My Young Family of Practitioners.

The Deeper Roots of the Family Medicine (FM) Physician’s Tree in Kenya.

I remember my first lesson in the FM class at The University of Edinburgh’s Medical School when Dr. Robin Ramsay took us through the European definition of FM using the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) tree. This was a while ago. However, this concept has never escaped my mind since that time. Best teachers leave students with memories that would help them to improve their skills while in practice after school. The WONCA tree resonates well with my practice up to this day. The illustrations made during that class have helped me to nurture my students in the direction which the practice of FM ought to go. As the leaves of the tree point towards care decisions in relation to patient-clinician interaction, the branches determine specific problem solving skills in primary care and the stem carries the management context of the practice itself. The roots, which are usually unseen, belong to the science, attitude and context of the primary care domain. Looking at this analogy, I would say that all my FM teachers in Edinburgh belong to the roots section. You may not see them physically but you can see them through me. I am now a bigger tree because of the strong roots. In legendary terms, a heavy tree does not stand by its branches, leaves or fruits but by the depth of its roots.

The Buttress Roots

There are other FM teachers whom I would mention in this article that contributed greatly towards my knowledge as a student and now as a practitioner. For instance, Dr. Alan Barnard’s teaching on reflection has helped me to become a great self-reflective practitioner. Keeping a journal for reflection of my practice has led to effectiveness in my clinical medicine practice. I also remember what Dr. Colan Robinson taught me. He said, “Benard, always make decisions in the best interest possible, then trust the process”. This was during a lesson on Professionalism in FM Practice. Dr. David Fearon on the hand, was one my strict academic parents for sure. His standards for research and academic writing skills left me with the best writing skills ever. I am sure that my future writing skills are going to be built on his firm academic writing character which he kept on emphasizing. I have many other teachers whom I so much hold in high esteem such that I would write numerous scripts about them.

Benard (in the middle) with clinicians at St. Paul’s University in Limuru, Kenya after a clinical practice session at Kiambu Level Five Hospital.

Multiple Trees, Multiple Branches and Multiple Figs

You may wonder why I am bringing back all these memories. I have a young family of my own now here in Kenya. In my place of work, I have a generation of FM clinicians whom I am raising. I am already sinking my roots deeper for this new tree of FM practitioners. I mean, my Edinburgh transferable skills are working for me now. My intuitive ability and insight into the issues surrounding medical practice has led to the discovery that the best approach to raising effective FM practitioners is in teaching and instruction. Just like a FM physician who is patient centered with effective skills in the coordination of care, I believe that my students also need to be taken through a journey that helps them to understand such FM values early enough before they begin their medical practice. I am the root which will hold their FM ancestry and practice in a genealogical sense. I am sure that if each of these students transferred the same culture to twenty other students in future, this would be a similar analogy to the WONCA tree and its branches.

References

The WONCA Tree. (2018). Promoting Self-Management and Patient. [Online]. Available at: https://www.semanticscholar.org/paper/Promoting-Self-Management-and-Patient-Collins-Rochfort/5aae63e1221a61bab2aa2682a96de6d7564c4bed/figure/1 (Accessed 26 February 2024).