Private doctors push for primary frontline roles

The President of the Samoa Association of General Practitioners, Le Mamea Dr. Limbo Fiu, says Samoa’s private doctors want to become more involved in primary healthcare and are in talks with the Government about providing more family and chronic illness care. 

Le Mamea said doctors should be tasked with people’s everyday health needs, and leave just emergency and secondary health to the hospitals.

His calls echo those made last week by the National Kidney Foundation’s Clinical Director, Leituala Dr. Ben Matalavea, who wants private practice to oversee chronic and non-communicable disease screening and care, not hospitals.

While discussions have happened previously, the 2019 measles epidemic may provide the necessary impetus for change, Le Mamea said, adding that the “bread and butter of primary care” should become the domain of private practice. 

The proposed shift would mean that in the urban area, where the majority of the private doctors work, Tupua Tamasese Meaole Hospital (T.T.M.H.) could be limited to treating the sick and injured. 

“If the Government is willing to work with us on that, on subsidised kind of arrangement, we can provide that kind of arrangement," Le Mamea said.

“I think it’s about time they look at some new, innovative ideas to roll out this kind of service delivery to the public.”

In New Zealand, primary care is primarily the province of family doctors, who are the first port of call for most aches and ailments. 

These doctors are often the first to see and piece together disease or injury patterns and can report them to the national healthcare system or Ministry of Health, Le Mamea added.

He called it a strong and functioning primary health care system, where people have ready access to services – something that is lacking in Samoa.

“People go to the hospital even though they are well to get their primary care needs. We need to prevent people from going to hospital.

“Immunisation, diabetes, hypertension, heart disease, strokes, screening, intervention, prevention and protection… that’s the bread and butter of primary care”.

If done well, the President envisions a system in which private practice could report emerging issues in community health, such as outbreaks, to the Ministry.

Today, many doctors work a day a week in the national hospital to help with the level of patients anyway. 

As of September 2019, there were some  37 private doctors in Samoa, or around 30 per cent of all registered medical professionals. 

Leituala, who is also the Vice-President of S.A.G.P this year, said that private practice should take on patients at a subsidised rate.

“I think if Government can subsidise visits by patients with diabetes and high blood pressure it will relieve the hospital and I truly believe the care of those patients will be a lot better,” he told the Samoa Observer last week.

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