The Indian Family Physician on his way to extinction?

The Indian Family Physician on his way to extinction?

Dr. Allan, happily welcomes Sunny, an otherwise chirpy 5 year old into his clinic. Sunny is feverish. “Measles”, says Dr. Allan confidently, having seen hundreds of cases in his clinical practice. Dr. Allan’s clinic is a landmark in a Mumbai suburb and has seen a steady flow of patients, morning and evening everyday for the last thirty years. Sunny is the third generation of the Bhatia family coming to Dr. Allan for medical treatment. Several general practitioners like Dr. Allan, custodians of family medical histories, have formed the primary healthcare foundation of India. They play an elementary role in the Indian healthcare system, not just addressing the patient load efficiently but also providing the affordable healing touch.

Recent studies however indicate that there are far lesser numbers of medical graduates opting for general practice. Dr. Raghvendra M.S, Bangalore based Dean of Family Physicians of India says “the era of 10 x 10 clinics is gone”. Progressing medical research has so expanded the realms of medical care that it is increasingly being felt that no individual can provide the best possible medical care in general. Fueled by rising incomes and augmented awareness; patients are naturally gravitating to specialized centers. Today is an era of specialization. Tomorrow, may move to super-specialization.

From an India perspective is this a healthy shift? Brandcare’s report on “Understanding Healthcare Consumer Behavior: The Young and Urban” reflects such a shift where 41% of the respondents prefer visiting a specialist over a general practitioner. As per the Medical Council of India (MCI), the total number of doctors registered (allopathic) in the country is around eight lakhs Which means the doctor-population ratio is around 1:2000. When the first point of care is in such under supply can we afford a run for the specialist? Without a solid foundation of primary care the entire health system can become unstable and unbalanced. In the United Kingdom, for example; it is required that every individual must have a GP and a patient can be admitted to the hospital only on advice of the GP. Studies have revealed that an effective primary care system — with the family physician as its backbone — can bring down health costs drastically.

The answer to reinstate the vanishing family physician may lie in persuasion at different levels. The IMA needs to pursue the issue with the government in creating referral policies and family medicine specializations. More persuasion is required perhaps at the student level to revive the lost glory of the family physician. On an equal scale the consumer needs persuasion to go back to his Dr. Allan!

1. http://data.gov.in

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Rashmi Thosar, CEO

Brandcare Medical Advertising & Consultancy

 

2 Replies to “The Indian Family Physician on his way to extinction?”

  1. According to India Knowledge@Wharton, the primary health care sector in India is around US$39 billion in total size and the industry is highly fragmented. It has been estimated that India has around 26,000 government-run primary health care centers and 615 district-level hospitals. We have around 200,000 privately-owned general physician clinics in the country. These facilities are meant to provide low-cost health care system to public. Also a first contact for a patient with an undiagnosed health concern. Brandcare’s report on “Understanding Healthcare Consumer Behavior: The Young and Urban” reveals that large % of today’s youth are visiting to specialists directly and even multi-specialty hospitals. One of the reason can be perceived poor quality of delivery at primary care physicians end. Because of this, primary care healthcare system will may remain underutilized and it can also boosts the overall healthcare costs of the country. Our healthcare system is going heavily skewed towards tertiary services and focus on primary care system is reducing. 25-30 years ago, first point of contact for all illnesses was Primary care. People trusted their physicians and was relying on primary care physicians for continuous management of their disease. But its not the same scenario now. Efforts should be taken to give required strength to primary care healthcare system.

  2. Family physician is quite skillful when it comes to preventing or treating sensitive illnesses that patients suffer from. Also they are the ones who can properly guide someone for long term diseases. In Tier 1 cities like Mumbai, Delhi, Bangalore, etc. taking decisions without any reliable doctor’s consent can be risky. Trusting suggestions by family physician may be a safer option.

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