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The family doc rocks

The launch of a new healthcare centre in SoBo became an occasion for doctors to call for recognition of the merits of your General Practitioner (GP) or physician, in an age of specialists and super specialization

Yesterday, the occasion of a launch of a healthcare centre at Advani Chambers in Kemps Corner called Healthspring, was used as a springboard for a discussion by doctors and those associated with medical practice on primary healthcare. For the layperson, primary healthcare simply means the first step in the ladder to healthcare with the focus on the  physician who looks after you and your family's well being.


Desi Whirl: Dr Ganguly stresses a point

It was meant to be a "round-table" discussion, at least that is what the invite said. The panelists though, sat at a long table, rectangular in shape, not round. But that is to dissect a non-issue. And, in a gathering of such established names in medicine, it is best to leave dissection to those that wield the scalpel with such skill, namely the surgeons.

Glamour
So it is over to Professor Gautam Sen, senior consultant in surgery, who kicked off proceedings on a warm Thursday morning, by a short welcome address and began his discussion by defining primary healthcare. Dr Sen said, "Primary healthcare is the fundamental issue of you and your family's health. There are at least 80 per cent of ailments, which could be effectively tackled at the primary healthcare stage itself. It is the remaining 20 per cent that need specialist care, which is called secondary and tertiary medical care."


Screen savers: An image on a computer at the centre

In a world where hype and hoopla is all, Dr Sen acknowledged that like everything else, even medical care needs to be "marketed" or "glamourised" to make it appealing to the public. Currently, the family doctor, or the General Practitioner (GP) as he is called, is being relegated to the mothballs. Unsung and de-glamourised, perhaps the most important cog in the healthcare wheel, is going unnoticed. Said Dr Sen, "Today, the trend is to glamourise tertiary care." In response to a question about what he meant by the need to glamourise GPs he said, "Most people are skipping the GP and going directly to the specialist. This should not be done." Dr Sen added that this was not the case in developed countries that concentrated on primary care. "Prevention of illness is important and the GP can do this. With timely action, one can avoid secondary and tertiary care."

Simply put, the family physician is going out of fashion and needs a resurrection. "In a world where healthcare is getting more complex and values are changing, the patient is being pushed towards secondary and tertiary care,  sometimes maybe for commercial reasons. We hope to transform that scenario," ended Dr Sen.


Perspective: Dr Shastri states his case

Government
K Sujatha Rao, ex-principal secretary Health, Government of India (GoI) and member of the Planning Commission Committee on Health Insurance brought a different perspective to the discussion when she said, "We need a good policy for primary care in the urban sector. For whatever it is worth, there has been a structure in the rural areas but none in the urban." Just like flower power in the 1960s that became a turning point for that generation, the 1980s were the turning point in India's health care scenario. Rao said, "The changing socio-economic patterns brought new diseases like diabetes, hypertension, asthma and it was 1980s onwards that the Govt. started giving some incentives to the private sector and the public policy shifted." Having said that, Rao emphasised that there was a need to "regulate" the private medical industry, because, "It is like a tiger out of a cage. By private sector I also mean, those quacks sitting in villages doing enormous damage by peddling their dubious cures." Rao also stated that she thought the winds of change were already blowing through healthcare. "First, the focus was on rural, it moved towards private and now, of course, there is a shifting towards and stress on medical tourism." Rao hoped to see more information dissemination in the 12th Five-Year-Plan. In an age where the Internet and other social media have transformed communication, "there is no excuse not to know," said Rao, adding that, "there should be more awareness about tobacco being a real killer." Rao called primary care and GPs, "gatekeepers" of the medical system and emphasised, "Human wellness and home-based family care where the emphasis is not just on curing the disease but seeing that the person is well."Rao asked, "Can we incentivize clinics? We need to think about that." Having said that, Rao admitted that with the boom and different aspects in healthcare, "We are the fortunate generation. These are exciting times to be in."


Doc the talk: Dr Gautam Sen with K Sujatha Rao. Pics/Bipin Kokate

Desi
The upbeat Dr Ashok Shekar Ganguly, Padma Vibhushan, took up from there, stating, to the amusement of some, "I remember playing cricket barefoot on the roads of this city. Childhood is a time when you fall ill, but I had a GP at Tardeo called Kamath. My temperature came down by two degrees when I saw him, such was the reassurance. My children too, grew up with a GP, Dr Gokhale, and they learnt his name first." Dr Ganguly added that initiatives like these bring back the concept of primary care and were thanks to people like Dr Gautam Sen, "Who is just like a Rottweiler. Once, he has a hold of the concept he will not let it go." The doc struck one for India stating, "Right now, this is the country to be in. The mess in Delhi and Mumbai is going to continue. Yet, we have two choices -- either we sit on the sidelines and criticise or we get up and do things. India is going to continue to thrive; there is no need to despair about what is going to happen to India," finished the doc on a gung-ho note.

If one was tempted to do a jig on 'Desi Girl' at Dr Ganguly's words, one would have to stop mid-step and hear Dr Satyanand Shastri, leading consultant surgeon at Lilavati Hospital, who said it is important to note what community care has done. "For the first time, there is a drop in malaria, dengue and lepto cases because the municipal authorities set up community centres at different parts in the city and doctors were available to people." Dr Shastri cited the case of a patient who was vomiting blood. "This man was diagnosed as an alcoholic and went to the hospital eight times for liver treatment. In the end, he actually had TB. If his physician had seen him, he may have been saved the expense and the ignominy of being dubbed an alcoholic.

His family doctor would have known that he had one drink a week and that does not make you an alcoholic."
On that rather intoxicating note, the debate ended. It is evident that some new age marketing will be needed to bring the good ol' family doc with his wise words, reassuring ways and gentle manner, to the forefront of medical care once again.

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