‘Specialisation, patient choices make family docs rare’

Bengaluru: Be it common cold, headache, allergy or even serious ailments, Indian households have always turned to the family doctor for help.
However, experts say the number of family physicians is reducing of late, with patients heading to specialists. Members of the medical fraternity expressed the view during a recent talk at Bangalore International Centre — ‘Rescuing Health: A Call to Citizens and Doctors’.

An audience member, Dr Hema Pai, who retired as a family doctor, shared the concern.“Only 10 per cent of family doctors remain. Family physicians are extremely important as they are more than just doctors. They provide a psycho-social safety net to the family, and it is unfortunate that we are seeing few of them around,” said Dr Pai, who is in her 70s. She explained how such doctors know a family in and out and can understand the cause behind their ailments.
Experts said there are two factors involved. With corporatisation of healthcare, doctors are choosing to opt for specialisations as they offer monetary benefits. Secondly, patients have started opting for what looks attractive and ‘branded’.
Dr Pai said patients tend to self-diagnose their ailments through Google and decide for themselves that they need to visit a specialist. “There is no personal touch or warmth to it. With a family doctor, one can say anything under the sun,” she added.
Dr Anjali Rao, former additional director of Central Government Health Scheme, told TOI family doctors know patients well enough and facilitate the best treatment, with a holistic approach, avoiding unnecessary medication and repetitive tests or scans. “To be a family doctor is also an art. There is a certain rapport and a personal touch with the doctor. These days, there are specialisation courses after MBBS like diplomate in family medicine for one to become a family doctor,” Dr Rao said, explaining how family doctors are not specialists but follow a comprehensive approach when it comes to their patients’ health. “Go to your family doctor, not directly to a specialist. Your doctor knows when to refer you to a specialist,” she advised.
Dr Rao also had suggestions to make rural postings of doctors a rewarding experience, not just for medicos but also the areas they are posted in. “Instead of sending just doctors, we must also send a team of civil engineers, electrical engineers, mechanical engineers and lawyers and economists. The DCs will handle administration and finance. This will facilitate well-rounded development of the rural area through required infrastructural growth that a doctor needs to discharge his/her duty,” she suggested.
Dr Kavery Nambisan, author and surgeon, called corporatisation of healthcare a dicey business, where profit and healing are two branches. “The government has a huge responsibility in ensuring social welfare in healthcare,” she said, adding that humanities must become a part of medical education to help doctors develop the ability to reflect and not just stick to the mechanical task of repairing bodies.
The audience also expressed concerns over violence against doctors. Dr Mario Vaz, professor of physiology, IMS Ramaiah, said citizens must take a stand for a good healthcare system, but violence is not the way.