Wes Fabb Oration 2026: Dr Donald Li

At the WONCA Asia Pacific Regional Conference 2026 in Iloilo City, Philippines, Dr Donald Li delivered the Wes Fabb Oration, one of the conference’s most significant addresses. Opening on the 25 March, the conference brought together family doctors from across the region under the theme, “Family Physicians Gifted to Give: Hearts that Care for Persons, Family and Community.” In that setting, Dr Li’s speech stood out as a thoughtful reflection on the identity, responsibility and future of family medicine.

Dr Li is one of the most respected figures in global family medicine. A family doctor in Hong Kong and mainland China, he is Chairman of the Elderly Commission in Hong Kong, Chairman of ACAN, the Action Committee Against Narcotics, and a past President of WONCA. Across many years of service, he has helped shape policy, education and leadership in primary care, while continuing to speak with the perspective of a practising clinician.

His oration, delivered in honour of Wes Fabb, resonated strongly with delegates in Iloilo. Rather than focusing only on systems or technical change, Dr Li spoke about time, continuity, ageing, wisdom and stewardship. He reflected on what it means for family medicine to grow older without losing its purpose, and how the discipline must respond to digital change, climate instability, burnout and fragmentation while holding fast to relationships and community.

We are pleased to share the full text of this speech with the wider WONCA community.

Wes Fabb Oration 2026

Delivered by Dr Donald Li
26 March 2026
Iloilo City, Philippines

Colleagues, friends, fellow family doctors.

We gather at this WONCA Asia Pacific Conference in a region of breathtaking diversity, thousands of islands scattered across oceans, vast continents, megacities of glass and steel, and remote villages reached only by boat or mountain road.

We come from different languages, different cultures and different health systems. And yet, despite those differences, we share something profound. We are family doctors.

It is a deep honour to deliver this oration in the name of Wes Fabb, a man who believed that Family Medicine was not an accident of training, but a conscious commitment to people, to communities and to continuity. He understood that generalism was not a compromise. It was courage.

Today, I do not wish to present clinical guidelines or workforce graphs. I want to speak about something more fundamental. I want to speak about time, about the passage of time, and about ageing.

Three years ago, I began serving in Hong Kong as Chairman of the Elderly Commission, advising government on policy for older persons. In that role, I have confronted a question that medicine often avoids. What does it mean to grow old, not as failure, but as meaning?

There is a quiet fear in modern medicine that being old means being obsolete, that if you are not the newest, you are fading, and that value belongs only to innovation. But in Family Medicine, time is not our enemy. Time is our instrument.

We are the only specialists who use time itself as a diagnostic tool, the only ones who prescribe relationship as therapy, and the only ones who understand that meaning reveals itself slowly.

In many Asia Pacific cultures, ageing confers authority. Grey hair commands respect. Elders carry memory. So today, I want to ask: what would it mean for Family Medicine to age well? What would it mean for our discipline to become an elder, not obsolete, but wise?

Family Medicine in our region was not born in comfort. It was born in necessity, in rural provinces where there were no specialists, on Pacific islands where one doctor served an entire community, in mountainous regions, and in crowded urban settlements where hospital beds were scarce. We might also remember barefoot doctors.

It emerged because fragmentation failed. When medicine divided itself into organs and subspecialties, someone had to remain whole. That someone was the family doctor.

In the early years of WONCA, our discipline was often misunderstood. We were seen as less prestigious, less academic and less specialised. But our founders recognised something others did not. Complexity requires integration.

And our region is complex. It is shaped by multigenerational households, strong kinship networks, cultural traditions that shape health beliefs, and rapid urbanisation layered upon ancient customs. Family Medicine fit this landscape because it honoured relationship, respected context, and understood that illness cannot be separated from family, work, village or culture.

That was our youthful fire. We fought for university recognition. We built training programmes. We proved that General Practice was not the absence of expertise, but expertise in complexity, in uncertainty and in humanity.

Youth asks, "Will we survive?" We did more than survive. We grew. But growth changes us. Youth asks, "Will we survive?" Maturity asks, "What must we protect?" And that is where the long view begins.

When you are young and fighting for survival, your purpose is unmistakable. You are the underdog, fuelled by the energy of proving others wrong. But what happens when the movement becomes the establishment?

Let me return to the patient. In many parts of our region, it is common for a family doctor to care for three generations in one household. You treat the grandmother’s hypertension and diabetes. You manage the son’s injuries and work stress. You guide the daughter through pregnancy. You vaccinate the grandchild.

Years later, you sign the grandmother’s death certificate and continue caring for the rest of the family. In that consultation, you are not seeing one individual. You are seeing the arc of a lineage. That is the privilege of continuity.

In tertiary hospitals, care is often dramatic and episodic. In Family Medicine, care is longitudinal, sometimes lifelong. We also remember being the first in and last out during COVID.

Competence is necessary. Competence is knowing the guidelines and knowing drug Y for condition X. It is essential. But wisdom grows from accumulated relationships.

Wisdom is knowing when the guideline does not apply. Wisdom is knowing when not to treat. Wisdom is recognising that sometimes the most powerful intervention is silence, and the steady holding of a hand.

The young doctor longs to cure. The mature doctor longs to heal. And healing is different. Healing means preserving dignity when biology fails. It means helping a person find wholeness even when cure is impossible.

In many of our societies, filial duty remains strong, but economic pressures strain that covenant. We sit at the intersection of tradition and transition. We are not merely treating disease. We are witnessing social transformation in real time. That requires maturity.

We must not fear the ageing of our workforce. We need the energy of the young. But we also need the slow medicine of the elder, the physician who has seen enough cycles to say calmly, "This too shall pass."

Our region is among the most dynamic on Earth, digitally connected, economically expanding, demographically shifting and environmentally vulnerable. We practice at the crossroads of possibility and instability.

Two forces shape our present: digital acceleration and climate instability. Telehealth now bridges islands and mountains. Artificial intelligence calculates risk scores in seconds. Technology can democratise expertise. But speed is not wisdom.

Artificial intelligence can detect patterns, generate documentation and optimise workflows. But it cannot recognise hesitation. It cannot interpret silence. It cannot perceive fear behind polite reassurance. In many of our cultures, meaning is conveyed indirectly, through tone, through pauses, and through relationship built over years. No algorithm captures that.

Let machines assist us, but let us not surrender our identity. If screens replace faces, and if checklists replace listening, we will have aged poorly. Instead, we need high technology and high relationship, not one at the expense of the other, but integration guided by wisdom.

From cyclones to bushfires, from rising seas to extreme heat, climate instability is no longer theoretical. We see it in our waiting rooms: asthma worsened by smoke, elderly patients dehydrated during heatwaves, families displaced after storms, and rising anxiety after repeated disasters.

For small island nations, rising sea levels threaten identity itself. Climate challenges continuity. How do you provide lifelong care when communities relocate?

Family Medicine has always understood that health is contextual. Now the context itself is shifting. Maturity demands a wider lens. Continuity is not only between doctor and patient. It is between generations. Stewardship means protecting both.

And yet, even as responsibility expands, our discipline feels strain. Clinics are overloaded. Administrative burdens grow. Young doctors drift toward narrower practice. Too often, systems reward procedures more than thinking, volume more than value, and throughput more than trust.

In some settings, healthcare risks becoming transactional. In others, burnout erodes idealism. The temptation is discouragement. But maturity is not retreat. Maturity is steadiness under pressure, integrity when incentives distort, and professionalism when systems falter.

It is saying: the system may be imperfect. It may even be broken. But my relationship with this patient is sacred, and I will protect it.

If we abandon relationship for throughput, and if we reduce ourselves to referral triage, we lose what makes us essential. Family Medicine is not defined by billing codes. It is defined by covenant.

In many Asia Pacific cultures, the elder is not the loudest voice, but the stabilising one. They carry memory. They provide orientation. Family Medicine must assume that role, not nostalgic, not defensive, but grounded.

To our senior doctors, I say: model calm integration of technology, advocate wisely, continue learning, and show that this work remains meaningful.

To younger colleagues, I say: you inherit a complex century. But you also inherit a discipline uniquely equipped for it. You are custodians of continuity. In a region defined by rapid change, continuity is revolutionary.

We do not control the speed of the world. But we can choose our steadiness within it. That is stewardship.

We began with time. We remembered our youth, born of necessity and forged in scarcity. We embraced maturity, the privilege of seeing the arc of a life. We faced turbulence, digital acceleration and climate instability. We acknowledged moral tension, burnout, commercialisation and distortion of values. And we chose stewardship.

The long view changes how we measure success, not by quarterly targets, not by procedural counts, and not by the noise of the moment, but by quieter questions. Did this family feel known? Did this elder feel dignified? Did this young doctor feel guided? Did this community feel accompanied?

Long after technologies are replaced, long after policies are rewritten, and long after today’s urgencies fade, what will remain are the relationships we sustained.

In many of our cultures, an elder is not honoured because they speak loudly. They are honoured because they have seen enough seasons to recognise what endures. Family Medicine has seen enough seasons. We have known scarcity. We have known struggle. We have known growth. Now we are called to wisdom.

And we do not walk this path alone. WONCA is our gathering place, across oceans, across languages and across generations. When we were young, it gave us voice. When we were scattered, it gave us belonging. When we doubted, it gave us courage.

It reminds us that generalism is not small. It is vast. And as we grow older as a discipline, WONCA carries our shared memory so that when individuals step aside, the wisdom remains.

Let others chase speed. Let others chase prestige. Let others measure worth in headlines and metrics. Let us hold the long view.

Let us be the discipline that remembers that medicine is not only about prolonging life, but about accompanying it, from birth to frailty to farewell.

And when future generations look back at this era, may they say: they did not panic. They did not fragment. They did not surrender to fashion. They did not trade relationship for efficiency.

They became elders, steady, courageous and faithful to what matters. That is the wisdom of the long view. And that is the soul of Family Medicine.

Together, let us grow older, and grow wiser, for those who come after us.

Thank you.