“Family doctors have always been the backbone of health care. Family doctors have always been the bedrock of comprehensive, compassionate, and people-centered care”
-Dr. Margaret Chan, Director-General World Health Organization
Today, nearly 80 percent of the burden of non-communicable disease occur in low- and middle- income countries. To overcome this challenge, global health care has shifted toward prevention and primary care, focused on halting the rise of chronic disease.
Family medicine, first recognized as a specialty in the United States more than 40 years ago, aims to address just that. Family medicine focuses on comprehensive care for patients of all ages and genders that integrates social determinants of health and serves as an advocate for patients.
As Seed Global Health’s Director of Family Medicine, Dr. Esther Johnston, explains, “The strength of a family medicine doctor is that they are trained to be a “specialist in general medicine. They are trained to know how to treat the full spectrum of disease across the lifespan in the context of a larger community, which means they also excel at leading efforts in disease prevention and health promotion.” This person-centered, community orientated approach is beginning to gain momentum outside of the high-income countries and family medicine is growing as a specialty.
More than three years ago, Seed Global Health worked with the University of Malawi College of Medicine to help establish the first family medicine training program in the country. Today, the partnership continues with two clinical training sites in Malawi, where each year we have placed volunteer family medicine physicians to train the country’s next generation of physicians.
Dr. Johnston notes the success of the specialty so far, “Since family medicine has started in Malawi, the quality of care and also medical student instruction at the hospitals has dramatically improved. The team there has also opened a family medicine consultancy clinic which specializes in management of chronic diseases. Before family medicine began at these facilities, patients who have multiple conditions – for example, HIV, hypertension, and diabetes – would have each condition managed by a different specialist in a different specialty clinic. Now, these patients can be seen by one family medicine provider capable of addressing all of their needs at once.”
The partnership is continues to grow, and through collaboration with Swedish Medical Center, several of the Malawian family medicine students traveled to the United States to rotate at hospitals and attend the American Academy of Family Physician’s annual conference.
Dr. Elizabeth Hutchinson, who spent one year working in Malawi with Seed Global Health as a volunteer medical educator, helped establish the partnership and has supported the Malawian physicians during their time in the U.S.
“Before, only had U.S. residents rotate in Malawi. And they learned in the classroom how malleable family medicine is as a specialty – it can be applied in some very different contexts. We wanted the physicians from Malawi to experience the same thing first-hand during their time in the U.S.,” she explains.
Getting the Malawian physicians to the U.S. had been a work-in-progress for years, but Dr. Hutchinson was committed to seeing the partnership succeed.
For the Malawian physicians, rotating in the U.S. allowed them to see what community-orientated, primary care looks like outside of Malawi. And as Dr. Hutchinson noted, “We wanted them not only to see the success, but the mistakes that we have made. They can take those lessons and ensure they aren’t replicated, as their early-stage specialty continues development in Malawi.”
“We were excited to have our Malawian colleagues join us here in the U.S. Together we explored what challenges our work faces globally, and I think we all have a better sense of the community that surrounds us,” described Dr. Hutchinson. “By working together, we will continue to support the development of family medicine, strengthen leadership in primary care, and improve patient outcomes.”