Family doctors work in private practices, clinics, or health centres, serving as the first point of contact for patients seeking medical care.
Published Mar 09, 2024 | 8:00 AM ⚊ Updated Mar 09, 2024 | 8:00 AM
Representational image. (UNICEF)
In a compelling editorial, featured in the Journal of Family Medicine and Primary Care, Dr Raman Kumar, the National President of the Academy of Family Physicians of India, passionately implores the National Medical Commission (NMC) to integrate family medicine into India’s medical education curriculum.
Dr Kumar’s editorial underscores the pivotal role family medicine plays in the healthcare ecosystem, harkening back to India’s traditional Vaidya system. This ancient practice witnessed local healers, or Vaidyas, delivering personalised, holistic care to families within their communities — a precursor to the modern family physician’s role.
Despite its historical precedence and undeniable benefits, family medicine encounters significant hurdles in gaining recognition and integration into India’s medical education.
The editorial points out that, while the National Medical Commission Act, 2019, lays the groundwork for family medicine, it has yet to mandate its inclusion as an essential part of the MBBS curriculum. According to Dr Kumar, this gap restricts the potential of future physicians to provide comprehensive, community-oriented care.
Dr Kumar, in his editorial, explains the concept of a family physician, stating that the idea is not new in India. He argues, “It’s been around for a very long time, rooted in the country’s Vaidya tradition. ‘Vaidyas’ were local doctors who knew the families in their communities well and took care of them, offering personalised and basic healthcare. This role is much like what we call a family physician today, and it’s a practice that’s been part of Indian culture for thousands of years.”
A family physician, a type of medical doctor, provides primary healthcare services to individuals across all age groups. They serve as the initial point of consultation for individuals with medical issues, playing a crucial role in preventing and overseeing chronic diseases.
Family physicians work in various settings, including private practices, clinics, and community health centres, often serving as the first point of contact for patients seeking medical care.
In an earlier interview, South First had spoken to Dr Sujith Vasudevan, a renowned family physician continuing his father’s legacy in Ernakulam. “It is unfortunate that now, people go to one doctor for left thumb pain and another for the right thumb. They rush to different specialists for each problem. Instead, it helps if there is one family physician who knows your condition in and out,” he had said.
Meanwhile, Dr Kumar, in his editorial, stresses the ongoing need for doctors who understand and care for the community’s health in a personalised way. Family doctors play a significant role in keeping people healthy, preventing illnesses, and treating various health problems.
According to Section 24 (1)(c) of the NMC Act, the role of the Undergraduate Medical Education Board includes creating a comprehensive, skills-focused curriculum that meets the requirements of primary healthcare, community health, and family medicine. Section 25 (1)(j), on the other hand, mandates the Postgraduate Medical Education Board to support and expand advanced studies in family medicine.
Additionally, Section 57 allows the NMC to establish guidelines to implement these educational and practice standards effectively.
While the mandate suggests the return of family physicians, Dr Kumar urges the NMC to actively promote and integrate family medicine concepts within the mainstream medical education system.
He emphasises the need for a “sound foundation” of family physicians. “There cannot be tall buildings without sound foundations. Similarly, no tertiary care specialist system can survive without a sound foundation of family physicians at the base. Hospitals alone cannot address the pressing public health needs and medical care of the most populous country in the world, India,” he says.
A medical regulator like the NMC should work towards 360-degree development of medical education and health system in India, he asserts, adding that all Indians should have access to high-quality primary care in future.
Dr Kumar’s editorial serves as a call to action and a reminder of the invaluable contributions family physicians can make in disease prevention, health promotion, and managing a wide range of health conditions. By integrating family medicine into the educational framework, Dr Kumar argues, India can build a healthcare system that is more accessible, effective, and deeply rooted in the ethos of its ancient medical traditions.
Interestingly the Andhra Pradesh government, under YS Jagan Mohan Reddy’s leadership, launched the concept of family doctors in 2023 and has received much appreciation.
The World Bank Group and Research Triangle Institute (RTI) have commended Andhra Pradesh for its effective implementation of the Family Doctor programme, enhancing healthcare services for the state’s residents.
Dr KS Jawahar Reddy, AP Chief Secretary, announced that these organisations conducted district-level research confirming the health benefits associated with the family doctor system. The family doctor programme has led to a notable increase in the number of diagnostic tests ordered by family doctors, compared to those ordered at primary health and village health centres, said the representatives from the RTI and World Bank Group.
In fact, the Chief Secretary anticipated a decrease in the workload of the Aarogyasri scheme due to the family doctor programme. He also highlighted the government’s heightened focus on preventing malnutrition and anaemia among women and girls through the family doctor initiative.
Doctors not affiliated with the published editorial strongly urge other state governments in India to consider reintroducing the concept of family doctors, emphasising the necessity for the NMC to mandate its inclusion in the MBBS curriculum.