Newsletter No. 396

8 No. 396, 19.4.2012 …… 如是說 Thus Spake… 日趨流行的家庭醫學究竟是甚麼？ 家庭醫學屬於醫學專科中的其中一門，在世界多個地方包 括香港，都可以修讀和執業。理念是病人為本，以期及早 診斷病患，並提供全面和延續的醫療護理。人生病了，第 一個要找的通常是家庭醫生，醫生與病人會保持長久的關 係，為病人的健康統籌各種所需要的服務。家庭醫生不僅 治療身體的毛病，還會為病人的飲食和心理健康提供輔導 建議，以收預防、檢測和治理之效。 為何選擇家庭醫學？ 我的興趣一向很廣泛，不想太專注於哪門醫學專科。家庭 醫學令我有機會接觸各色病人，認識林林總總的疾患、症 狀和病案。醫治過程中要兼顧病人的精神或心理是否安 康，這方面能夠滿足我對人的興趣和好奇心。 賽馬會公共衞生及基層醫療學院成立家庭醫學及基 層醫療學部，目的是甚麼？ 在家庭醫學領域提供卓越的教學、研究和服務，着重對個 別病人的護理，而非全民醫護。我們的最新動向是開展一 個獲香港賽馬會資助的項目，從生理、心理和社會三方面 入手，為弱勢社群病人提供跨學科的全人健康服務。一些 常見疾患若由跨學科的基層醫療團隊處理，會控制得比較 好。除醫生外，護士、物理治療師和社工都會參與。 你怎樣看身與心的關係？ 身體的生理變化會影響心理和精神，反過來說，情緒的波 動也會影響身體機能。我感興趣的研究是禪修或靜觀對健 康的影響，已知道它對癌症或抑鬱症病人有正面療效，我 想更深入知道它對紓緩痛症、焦慮和長期緊張的功效，以 及對肥胖症和失眠等熱門公共衞生課題的作用。 香港正在和將會面對甚麼公共衞生課題？ 香港人口日趨老化，老年醫療無可避免是大問題—應該 提供哪種可以永續的老年醫療服務？本地空氣質素也每 下愈況，貽害不淺。老年醫療和空氣污染乃當務之急。但 我相信，如能實事求是，定會找到解決辦法。我們需要更 多能夠通盤考慮，並具備生物社會學識見的醫務人員和決 策者。 你從小就立志行醫？ 我一向對文理科都有興趣，尤其是生物學。在加拿大唸大 學時，修讀人類生物學和心理學，畢業後想找一門結合個 人興趣和所受訓練的學科，發現醫學正好合適。如果我不 讀醫科，可能會當實驗心理學家，因為我有一年暑假時在 心理學系系主任張妙清教授 Prof. Cheung Mui-ching Fanny, chairperson, Department of Psychology 下期預告 Coming 黃仰山教授 Prof. Samuel Y.S. Wong 加拿大一所心理學實驗室當實習生，那是難忘的經驗，它 也是研究人的精神和行為。 你愛看哪種書籍？ 心理學，乃至與宗教或靈性有關的。大學時代讀社會心理 學，我眼界大開，它把我從書本讀到的科學知識與所接 觸的社會現實接通了。最近，健康或正向心理學的書令我 興致盎然，因為與公共衞生很有關係。它不把疾病孤立看 待，而是從全人健康角度衡量有哪些方面可以增進安康。 目前，醫學仍然是以個別疾病為主導的學科，我們要摒棄 固有思維，才可以為現代人的奇難雜症找出睿智的解答。 除了教學及研究，你還擔任甚麼公職？ 我參加動物權益組織的活動。我養了許多寵物，有三隻 貓、兩隻狗和八隻鸚鵡，我必須為牠們發聲。我也是香港 家庭醫學學院會董，積極參加學院的研究計劃，且是《香 港家庭醫學學院季刊》總編輯。 這麼年輕便當教授，對教學生或醫治病人有影響嗎？ 也許我對學生的了解會多一點，因為我明白他們的用語， 熟悉他們社交和表達看法的方式。但歸根結柢，這關乎你 是否用心去了解和跟學生溝通，視他們為有血有肉的人。 跟病人相處也一樣。 Family medicine has been very much in vogue. Can you explain what it is? Family medicine is a medical specialty that can be studied and practised in many parts of the world, including Hong Kong. It is patient-centred and provides patients with early, comprehensive and continuous medical care. A family doctor is usually the first medical professional that a patient sees. He/she often maintains a long-term relationship with the patient and coordinates various services for the patient’s health. He/she does not only fix the biological disorders but also advises on prevention, early detection and management of illness by means of dietary and psychological counselling. What made you want to study family medicine? I had a wide spectrum of interests and I did not want to become too specialized in just one aspect of medicine. Family medicine would enable me to come into contact with a wide spectrum of patients and understand a greater range of diseases, symptoms and cases. In the course of rendering health services to these patients I would have to look at their mental or psychological well- being as well. This satisfies my interest in and curiosity about human beings. What does the Division of Family Medicine and Primary Health Care at the Jockey Club School of Public Health and Primary Care at CUHK set out to achieve? This division aims to achieve excellence in teaching, research and service in family medicine. Our emphasis is on personal patient care rather than population health care issues. Our new initiatives include a programme funded by the Hong Kong Jockey Club to take a multidisciplinary and biopsychosocial approach to rendering holistic health care to disadvantaged patients. Some common forms of illness can be more effectively managed with the involvement of a multidisciplinary primary care team. As a result, not only doctors but nurses, physiotherapists and social workers are also involved. How do you see the relationship between body and mind? What happens physically in the body may affect the psychology, the mind; and one’s emotions may in turn affect bodily functions. My research interests include the effect of meditation or mindfulness on health. Positive results have been found in patients suffering from cancer or depression, and I am interested to know more about the effects of mindfulness on reducing pain, anxiety and chronic stress, and in addressing present-day public health issues such as obesity and insomnia. What public health issue(s) is(are) Hong Kong facing or will be facing? An aging population like that in Hong Kong will inevitably face heath care issues for the elderly, such as how we should provide for the elderly in terms of medical services and whether it is sustainable. The quality of air seems to be on constant decline too, which would have serious implications on our health. I see care for the elderly and air pollution as the over-arching problems. But I also believe that by approaching these problems in a realistic and pragmatic manner we can arrive at solutions. We need more medical professionals and policy-makers with a holistic and bio-social orientation. Did you know that you’d become a medical doctor when you were little? I always had great interest in various subjects in the arts and sciences, in particular biology. When I was in university in Canada, I studied human biology and psychology. After my undergraduate studies, I looked for a discipline that would integrate my various interests and training, and the medical profession appeared to suit my appetite. If I had not gone into medicine, I might have become an experimental psychologist, as I quite relished my experience as an intern in a psychological laboratory one summer in Canada. Again, it’s not far from the study of the mind and the behaviour of human beings. What kind of books do you read? I like reading books on psychology, and religion or spiritual matters. Social psychology was an eye-opener to me as a university student. It closed the gap between the scientific knowledge I gleaned from books and the social reality that stared me in the face. Recently, I’ve been fascinated by health or positive psychology as it is related closely to public health. It does not look at disease in isolation but at the whole concept of wellness and how well-being can be improved. Medicine is still very much a disease-focused discipline. We need to think out of the box to truly derive intelligent answers to the health issues around us. What do you do besides teaching and research? I have participated in activities of animal rights groups. I love pets and I have three cats, two dogs and eight parrots. I must therefore speak for them. I am a council member of the Hong Kong College of Family Physicians and take an active part in its research activities. I am also the chief editor of the College’s official journal, The Hong Kong Practitioner . You are young for a professor. What effect does that have on your teaching of medical students or treating of patients? I might know the students a little better because I understand the language they speak and the media they use to socialize and express their views. But it really comes down to whether you make an effort to understand and communicate with them and relate to them as real persons. It’s the same with patients.