How to promote Primary Healthcare to the Young Healthcare Workforce?

This article was exclusively written for The European Sting by Ms. Regina Elmúdesi del Río, a 21 years old born and raised in Santo Domingo, the Dominican Republic’s capital and largest city. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Regina Elmúdesi del Río is a 4th year medical student at the Universidad Iberoamericana  (UNIBE) in Santo Domingo, Dominican Republic. She serves as an active member of the Standing Committee on Professional Exchanges (SCOPE) of ODEM-Dominican Republic. “To specialize or not to specialize? Doctors’ choices affect many people” – Carolyn Crist, Oct. 2013 In an ideal and utopian society, every system, including the health system, would run on a pyramid organization structure, reflecting a hierarchy. No steps would be skipped, and every one of them would have the same importance. Regrettably, we are far from living in this utopia, but we, as healthcare servers, can start making things more efficient (1). The Dominican Republic is a third world country, where the primary healthcare unit is barely existent (2). This is one of the reasons why it is so difficult to diagnose and to treat most patients correctly; because the moment people start experiencing any symptoms, they seek right away the care of a specialist, passing over the primary healthcare unit. For instance, if someone has a headache, they go straight to the neurologist; if they have shortness of breath, they go to the pneumologist, and so on. As we well know, these symptoms are not necessarily related to a pathology of the organ system in question. On the other hand, medical students nowadays believe that the only way they are able to make an impact in the society or the only way they can become good doctors, is by furthering their medical education in a popular specialty of medicine. They are also under the impression that they have to do so in order to earn a lot of money: because believe it or not, doctors have to eat and live as any other human being. It may seem that way, but let’s go back to our utopia from the beginning. Imagine that every single patient goes to the Primary Healthcare unit the moment they start experiencing any kind of symptoms, and that you are the one who advises them regarding the next step they must take. You would, first of all, help the most people and save more lives, you would put into practice everything that you learned in school, and second of all, you would evidently earn a lot of money due to the great number of patients you would treat. Let’s not forget another mayor dilemma that most of us, as medical students, have had at some point of our career: deciding about which residency program to pursue after you graduate, or simply deciding on what to do after you graduate. To specialize in one specific area, that you may or may not feel passionate about, requires you to focus on the “same” branch of medicine for the rest of your life. Working at the Primary Healthcare unit allows you to expand your knowledge and experience, seeing all kind of pathologies, either common or rare. This does not mean that you are not going to be as good a doctor as any other colleague working as a specialist, on the contrary you could stand out by treating your patients without having the need to refer them and making their lives easier. Working in the Primary Healthcare unit places you at the first step of the pyramid: the solid base. Without it, the system will simply not stand or function as needed. No matter how hard we try, public health will always be deficient if we do not develop a functioning and organized Primary Healthcare system (3). References

1. Crist C. To specialize or not to specialize? Doctors’ choices affect many people. Georgia Health News. 2013. Available from: http://www.georgiahealthnews.com/2013/10/specialize-specialize-doctors-choices-affect/
2. Observatorio Político Dominicano, La Atención Primaria en Salud en República Dominicana, July 2012. Available from: http://www.opd.org.do/index.php/analisis-politicas-publicas/salud-y-seguridad-social-analisis-politicas-publicas/965-la-atencion-primaria-en-salud-en-republica-dominicana
3. World Health Organization. The World Health Report 2008 – Primary health care (now more than ever). Geneva: WHO, 2008. Available from: https://www.who.int/whr/2008/en/

About the author My name is Regina Elmúdesi del Río, I am 21 years old and I was born and raised in Santo Domingo, the Dominican Republic’s capital and largest city. At the present time, I’m a 4th year med student and pre intern at the Universidad Iberoamericana (UNIBE). I belong to the IFMSA in the DR, ODEM, since September 2018. I am an active member of the SCOPE committee of this association, because I have always been interested in all aspects of globalization. I believe this is so, because since I was 2 years old, I studied in a French laic school, the Lycée Français de Saint-Domingue, and it presented a sharp contrast to the everyday realities I observed as I was living in a third world country. This showed me how much my country could profit from the influence of the european culture.