From the President: October 2023

One Term Ends That the Next May Begin

Crisis or transition of any kind reminds
us of what matters most.
― Russell Ballard (1928- )
Wherever the art of Medicine is loved,
there is also a love of Humanity.
― Hippocrates (460- 370 B.C.E.)
One should aim not at being possible to understand,
but at being impossible to misunderstand.
― Quintilian (35 B.C.E.)

,

These 22 months since I wrote my first Newsletter have sped by – with endless to-do lists, occasional frustrations, many action plans, with new and old working relationships, new friendships, and long road trips. Yet my term has also seemed to have lasted for an age. So much joy! It has brimmed over with extraordinary experiences, with ah-ha’s, and many deeply touching moments. Threaded through it all has been the humbling awareness of just what a privilege it is to lead our global network.

It’s a worthy tradition for WONCA Presidents to write monthly Newsletters. Besides shortening the distance between the leadership and the members, they help us define and fortify our shared identity. In my 2021 Inaugural Address, I put forth a WONCA Biennial Road Map that emphasized the priorities of Building Identity, Increasing Visibility, and Exerting Influence. As I’ve reviewed my various Newsletters, I’ve been pleased to sense that they do seem to reinforce those three aims.
So, it’s a touching milestone for me to be composing this, the last WONCA President’s Newsletter of my term. (I’ve taken the liberty of including extra epigraphs this time!)
My final President’s Newsletter, meantime, has a special function: to share a brief summary of the “President’s Report” that I’ve submitted to the Council.

***

Among the Issues and Agenda Topics Addressed This Term:

• COVID 19
The pandemic hit us all personally, as individuals and as members of the communities in which we live and work, and as Family Doctors. So much illness. So many losses – patients, friends, family, and community members. A world of fear and grief that it was our job to help people cope with.
The pandemic also impacted WONCA’s operations, with travel restrictions, lockdowns, financial constraints, increased health-provider workloads, etc. The process of relocating WONCA’s headquarters from Bangkok to Brussels had begun just before the outbreak of COVID 19. It was carried out – and successfully completed – against this destabilizing background.
The pandemic did give us one gift, however: it served as an unexpected catalyst for a large-scale experiment in digital communications, allowing us to weigh the advantages and disadvantages of virtual meetings. Not surprisingly, at the conclusion of our in-person Executive meetings in Oslo and Brussels, we could affirm that face-to-face interactions do tend to be more productive and effective than their virtual counterparts!

• Our Strategic Plan
It is essential to have a plan if one is to lead a global network of WONCA’s size and complexity. We have needed to recognize and assess our accomplishments, adjust our course, and prioritize our resource allocation.
The Strategic Plan for 2023-2028 is a specific agenda item on our Council Agenda. We base the Plan’s development on input from the broader membership of WONCA. I want to thank all of you who have contributed to that process.

• Membership Issues
One of WONCA’s primary objectives is to serve its members effectively. However, as our base expands, we are encountering a growing number of membership management challenges. Notably, issues connected to multiple member organizations and voting protocols have led to confusion, and to tensions. To address this, we propose the formation of a dedicated task force charged with studying these issues and suggesting actionable solutions. We plan to discuss their findings at the WONCA World Council Meeting, in Lisbon 2025. This agenda item will also be directly addressed during our Council meeting in Sydney.

• Accreditation Activities
There is a shared understanding that an aspect of WONCA’s mission is to support the development of training schemes, quality evaluation systems, and professional development within clinical practice. We have begun to look at how to develop WONCA`s consultancy services further, to increase our support for the development of Family Medicine in many countries. This is a work in progress.

About the Organization, WONCA

• The Executive Committee
For the first time in WONCA’s history, the Executive Committee was constituted virtually. Since then, we have met for sixteen online meetings; by the time the Council opens in Sydney, we will have met in person only three times. Eight of the fifteen members were newcomers to the WONCA Executive; for them, this was quite an unusual term. I send great gratitude to the entire Executive for their invaluable efforts and contribution – and their adaptability.

• The Secretariat
It has proved important for me to stay in close contact with the WONCA Secretariat team. I have followed their complex and at times difficult transition from Bangkok to Brussels, including the closing of the BVI branch, and the establishment of WONCA Association. Scheduling my visits to Brussels to be physically present also for the online Executive meetings created opportunities to plan and assess WONCA operations in face-to-face meetings with the WONCA CEO and his staff. This afforded the additional advantage of having in-person meetings with members and working groups in and around Brussels.

I am deeply grateful to CEO Harris Lygidakis for all the effort he has put in during these most trying circumstances. He has established a well-functioning, service-minded Secretariat. We now have a full-time Communication Officer as well; a communication strategy and communication skills are pivotal for increasing WONCA’s visibility.

Meeting You, WONCA’s Members

Once the pandemic restrictions that had so disrupted our long-planned conferences were lifted, everything seemed to happen all at once. Despite little time to plan or coordinate, the CEO and I made it to meetings in several countries and on several levels – with WHO, with the OECD, and with such stakeholders as politicians and policy makers.
Best of all, we met the WONCA members. To build a common identity, we need to meet! I’ve attended Regional Conferences in all seven WONCA regions at least once since I became President-Elect in 2018, as well as national conferences in several regions. I attended Regional Councils and YDM pre-conferences, virtually and in person, and delivered keynote addresses at conferences in all our regions. During my term as President, I’ve spent close to 150 days on the road representing WONCA, enabling me to meet many of you members on your home turf, within your own context.

• Travels
To give you a sense of what those 150 WONCA travel days meant in practice, here’s my itinerary for just the late autumn of 2022:
On 02. November, I left Oslo for Brussels, for a two day Executive meeting and work sessions with the CEO and the Secretariat. I then flew to Guatemala where I spoke at the La Cumbre/The Health Summit and toured the country’s Health System. Next, I headed to Phoenix, Arizona, for the North American Primary Care Research Group (NAPCR) conference, where I’d also been asked to speak. Finding no direct flights from Arizona to Abuja, Nigeria, I flew via Frankfurt. Once in Nigeria, CEO Harris Lygidakis and I both attended the WONCA Africa Conference.
After nearly four weeks away, I flew home for a short week. I checked in with my GP practice patients and colleagues, and, of course, with my family and friends, before my next long haul flight – this one to the WONCA Asia Pacific Conference, in Bali, Indonesia. After that week of attending in person and online meetings, and experiencing Bali, I flew home for a fast stopover in Oslo. Then, I was off to Cairo for the EMRO UHC week, and the launch of the Family Medicine Diploma.
May and June 2022, as well as March and April 2023, offered me similar logistical, and stamina, challenges.

• Learning
This tells you where, but little about what. Imagine if you can how my worldview expanded thanks to my immersion in such an inspiringly wide array of contexts, many of which are vastly different from my own! The Family Doctor that I am is still at work – body, mind, and being – digesting the knowledge that you WONCA members and groups so generously shared with me.
I have sought to put that learning into practice; some of it made its way into my Newsletters. After my tenure as President, I see an outlet for more of it via my participation in the upcoming Core Values brainstorming project. Shedding light on the core values that WONCA stands for can help us define our shared identity and thus increase our visibility. That, in turn, broadens our opportunities to exert influence.

Speaking As Your (Nearly) Past-President

Various suggestions have come to mind during my term:

• Elections
WONCA work is volunteer work. It is important that members who put their names forward to fill elected or appointed positions and roles understand the nature and complexity of the tasks and responsibilities for which they are volunteering. To this end, I strongly recommend that WONCA’s Executive Committee consider formulating rules and guidelines for members running for offices. These could also ensure equal conditions for all candidates, regardless of geography/time zones or local resources.
In 2016, the length of each President’s term was reduced from three to two years. We might want to evaluate whether that length has proved to be optimal.
Once WONCA officers are elected, further professionalizing of WONCA operations will require that they receive governance training. Clear visions of principles, obligations, and roles help enable our trusted people to fulfill their duties to the best of their ability, as well as for the best of the organization.
Because of the disruptions caused by the pandemic, the 2021 campaigning and elections were carried out entirely on a digital platform. Utilization of such platforms will most likely predominate in the years to come, as we see happening now, in the lead-up to this year`s elections. It’s important to communicate and ensure this overriding principle: that election procedures take place during the WONCA World Council, under the jurisdiction, responsibility, and supervision of the WONCA World President and the Executive Committee.

• The Executive Committee
The current Executive Committee framework was established decades ago. Given the evolving complexities of our world and our expanding membership base, it may be time to reevaluate this structure. For example, as legal frameworks and global financial systems have evolved, we have seen their accompanying bureaucratic hurdles hinder our operations increasingly over the past two terms. Consequently, I suggest, for example, that we consider transitioning to a smaller, skill-based Executive Board, supplemented by a broader panel with advisory and representative roles.

And Finally…

I will miss the entire monthly Newsletter process: exploring topics that are close to this Family Doctor’s heart, contemplating the implications of each of them, formulating my thoughts as best I can, then getting to share them with a huge group of peers whom I respect!
I`d like to thank Susan S Senstad for supporting me in the writing process, enabling me to express my views and messages with clarity in a language that is not my mother tongue.

I am looking forward to extending my gratitude in person to those of you who come to Sydney. To all WONCA members, whether I have met you in writing, online, and/or in person during the past two years: for your support, your kindness, and respect, I simply say: Thank You!

It will soon be my honor to enact that core principle of Democracy: The orderly, peaceful transfer of power. It is with a happy heart that I place the responsibility and privilege of being WONCA’s next President into Karen Flegg’s caring and competent hands.

Dr Anna Stavdal, 
WONCA President