Hyderabad medical fraternity advocates for return of family physicians

HYDERABAD: The medical fraternity in Hyderabad is advocating for the return of the concept of family physicians (FPs) after CM Revanth Reddy's push for it earlier this year.

Their key solution: Introducing family medicine departments at the postgraduate level across hospitals and colleges in the state. Doctors feel this can go a long way in reviving the FP model, which is crucial for comprehensive care, cutting down healthcare costs, and improving chronic disease treatment over specialist-driven care.

"About two decades ago, family medicine was offered in colleges in the state. Now, it is no longer part of the 22 specialties offered as part of the MD course," said Dr Kiran Madala, general secretary of the Telangana Teaching Government Doctors Association (TTGDA). He urged the Telangana govt to take this up with the National Medical Council (NMC) so that family medicine can be made a regular course in medical colleges.

While Telangana has zero such seats at present, across India too, the situation is rather grim. As per the NMC website, barring seven states that offer just about 17 seats, no other state has provision to pursue family medicine. These seven states include all the other major states from the south except Telangana. While Goa Medical College (GMC) mulled introducing an FP-focused MD course in late 2024, a year earlier, former AP CM YS Jagan Reddy launched the family doctor programme under which over 10,000 qualified doctors were attached to villages.

Incidentally, the Academy of Family Physicians of India (AFPI) also recently submitted a representation to the health minister, Damaodar Rajanarasimha, appealing to start a family medicine department in medical colleges. "The minister gave orders to the DME to do all the paperwork and apply for the family medicine department in Gandhi, Osmania, NIMS, and another hospital in Warangal. We pointed out the need for a family medicine department in all govt and private medical colleges and having an FP as a specialist in CHCs and other secondary institutions as it is mandated under Indian Public Health Standard (IPHS) guidelines. We will be giving a presentation on the same to the minister in the coming days," Dr M Sunil, a general physician and AFPI general secretary, told TOI.

Seconding it, Dr A Narendra Kumar, director of medical education (DME), reiterated how family medicine courses can help in ensuring better healthcare with reduced costs. About introducing the course in the department, he said, "It takes a unit of professors to start a department. But until we rope them in, a professor from another department, maybe a general physician, can take over the family medicine department and manage it. This is because the NMC norms provide a relaxation of a few years regarding this."

Dr Madala noted that the govt push is necessary for the family medicine course as it will also encourage private players to employ more doctors from this field. Apart from this, doctors also stress the need to incentivise more graduating doctors to pursue family medicine. They recommend that these graduates be integrated as FPs into primary care systems, particularly PHCs and CHCs, and the Ayushman Bharat scheme.

"Clinics and nursing homes are on the wane owing to lack of demand, especially with corporate institutions now also moving into tier-2 and tier-3 cities. However, this has made healthcare more expensive. We, therefore, need to offer the family medicine course initially to encourage the trend of FPs," Dr Burri Rangareddy, chairman, public health, IMA Telangana. He added that this will ensure that 80% of patients in the state receive good quality treatment near their homes. "Collaboration between policymakers, medical institutions, and private healthcare is essential. This will reduce out-of-pocket expenditure (OOPE)," he added.

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Dr D Nageshwar Reddy, chairman, AIG Hospital, stressed that private hospitals can have separate facilities for the FPs. "We have a family physician cell in the AIG that looks after several families. Over time, trust also develops between the patients and family physicians."

Dr Sudhir Kumar, senior neurologist, Apollo Hospital, emphasised that conducting awareness campaigns will encourage patients to visit family physicians over specialists. "In countries such as the US and UK, it is mandatory to meet a family physician first, but in India, people directly consult a specialist even for a small diagnosis, which sometimes has a very simple solution. This leads to high costs and more time in treatment."