There were times when seniors in the family preferred visiting their family physician over consulting a specialist. While there are probably a handful of families who still insist on this, the practice has largely faded away in favour of specialist doctors.
However, it’s interesting to know that several specialist doctors, themselves, are now advocating for the return of the concept of family physicians or doctors.
“If the family physician concept is brought back in India, there will be many chronic diseases that can be diagnosed early, including chronic kidney disease,” says Dr Sundar Sankaran, programme director at Aster Institute of Renal Transplantation.
“Simple blood tests done at every primary healthcare centre by the family physicians can reduce out-of-pocket expenditures too. A specialist consultation can definitely be minimised then,” Dr Sankaran told South First.
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Who is a family physician?
A family physician is a medical doctor who provides primary care to patients of all ages. They are often the first point of contact for patients with health concerns and they play a vital role in preventing and managing chronic conditions like kidney disease.
Speaking to South First, Dr Rajeev Jayadevan, former IMA president from Kochi, agrees that it is absolutely important to have a family physician.
He says that in all developed nations, a family physician or general practitioner (GP) occupies a key position in healthcare delivery. This used to be the case in India as well, but with urbanisation and an increase in the number of specialists, patients in India tend to refer themselves directly to the specialist.
However, a regular family doctor knows all the members of the family and understands the social, economic, and health-related issues of the entire family, and is able to guide them over a long period of time.
Shift in disease burden & role of family doctors
Doctors were of the opinion that health is being shaped by powerful forces like demographic ageing, rapid urbanisation, and globalisation of unhealthy lifestyles.
“With pressure from these forces, the disease burden has shifted in a fundamental way. Chronic non-communicable diseases have overtaken infectious diseases as the leading cause of morbidity, disability, and mortality. This shift has major implications for the organisation, financing, and delivery of healthcare,” says Dr Sanjay G, an independent physician in Bengaluru.
Regardless of the type of chronic disease, early detection and treatment are essential for managing the condition and preventing complications. This is where the role of a family physician becomes crucial.
These family physicians, who will not only know your own history but also that of your entire family, make it easier to diagnose and take care of all types of conditions and believe they all need attention.
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“Family medicine physicians are trained to address the most common medical needs of a patient, irrespective of age and gender. They also have knowledge of a range of medical subjects and specialities. The focus of a family physician is the patient as a whole. Not just physical illness, but also wellness of the patient,” explains Dr Kaiser Raja, renowned liver specialist from Aster Hospital, Bengaluru.
Sometimes, a patient ends up seeing a cardiologist for his heart issue, but then if there is any other hidden disease — like a liver-related issue or a gynecological problem — it may be missed. If screened by a family physician, the patient can be looked at holistically, say the specialists.
Many celebrities, politicians have family physicians
Explaining the importance of having a doctor for your family, Dr Sujith Vasudevan, who is a family physician continuing his father’s legacy in Kerala’s Kochi, says, “It is unfortunate that now people go to one doctor for left thumb pain and another for the right thumb. Even for acidity, they rush to a gastroenterologist. Instead, if there is one family physician who knows your condition in and out, this helps a lot.”
He says that in cities like Mumbai, many people have a family doctor. In fact, many celebrities refuse to see any other doctor unless referred by their family doctor.
“We are like glorified traffic policemen. We watch people and direct them where to go so that they don’t end up in trouble,” the family physician at Ojus Clinic in Ernakulam tells South First.
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India needs the concept of family physician!
Interestingly, the Andhra Pradesh government, after a pilot study, launched the “family doctor project” on 15 March. Under this, a doctor from a primary health centre (PHC) will be made available to look after the health needs of people in wards and villages. The doctor will provide patient services for the residents of the wards.
Dr Arvind Conjeevaram, consultant nephrologist and transplant physician at Trustwell Hospitals, Bengaluru, says that similarly, state governments and the Union Health Ministry must bring in the concept of family physician to every PHC.
“Namma Clinics, set up by the Karnataka government, can implement this there. Andhra Pradesh is also doing something similar. Even if some basic screenings that cost very little can be done here by these physicians, the out-of-pocket expenditure and burden on healthcare can be reduced to a great extent. Prevention of several chronic diseases can be seen,” he said.
These families will contact their family physician and, if required, they will approve referral as per government or the local system to develop for secondary or tertiary care.
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How to find a family physician near me?
Doctors also suggest that people themselves should track down a family physician in their respective areas and visit the person for all check-ups.
Family physicians should be certified in family medicine. There are many hospitals that give certified courses of family medicine as well.
Dr Sujith Vasudevan predicts that family physician as a stream of medicine is going to pick up in India soon.
“India is known to imitate the West. The concept of family physicians, which was there in the US, had died down but it’s being revived now. So, in India too this will work. The personal touch that is needed, where your family physicians are even invited homes for lunch/dinner, will come back,” he says.
Doctors explain that the family physician need not be only those who are independent practitioners, but a hospital can have a family physician too.