Kamal Narayan, CEO, IHW Council emphasises that it is interesting to note that the problems of accessibility and affordability can be effectively managed if the notion of family physicians catches the fancy of the Indian middle class, as it was previously
Medicines can cure diseases it is said but it is only doctors who can cure patients, the statement rightly emphasis on the important role that doctors play in our lives, more so if they are known to us since the early days of our lives as our family doctors. Primary physicians play an imperative role in ensuring personalised and comprehensive care to patients as well as their families. However, it is disheartening to note that the concept of family physicians has been reduced substantially, in the overall healthcare ecosystem, owing to a gamut of reasons. Development of super-specialty sections in healthcare with focus on single organ care and diseases being one of the most evidentreasons for shifting the focus fromnearby clinics to multi-specialty hospitals.
In the present circumstances the shifting of health discourse from curative to preventive and the importance of family history in the course of treatment and prevention of genetic disorders, it has been realised that the family physicianholds the key to better health of all in the family. Family medicine has also emerged as an important aspect of healthcare systems and in keeping with present discourse on health focusses on the holistic development and wellbeing of individuals. Even during the pandemic, it was realized that though the efforts of the tertiary care units were noted and lauded, the relentless contribution of primary care workforce in providing home – based care, monitoring and treating a large chunk of the population was negated.
At the present juncture, the healthcare ecosystem is all set for great strides with a host of possibilities and avenues provided by the changing landscape including rapid digitalisation. However, with the series ofchanges being ushered in, it is equally important to revive the concept of family physicians and to promotefamily medicine as a significant clinical specialty.
Revisiting the concept of family doctors
The concept of family doctors is not an alien notion for Indians and traditionally family physicians were important part of Indian households. They not only managed the health of the family but also played the role of friend and counselor of the family, providing suggestions on critical issues ranging from health and wellbeing though not limited to that. In fact, there are many health issues that plague Indian healthcare system and can be managed effectively by promoting the concept of family physicians, who traditionally were the first point of contact, for immediate health concerns.
Role models to address public health concerns
It is interesting to note that the problems of accessibility and affordability can be effectively managed if the notion of family physicians catches the fancy of the Indian middle class, as it was previously. Family physicians are not only easily accessible and literally just a phone call away but can also address the issues of cost-effectiveness, reducing unnecessaryout-of-pocket-expenses in healthcare. By providing preventive care and early intervention, they can help avoid costly complications associated with untreated or poorly managed conditions.
Another important aspect that needs to be discussed in this regard is the role of family doctors in initiating attitude change and creating relevant awareness on many important health issues which are otherwise not discussed in mainstream health discourse.A range of health problems like mental health, sexual health and reproductive health are not discussed frequently thus creating a vacuum as far as awareness on them is concerned. Family doctors can play a positive role in busting the misconceptions and stigma related with these health conditions and also ensure timely interventions to treat them. Thus, playing the role of advocates as well as acting as a bridge between the patient and specialised medical professional.Even for management of mental health disorders, family doctors, who are familiar with the family dynamics, can play a crucial role. The relationship can work towards countering the negative perceptions about the noble profession as time and again the accusations of prioritising commercial gains over patient safety are hurled at hospitals and doctors. The idea of a family doctor can reinvent the faith and trust attributed to the medical profession, since time immemorial.
Compliance and continuity of care is another critical area in healthcare that can be effectively managed by the involvement of the family doctor who can successfully ensure, keeping a close eye on the patient, that he is following all the modalities of compliance and continuing with the right treatment to better health outcomes. They can provide better continuity of care by managing and coordinating their patients’ overall health, right from childhood to adulthood and through various stages of life. The association helps in understanding the patient’s medical history, family background, and specific health needs, leading to personalised and comprehensive care. With customisation being recognised as an important aspect of public health in place of one-size- fits -all- approach, the notion of a family doctor can surely ensure that each individual in the family gets personalised care and treatment.
Family doctors also play an essential role when it comes to holistic health needs taking a holistic approach to healthcare, considering not only physical health but also mental, emotional, and social well-being. They address a broad range of health issues, provide counseling, and offer support for mental health concerns, lifestyle modifications, and family dynamics. This comprehensive approach ensures that patients receive comprehensive care tailored to their individual needs. Family doctors are essential in population health management, as they have a broad view of their patients’ health needs. They identify common health concerns of their communities, participate in disease surveillance, and contribute to public health initiatives such as immunisation campaigns and health education programs. Their insights and expertise are valuable for addressing community health needs effectively and in a pro-active manner.
For many NCD’s early detection is a game changer as far as treatment outcomes are concerned. In such a scenario a family doctor who knows about the family history can play a vital role, in identifying the early symptoms and initiating diagnosis, that can accelerate the treatment thus facilitating the chances of better response of the patient towards thetreatment.
Role of family doctors in changing the healthcare discourse: Prevention the key to better health
Last but not the least family doctors play a crucial role in shifting the discourse towards the much-needed, preventive health care. Family doctors emphasise on preventive healthcare, including regular check-ups, vaccinations, screenings, and health education. By identifying and managing health risks at an early stage, they can prevent the development of chronic diseases and promote overall wellness. They also manage the dietary and nutrition requirement of the whole family, nudging them time and again for healthier options and a physically active lifestyle. They play a crucial role in promoting healthy lifestyles and disease prevention strategies.
Overall, family doctors are the backbone of the healthcare ecosystem. Their significant role in providing primary care, continuity, prevention, and coordination of healthcare services makes them essential for individuals, families, and the overall well-being of the population. They serve as trusted advisors, advocates, and gatekeepers in the healthcare system, promoting health, managing diseases, and ensuring quality care for all.