The Family Physician Revisited

This is the era of specialisation, nay super specialisation and more. In healthcare services, the immediate casualty of this madness has been the family physician. And what a loss it has been.

During my childhood and teenage, which happened in the eighties, we always had Dr. Bajpai as our family physician. Dr. Bajpai had a clinic in the MG Road area in Indore, where we lived. He also ran a clinic from his residence and we were regular visitors at both these places. His residence was closer to ours and we would visit him there more often. I still recall his magnificent dog ‘Sultan’, who would invariably greet us with his loud barks. Dr. Bajpai was a kindly soul, who would usually prescribe simple oral medicines and we would be back in school in a day or two. I do not recall being asked to submit to the needle too often or visit a radiologist for X-Rays. The only time we were sure of needles, was when we would be taken to him for cuts and bleeds. He would get his ancient compounder to give us a tetanus shot. After this trauma, our mother would buy us a Limca from a neighbouring store (Ratan Sweets if I recall correctly)  

Family Physicians of yore were very often family. They were always invited to a family wedding, were welcome home and really in a broad sense were family friends. I vividly recall my father taking a box of sweets to Dr. Bajpai, when my sister started medical school and Dr. Bajpai stopped charging her his fee as is the custom amongst doctors. 

We never ever saw a hospital in all those years in Indore. We grew up with our share of illnesses, which Dr. Bajpai had no problems in fixing. To us he was the final solution to all our medical problems. 

Now, when I see parents with young children in hospitals seeking specialised care for their family, I wonder where have all the old fashioned family physicians disappeared. I understand young graduates passing out from medical colleges hardly want to get into family medicine. The lure of a large hospital, big bucks and the the possibility of trying their hands on the latest gizmos drives most of them away from Family Medicine. Over the years ‘Family Medicine’ has slipped down the totem pole and many family physicians hate to be called family physicians!

This is sad but true. The gradual loss of the Family Physician is inducing more and more people to self medicate. Many people (including, I must confess, me) prefer to tryout self medication before going to a specialist. This I know can be very dangerous. Why would I do this? I believe I do not need a specialist for minor ailments, I would hate to undergo a battery of tests that a specialist would inevitably prescribe and for many folks going to a specialist is too expensive an option.

I would also like to believe that a Family Physician represents the most benign face of medicine. Big doctors in big hospitals around bigger machines are scary. A gentle family physician, with his stethoscope conjures up a friendlier image.

Family Physicians have traditionally been the repository of the entire medical history of the family. They knew when the little one had a upset stomach last, and when a bug had the elder one down with measles and when the naughtiest one broke his arm. All this and more allow for great continuity of care.

Here is my salute to Dr. Bajpai, and all those family physcians, who have kept the tradition of the friendly neighbourhood doctor alive. I would love to see their breed thrive and grow from strength to strenght. 

They have my best wishes.

Pic courtesy http://www.flickr.com/NYN

 

 

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One thought on “The Family Physician Revisited

  1. That’s very true!
    This brings to question as how does one become a family physician, what skills are required to do so and what training pathways exist to achieve these; unfortunately not much barring the DNB program. Therefore these days’ physicians who are unable to make it to any specialty programs end up practicing family medicine by default. Whereas in the West the medical graduates are encouraged and specifically trained and certified in general practice (rotated through all major specialties) and subsequently strongly supported in their practice. It is important to recognize that in this era of rapidly expanding knowledge base in Medicine it is not an easy task practicing in a wide spectrum of disorders requires regular updating & upskilling. The skills acquired in the undergraduate Medical programs fall short of this requiring further training.
    Family medicine is not necessarily as unpopular as thought to be and people understand the rewards it can bring (both in relationships & kind), but it is lack of any support & official recognization that is the frustrating bit.
    In an era of cost blow outs in health care it is imperative to nurture and develop family medicine but like many other things the governments of the day, Medical Council of India and the universities fail to see this simple logic. They should be understood that if they fail to achieve clinical governance the insurance companies will thrust it upon them one day ( read: make it mandatory to see a family physician before seeing a specialist)

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