© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
HEALTHCARE FOR SOCIETY
Community health advocate from paediatrics to elderly healthcare: an interview with Dr Ching-choi Lam
Michelle Tsui1, Natalie Cheuk2
1 Year 6 MBChB, The Chinese University of Hong Kong
2 Year 6 MBBS, The University of Hong Kong
Dr Ching-choi Lam, a dual specialist in paediatrics and community medicine, is a man who wears many hats. He is the current Chief Executive Officer of the Haven of Hope Christian Service, a non-official member of the Executive Council, Chairman of the Elderly Commission, and Chairman of the Council for Sustainable Development. Dr Lam has served two terms as a District Councillor in Sai Kung, and now advises the Hong Kong SAR Government on primary healthcare development. In addition to these varied roles, Dr Lam remains tirelessly active as a community paediatrician, serving the underprivileged population in the community clinics of the Haven of Hope Christian Service.
Dr Lam has engaged in public service throughout his career, reflecting his ardent desire to improve the lives of all those in need, from young children to vulnerable older adults; from patients in his clinic to the wider public in Hong Kong. Motivated by concern for those in need outside the traditional confines of a medical career, Dr Lam has extended his career into the realm of policy making. Dr Lam’s dedication to public service was recognised with a Silver Bauhinia Star in 2019 and he was appointed as a Justice of the Peace in 2003.
From paediatrician to champion for elderly health
After graduating from medical school, Dr Lam trained and practised paediatric medicine for many years before taking up his current role as the CEO of the Haven of Hope Christian Service. Dr Lam is often asked about his surprising change in direction from paediatrics to elderly health care and palliative care. Although children and elderly people occupy opposite ends of the age spectrum, in his eyes, they are both vulnerable populations deserving of care and attention. Dr Lam traces the beginning of his work with the elderly to his paediatrics training. He recalls that while a paediatrics trainee he read the first chapter of the Textbook of Paediatrics, titled “Community Paediatrics”. The chapter highlights the role of the environment in shaping a child’s development, sparking his belief in the importance of community work as a means of health promotion. While promoting the Healthy City Initiative, he further learnt about the “New Public Health” concept, which states that effective health promotion is based on a recognition of the interdependence of the health of people and the environment. When the government invited him to join the Elderly Commission in 2003, he embraced the opportunity gladly, considering it a natural direction to take.
Applying the art and science of medicine in the community
One of Dr Lam’s most eminent projects is the Elderly Service Programme Plan, which proposes a new direction of “Ageing in Place”. In Hong Kong, as in many other regions of the world with an ageing population, demand for residential care services for the elderly is outpacing existing supply. Although international and local research has demonstrated the benefits of ageing in place, that is, providing care for the elderly people at home rather than moving them to a dedicated residential care facility, the concept has faced much resistance and even protests from the Hong Kong community. The government was accused of proposing this policy to try avoiding its responsibility to provide adequate residential care places for the elderly with long-term care needs. In the face of dissent, Dr Lam sought to understand more deeply the perspectives of the patients, so he spent months listening to local older adults through personal meetings. His research revealed that 80% of older adults in Hong Kong prefer to age in place. Dr Lam realised that, despite resistance from many sectors, most older adults did not object to the idea and even wished to remain in the community. Determined that the challenges and worries of the elderly people should not be ignored, Dr Lam led the Elderly Commission to formulate the Elderly Services Programme Plan and proposed strengthening community care support to boost confidence in “Ageing in Place” among the elderly people and their families, and help them see community care as a desirable alternative to residential care.
Dr Lam rises to confront challenges with the humble and caring heart of a physician. This approach, which he also applies to his role as a community health advocate, strikes a parallel to his days as a paediatric trainee at the neonatal intensive care unit at Queen Elizabeth Hospital. At that time, he often faced the empathic reproval of parents who had very recently lost their newborn child despite the best treatment. Dr Lam admits that he often shed tears, even before the parents, showing them the depth of his sincerity and his care. Now, when he is communicating with the elderly protesters, he evokes their empathy in a similar way. He whole-heartedly believes that humility and sincerity of spirit speak louder than words, or any objective facts he may hold. The elderly individuals who attend the rallies against his policies are often moved by his sincerity and sometimes reconcile by shaking his hand and taking photographs together.
Integrity in action as well as belief
One might question how it is possible for a doctor to fill so many roles. Dr Lam says that, despite rarely taking a day off from work, he avoids burnout by maintaining a balanced lifestyle and keeping his body and mind healthy. As a Christian, Dr Lam names integrity as one of his core values. He believes in the importance of consistency in one’s professed beliefs, which bridges the gap between theory and action. As a doctor, he advocates exercise as a form of preventive medicine, and he practises what he preaches; Dr Lam is an enthusiastic recreational cyclist who covers more than 200 km per week.
In his trans-disciplinary career, Dr Lam brings medicine from the clinics into the wider community, demonstrating how to “go beyond”, as he likes to put it. Ultimately, health is a multidimensional concept. Applying his range of clinical experience creatively in his many roles, Dr Lam combines the art and the science of medicine as a true advocate of community health.
Figure 3. Dr Lam taking part in a discussion on Innovating Future Health and Care forum at the 2021 Knowledge of Design Week
Figure 4. Dr Lam (bottom) with Hong Kong Medical Journal Student Reporters Natalie (left) and Michelle (right)