Whether you live in the U.S. or abroad, we would love to hear your ideas about how to better communicate between U.S. and international members. If you or your institution has an interest in hosting a visiting medical student or resident, please contact the international office and we will see if we can perform a “matchmaker” role. If you are in the academic world and might have some time to spend as a visiting faculty member, this could be tremendously helpful. Finances certainly vary, but volunteer services in the developing world could provide tremendous help to medical students and residents in many countries. Please feel free to contact me or ACP’s international office with your thoughts.

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