On this world family Doctors day…..for the desk of a family doctor(family physician)

Wishing all my colleagues and patients a happy family doctors day.

You will not find super sale offers on this day unlike other day which are commercialized. So there are chances that unlike our contribution to society this day you could not have remember easily or might not be even aware of.

As we all know and it is well established fact that family physicians are important pillars of any healthcare system of the world. We are essential to maintain balance in terms of quality of care, affordable healthcare and  most needed health care all near them; family physician is essential and forms the most important part of healthcare delivery system. 

The next decade is of lifestyle disease and family physicians role will gain more importance for effectively managing this and most importantly preventing it. Preventive medicine is most the neglected part and we family physicians are the most important workforce to fight this looming threat of lifestyle disease affecting approximately 1/5 of the populations worldwide.

What a family physician does for society….

• ·         He or she understands your social as well medical conditions better than any other specialty.
• ·         Lots of conditions especially lifestyle diseases require multi pronged approach, a blend of social, medical and psychological aspects, which only family physician can do.
• ·         Economical yet effective treatment delivery is essential world vide as the cost of treatment are going up due to various uncontrollable factors. That`s the key of effective primary care.
• ·         Mental health is a really concern in today`s era, stress, anxiety and other mental disorders affect ones productivity and other aspects. A 360 degrees approach is required to manage this and family physician is the person who can do it very effectively.
• ·         Timely diagnosis and effective referral for life threatening condition is life saving and important to limit the morbitidity (effect on quality of life) and prevent death as far as possible. With limited resources we are doing this.
• ·         Effective rehabilitation (a totally neglected segment as far as India is concerned) after major illness like cardiac etc. Regular follow up with vigilant eye on medical condition, constant motivation and keeping in loop all the healthcare providers is key for this.
• ·         Guiding to select the right treatment, helping in taking decisions at a time when patients needs help and confused due to variety of treatment options and fear of unknown and obvious lack of knowledge.
• ·         Day to day management of minor or seasonal aliments is also important. This is gaining importance as there is indiscriminate use of antibiotics in minor ailments due to ease of availability (lack of knowledge, dispensing without prescription and re use of prescription are main cause) this is led to emergence of antibiotic resistance which is quite dangerous.
• ·         Most importantly apart from treatment, family physicians gives you time, he listens to you, answer most of your questions patiently which is important for satisfaction on part of patient and relatives.
• ·         It is seen worldwide that bypassing primary care always results in high treatment expense and many a times low level of satisfaction.
• ·         Home Care: as the life expectancy has increased and treatment options are effective the management of chronic disease and ageing issues require domiciliary treatment. Effective home care is now becoming very important.

We feel happy and thank god for giving us this noble profession when:

• ·         When our patients does well after recovering from a serious illness, comes back to us and say few words of gratitude, this makes our day even without monetary gain.
• ·         When we counsel someone for a social condition like teenage issues or some family disputes etc and they accept our suggestions and family lived happily.(recent example of girl who do not wish to marry due to some misconception in her mind and after engagement family comes with box of sweets)
• ·         When we treat someone for something trivial or routine aliments at his or her important time of life like important exams, marriage or special occasion or something like that, and do they could do well in that and acknowledge that.
• ·         When some senior citizens(staying alone or in family & who are always looking for social warmth) come to us and bless us with few words after being treated and feeling better.
• ·         Being invited at good occasions and our need felt bad times of our family patients.

We feel bad when……

• ·         When patients become impatient and visit a specialist directly for a minor aliment on first day or visit a specialist on advise of family member or friend based  on their “experience”
• ·         Parents of a child feel that family physicians are not capable of treating pediatric patients and do routine work like vaccination. (At times they bluntly told us that please manage my child for a day, as my pediatrician in not available today). Family physicians are good for all ages and children are not an exception.
• ·         After diagnosing a life threatening condition like Heart attack immediately and suggesting a timely referral, the patient and relative do not turn to say just “thank you doctor” after being treated in a corporate hospital.  Even God needs appreciation, and then family physicians are humans only. This is not with all but with many.
• ·         “Just asking “for certificate even without taking treatment.
• ·         After showing piles of reports and files of 3-4 hospitals (on which they have spend thousands of rupees) for seeking professional opinion on what to do as they are confused , When they are leaving the consulting room, they will ask “Sir, are we supposed to pay anything ? “ Because you are our family doctor.
• ·         The person who knows everything  in the city(like where to eat famous food items etc), very particular in choosing things used in day to day life,  takes treatment from a quack or crosspatch even without bothering to know his degree. When you can choose everything perfectly why not a doctor?
• ·         When the other stake holders of healthcare system like Government do not bother consult us or just meeting our recognized body even once year to discuss about our core area of expertise
• ·         When the corporate hospitals tries to get patients directly bypassing primary care at all, by various check up schemes etc and not sending patients back for day to day management once admitted there.
• ·         Not being paid enough. Because of cut throat competition from quacks, cross paths doctors and undercharging specialists and mindset of society of asking some causal consultations for free or taking things for granted.  Everyone has right to leave good life, everyone has right to dream and to have basic comforts of life. Why expecting charity from us only?

The bright future:

• ·         Family practice in phase of complete transformation. Newer generation family practice will completely changed with effective primary care, more treatment options for patients in their vicinity and more range of service at family physicians clinic.
• ·         Technology like virtual visits, online consultation will increase so patients can consult or contact doctor at their comfort.
• ·         One stop shop for all primary care needs like pharmacy, blood investigations, home care, medical equipments etc.
• ·         Completely coordinated care with super specialist for chronic disease like Heart disease, diabetes, cancer etc.

 As we always look upon for new things from western world all the time, let’s see that they are putting so much of efforts and money behind strengthening the primary care.

We wish that tomorrow every family has a family doctor to rely upon and will try to deliver as per expectation.

Have a great time.

Dr.Pragnesh M.Vachharajani

Family physician.