Reemerging and reaffirming importance of Primary Practice

Silver line in Dark Cloud of Corona Pandemic:

Reemerging and reaffirming importance of Primary Practice.

On the eve of doctor’s day a thought came to my mind about how the basis of delivery healthcare delivery has changed over a period of time.

Before the current pandemic, the society and unfortunately major stake holders and policy makers have just forgotten or overlook the importance of primary care in the country.

We family physicians firmly believe that primary care or family physicians are backbone and most important pillar of any healthcare system, anywhere in the world, but all miserably failed to accept it and have move forward and this fast life and unfortunately paying price for it.

Robust primary care in needed at all times, may it be current pandemic or ever emerging threat of lifestyle diseases.

Let’s have a look what primary care has done in these unprecedented times for across the world.

The main weapons or strategy  to counter current pandemic and manage it are:

1.    Change in behavior of public: most important, the specialty which connected to grass root can do it the best.

2.    Mass public education: via clinics and social media and people still believe what there doctors say….

3.    Early diagnosis: first contact point

4.    Community tracing: good knowledge of social background of patients and community

5.    Early referral in cases where it is needed: identifying danger sings early

6.    Effective follow up of confirmed cases after acute phase is over: post discharge care: answering never ending questions

7.    Home quarantined patients care: customized guidance depending upon patient profile,follow up of vital signs

8.    Psychological counselling: dispel the myths and remove anxiety,panic

And much more, which could do it effectively or better to say already, done it? Of course the answer is loud and clear.

You will be surprised to know that many patients were diagnosed (because family physicians could identify high risk patients as they have strong index of suspicion and community connect and of course they are updated) in just first visit and that too in just 100Rs (most of the family physicians are under paid for the class of service that they provide-but that is not the topic today, some other time): single consultation.

Can you imagine such an affordable care that country like India needed the most?

There are some very milder cases that can be easily managed on out patient basis and treating at home and yet too economical.

This pandemic has 2 main challenges

1. Economic burden on society: because most of the businesses are affected badly, so need affordable care and this will be needed for may be long time.

2. We do not want people to roam around: so need easily accessible healthcare in their nearby.

Both this challenges can be easily met with robust and efficient primary care.

The intent of this article is to show torchlight to the society and planners to re look at the way they deal with primary care.Need is to plan and promote it properly and secondly I wanted to thank you to my family physician colleagues, any where in the system, government or private to keep up the good work that they are doing now and always.

Let’s take a pledge and make a society, where everyone has a family doctor, making healthcare the way it should be: Good quality, easy to access and yet affordable.

Thanks you.

Dr.Pragnesh Vachharajani

Family physician, Ahmedabad

Joint Secretary, federation of family physicians of India

Secretary, Gujarat state family physicians` forum

Past president, IMA, Ahmedabad.

(Views expressed here are personal)