Family medicine internship training: importance for Hong Kong's primary care.

Over recent years, the Hong Kong SAR Government has realised the importance of primary care in the provision of cost-effective quality health care, as is evident from its latest health care reform document “Your Health, Your Life”.1 This is in line with “Primary Health Care, Now More Than Ever”, the World Health Organization’s 2008 annual report2 that emphasises the importance of primary care in improving population health outcomes. In some jurisdictions including Hong Kong and the US, primary care is practised by doctors with different backgrounds, including family medicine specialists, hospitalbased specialists working in the private sector, and others without any formal specialist training in family medicine.3 As of 2009, over 11 000 fully registered doctors work in Hong Kong, of whom 50% are in the private sector and around 40% (encompassing private and public doctors) have a family medicine or generalist background.4 Evidence from international literature has shown that primary care provided by family medicine specialists is associated with better health outcomes,5 earlier detection of various cancers,6-8 and lower hospitalisation rates.9,10 In general, policy changes in other countries paralleled improvements in primary care practice. For example, Spain attempted to strengthen its primary care through increasing its supply of family physicians, resulting in better continuity and technical quality.