Once Upon a time, society was known to have a good number of family physicians who were part and parcel of the healthcare system of family structure in Indian society. A Family Physician is an aptly trained & skilled clinician who has an expert knowledge of a wide range of common health problems which are small, transient, and more prevalent. A family physician attends patients with his private practice in a local community and takes care of primary and less common but life threatening and treatable emergencies also in patients of all age group and in their family. Family physician provide healthcare services based on best scientific evidences. These evidences are integrated sensitively, skilfully and after appropriate search for prevailing patterns of disease. This way family physician comprehends an effective management of diseases on OPD basis at a very affordable costing to end user to keep them healthy.
In last few decades concept of family physician or general practice is thinned. Times are gone of family physician as once society used to this grass root level Doctor . And now the scene is reversed as society has ample number of consultants/specialists and super specialists. Time is ripe to have high end techno-savvy and intervention oriented super physicians and super surgeons. But in process of becoming a high-end doctor, this concept of family physicians has seen a downtrend. The Doctor attending families on a regular basis was a cushion between the consultant and home Remedy Treatment protocol. He was a cushion between early diagnostic treatment and high-end investigation in hospitals. He was a cushion between small and trivial surgical repair works and high-end surgical interventions. He was a cushion between early detection of crucial disease and late-stage expensive treatment. He was a cushion between economical, cure protocol and expensive corporate hospital protocol. He was instrumental in keeping a family Profile of his patients and families and patterns to detect disease early enough. He was instrumental in attending the patient all through the day and get a proper treatment done at a very affordable price. Due to lost Family Physician now society has lost faith in doctor in general. Battery of investigation and referral to consultants have made holes in the pocket of the patients. Remaining damage has been done by mushrooming of corporate hospitals. High end Hospitals have their sole Motto of money making only and getting their company listed to stock exchanges or to concentrate on growth in topline & bottomline in their balance sheet. Poor status of government hospitals with respect to human resources and availability of medicines have been a long-lasting stand and leading to poor societal status of health providing services. Need of the hour is to revive this institution of family physician in society where people can avail basic and primary treatment at minimal cost. Many MBBS graduates who don’t get postgraduate admission may opt to have a family physician establish their practice in small town area which attract rural population for their market needs. Many quacks and medical shop owners are having a shadow practice in this way only in rural areas. Such half cooked Medical man have generated a pattern of malpractice which leads to delayed diagnosis and delayed referral to higher centres in case of major diseases costing much to the end user.
Religious or Societal institutions may come forward who have community halls where in a room for daily OPD can be spared. These rooms may accommodate family physician on salary or on rental basis to extend Sharing of knowledge and medicines. This way, society will incorporate family physician who can serve to have early diagnosis of critical situations and refer critically ill patients to higher centres. Primary Health centres in government sector are barely fulfilling their duties because of lack of human resources and infrastructure and above all their remote locations and difficult access. Recruited doctors join these remote PHCs and leave as there is no residential Building or other institutions. Neither it’s possible to have all facilities at such PHCs. A residential House and good salary with the team of paramedics will enhance the moral of new graduates to work in such grave situations at such remote postings. Neither doctors nor school teachers join for such rural postings and this situation continues to serve sequentially. Need is to recruit such fresh medical Graduates who are from a rural background and are willing to serve in their home district or in Hometown or even in their PSC village where from they can look after even their farmland as well. The understanding of medical profession as a cash crop has ruined the whole structure of medical education as its very cost driven affair nowadays. One me ask why and how? The answer is simple. No doubt private medical colleges have cashed in, on demand of social status lying behind a medical degree to their ward and generate high profile on intellectual, social, and financial scale in a single shot. Social reformation in field of medical education must be incorporated, one day or the other, as a student from low socio-economic strata or from peasant society will generate in altogether different societal and familial bondage which at this moment, we are losing. Family Physician is an axis around which family and secondary-tertiary level hospital run around. Nowadays, rushing into a corporate hospitals for small and trivial ailments, ultimately leads to too expensive outcome. And thereby generating an uproar that doctors are dacoits and looters. That's the wrong narrative. And this is because of possibility of lost entity of family physician. Let's turn around and move to our local family physician
AK Bhadoria Blog 
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