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