MAAGAARD, A/Prof Roar
Denmark : President HOC, WONCA Europe conference Copenhagen 2016
Roar Maagaard from Denmark is president of the Host Organising Committee for the 2016 WONCA Europe conference coming to Copenhagen in June. Next month he will talk about his hopes for the conference - here we find out more about him.
What work do you do currently?
Come October, I have been working as a GP for 27 years - and all years in my “second home” - the GP Practice in Skødstrup which is situated 15 km north of the centre of Aarhus, Denmark. Aarhus is the second city in Denmark (after Copenhagen) and first of all Aarhus is the home of a very big and respected university - and also known to be the city of green wind technology.
Compared to Danish standards our practice is a bit unusual regarding the size of the practice: we have 12,000 patients on our list and we are eight GP partners, two trainee doctors and a staff of 11 people (nurses, clinical assistants/secretaries and a dietician) - the norm in Denmark is 1-4 doctors in a practice. In Denmark, a GP typically works in his practice for all active years as a GP - so the 27 years are in no way unusual. And the practice is my second home!
What is your philosophy regarding your practice situation?
You spend so many of your waking hours in the clinic, so it is very important to have good working conditions: cooperation with your colleagues should be good; the working environment physically/socially/psychologically must be good for all working in the clinic; and the premises should be spacious, nice, letting lots of light come into the premises! In this way the clinic gives good conditions for our patients and for all working in the clinic. The premises are owned by the doctors and we have prioritised these characteristics of good premises - and so it should be when it is your second home, I think.
Over the years, I have had other commitments as well as my daily work in the practice - but still, the most important part of my working life is the daily contact and continuity with my patients in Skødstrup. A perhaps slightly adopted quotation of Gandhi expresses it very well: “A patient is the most important person in our hospital. He is not an interruption to our work. He is the purpose of it. He is not an outsider in our hospital, he is part of it. We are not doing him a favour by serving him, he is doing us a favour by giving us an opportunity to do so.” This is the motto for Bombay Hospital - but it also should go for every GP practice. And I think Gandhi also added: “the patients are our bread and butter”.
The broad spectrum of reasons for the clinical encounter has my interest - and the continuity with patients I have known for all 27 years. And on top of that I have a special interest in palliative and terminal care. This interest began during my training in general practice where two charismatic tutors demonstrated their commitment to these important tasks for a GP - it was a huge inspiration to the young trainee doctor! I think dedicated help to palliative and dying patients is an essential task for us GPs. It can mean so much for the patients, for their relatives and it is also rewarding for the doctor himself. At least to me, it holds more meaning than minor changes to medication for hypertensive patients… not saying that this is not an important task, too. In Denmark, we have recently launched a new clinical guideline on palliative care in GP - and later this autumn an App for your mobile device should be ready on palliative care.
What other interesting activities that you have been involved in?
For 25 years I have been involved in medical education. The work has been on all aspects of medical education: from student education, to GP specialist training and to CME/CPD for GPs. I am a trainer in our GP practice but also responsible for training on a regional and national level. Much inspiration has come from colleagues abroad too - especially through the European organisation for teachers in GP, EURACT. I have enjoyed being active in EURACT for many years and am still participating in the work, including ongoing developmental work on assessment of teachers funded as an EU (Leonardo da Vinci) project. I sometimes have fierce discussion with colleagues who talk about the “art of medicine”. I do not like the word “art” in combination with our discipline! As a GP trainer I think the specialty of GP/FM can be taught, one must be trained - and after many years of practising, you might become a very good and skilful GP for your patients - but there is nothing artistic about it! To my opinion artists have some native artistic competencies - and you can bet that I do not have any artistic genes!
In Denmark, you have to be specifically trained to be a GP trainer. We emphasise to trainers how important the feedback is to the trainees on their clinical work - and that they should be aware of the fact that the trainers will be seen as role models. All surveys show what a great effect it has when a young doctor experiences a dedicated senior doctor/trainer. Good role models are the principal recruitment instrument for our specialty.
What are your interests as a family physician and also outside work?
I have explained some of my interests already, especially the educational work, but I also have had an interest in medical organisation matters. I was the chair of The Danish College for GPs (DSAM) for six years and experienced significant challenges in this work. I think cooperation among all medical specialties is very important (I don’t see GPs as “we” and the other specialists as “them”), so I am on the board for the umbrella organisation for all Danish specialist doctors.
On the international level I am now part of the Executive Board of WONCA Europe - and this gives me a good insight into the conditions that GPs face across Europe - and very few are as privileged as we are in Denmark.
Despite there being so little time outside my work interests, top priority is of course my family. When my children were smaller my wife and I tried to show them many places on the globe, and in that allow them understand that living conditions vary a lot around the world and hopefully also give them humility regarding the privileged conditions we have in northern Europe, and awareness about how we have to cooperate with all people on the globe. My children are now older and our first grandchild , Sigrid, arrived six months ago so she is now the top-top priority :) - she is surely the 'icing on the cake'.
Read Roar's views on the 2016 WONCA Europe conference coming to Copenhagen