Family Medicine touches lives of individuals irrespective of age, sex, community and language. When we talk of India, we mean to touch lives of more than one billion people on the face of earth.
We live in today's vibrant India, in the times of economic growth and growing aspirations. When we are aspiring for and achieving international standard tertiary health facilities, there should be no reason why Indian population should be deprived of quality primary health care.
There is widespread misconception about family medicine in India. The image of primary care physicians who practice as "family physicians" is that or less qualified, less skilled and less knowledgeable doctors. By adopting the approach of the specialty of "Family Medicine", we are promoting a new breed of highly skilled primary care physicians, who are best equipped and skilled to provide community based preventive and clinical services. Their specialization lies in provision of comprehensive and continued care for individual and the community.
For other specialties and sub specialties, the focus of training and knowledge base is VERTICAL in nature i.e. skills to manage rarest of the rare diseases. The approach of family medicine is HORIZONTAL and training focus is on developing skills for managing common illnesses, encompassing a wide spectrum of medical science. Family Medicine is about decentralization and democratization of clinical skills for the benefit of the community, so that individuals can avail quality care at a price they can afford. It is well established fact that skilled family physicians can manage up to 90% of illness related problems in a given community.
We need dispel the myth from the minds of medical students and post graduate aspirants that "Family Medicine" is less academically challenging, low income generating, and relates only to referral of patients to the specialists. In past, we have seen individual family practices sites growing into large hospitals and institutes. This happened because unlike other specialists family physicians started their practice early and were directly based in the community. They did not depend on others for success. Family practice is also fulfilling academically and professionally as skilled family physicians can manage a wide variety of clinical conditions by themselves and they have to identify rare and appropriate problems for referral to specialist care. India still needs thousands and thousands of community based medical practitioners.
To my knowledge, ten medical colleges have applied to MCI (Medical Council of India) for starting MD- Family Medicine(Post Graduate level). Unfortunately none of them materialized due to various reasons. Very good progress has been made at CMC Vellore, where a separate department has been created with faculty from family medicine itself.
We have inspiring success stories in our neighboring countries. We have MD (GP) at Kathmandu since eighties, MD – family medicine (now changed to General Practice and Emergency Medicine ) at BPKIHS Dharan Nepal, four year well established program at Aga Khan University at Karachi Pakistan and MD- family medicine at PGIM, University of Colombo.
Due to existence of wide disparity of health care facilities in various parts of India, family medicine must reflect local community needs. Apart from helping government agencies in implementing health care programs, we need to set academic standards and practice protocols for Indian conditions. We need to actively participate and associate ourselves with ongoing process of advance scientific knowledge, public health initiatives, policies related to health sector and medical education.
We are looking forward for association with academies of international primary care physicians, residency programs, faculty and practicing clinicians for mutual exchange of resources.
Once again I offer my heartiest congratulation to the whole family medicine fraternity of India. We all need to put our efforts together to take family medicine to “next level” in India.
Dr Raman Kumar
President AFPI India