Family physicians were the base of the healthcare system in India for ages. When we watch any Bollywood movie released between the 70s & 90s, there was always a family physician who will be called for whenever someone falls sick in the family. However, as time passed, the family physician was given a skip both from movies as well as from real life.
Dr. Raman Kumar, National President, Academy of Family Physicians of India (AFPI), says, “Family Physicians were the very basis of Indian healthcare delivery system. However, unfavourable regulations have disrupted this healthcare delivery system. In the absence of a qualified family physician, patients reach out to quacks for the treatment because of their easy accessibility & affordability. Quacks may help patients with mild bacterial or viral infections, but often complicate serious illnesses, which they are not able to diagnose. A patient, which could have been treated with basic medical care then becomes a patient that needs super speciality care further burdening the already burdened healthcare system.“
“With the introduction of National Medical commission (NMC), I am hopeful that the stream of family medicine will be strengthened. Academy of Family Physicians of India has suggested to the commission to include the Department of Family Medicine within the regulations ‘Establishment of Medical College Regulations’. Every medical college needs to have a family medicine department if we want to streamline our healthcare delivery system & release some pressure from our healthcare system which is already burdened. WHO recommends 1 doctor for every 1000 patients; however, in India, we have 1 doctor for 1700 patients. If we analyse the data carefully we would realise the actual doctor to patient ratio is even lower as 66% population lives in rural but we have nearly 75 per cent of dispensaries, 60 per cent of hospitals, and 80 per cent of doctors located in urban areas.”, he further added.
Speaking on the AFPI’s suggestion to NMC, Dr. Kumar said, “Government has the realisation of the importance of family medicine & several policy documents of the Government of India, from time to time, have strongly recommended establishment of family medicine training programs in India. However, despite multiple recommendations, erstwhile MCI never made it mandatory for medical colleges to have a family medicine department. As it was not mandatory, most medical colleges gave it a skip, which halted the growth of the stream, depriving India of family physicians. Doctors who wanted to pursue family medicine moved out of country & now even if they want to give their services in India, the current regulations do not create optimistic opportunities.”
“It is sad to note that recently released competency-based MBBS curriculum doesn’t mention a single word on Family Medicine or family physician or general practitioner within the entire 700 odd pages. As none of the writers was a family physician, the stream was given a selective skip. Family physicians have been historically and deliberately disenfranchised from the medical education system of India, which has blocked the development of family medicine in India. With the new era of healthcare regulation, we are hopeful that NMC will take cognisance of our suggestions & family medicine will get its due for the betterment of our healthcare system”, he added.
Family medicine is an established medical stream in the developed country & somehow India, who needs it most to serve its 1.3 billion population failed to realise its importance. On-going pandemic & stress to survive in dynamically changing financial conditions have highlighted the importance of family physicians, who were just a call away. For a country with diverse culture, geography, & healthcare ailments, perhaps family physicians are the only solutions If India wants to improve in health & survival, where it is ranked at 150 in the World Economic Forum report.