HT: Death of the family doctor: March 03, 2008 | Public Health : News Articles

Death of the family doctor
Specialists, self-diagnosis websites, ready-to-oblige pharmacists script a dangerous prescription for general physicians .Visiting my family doctor is convenient. His clinic is close to home, and he knows my family well. I consult a specialist, when it's necessary .I know of patients who refer to websites to self-diagnose, using e-consultation tools. That is a dangerous practice.....By Alifiya Khan

THE FRIENDLY family doctor, with his reassuring smile, is soon becoming a rarity in the city. This, thanks to rising competition from specialists, pharmacists and..., well, the Internet.
The declining trend has general practitioners (GP), popularly known as family doctors, worried. They say that not many medical students are interested in setting up practice as simply a ‘family doctor' any longer.
"Today, it's rare to come across a medical student who wants to practise as a family doctor," notes Dr Deepak Jumani, a practising family doctor from Bandra (east).
Despite having a successful practice for nearly 20 years, Dr Jumani admits he finds it difficult to convince his son to take up family practice. "He wants to be a specialist. And this is not a stray case, such a trend is quite rampant," he adds.
Dr Hozie Kapadia, president of the General Practitioners' Association of Greater Bombay, echoes the view. "It is sad but true that students don't want to be mere general practitioners," he observes.
Dr Kapadia attributes this changing trend among medical students to various economic factors at play. "With rise in people's incomes, and with corporate backing, like medical reimbursements, people don't mind paying more, and prefer consulting specialists," says Dr Kapadia.
Besides, in the past, specialists took up only those cases, which had been referred to them by general practitioners, states Dr Kapadia. "Today, they even take up new cases, thus cutting into the general practitioner's clientele."
Shenaz Lokhandwala (29), a banker, says she prefers to consult a specialist rather than the family doctor. "I don't mind spending more to get quick treatment. For routine ailments like cough or cold, I usually ask the local pharmacist to prescribe medicine," says the Jogeshwari resident.
Incidentally, technology too is slowly threatening the GP's existence. "I know of patients who refer to websites to selfdiagnose with help of e-consultation tools but it's an extremely dangerous practice," cautions Dr Shrirang Bakhle, a family doctor from Chembur. "If something goes wrong, do these websites take responsibility?" he asks.
While Dr Bakhle feels it is advisable to look up websites for supplementary information after consulting a doctor, he feels that the new trend of "consulting websites" is not only diminishing the family doctor's role, but is also an unsafe trend.
The slow edging out of the family doctor is also thanks to ever-willing-to-oblige pharmacists, as much as to quacks, say general practitioners.
"Be it anti-malarial drugs or antibiotics or any potent drugs, chemists dispense them freely over the counter. Patients too prefer buying from them in order to save time and money. But one needs to realise that this can have serious side-effects," opines Dr Priti Bhargava, a family doctor from Vile Parle.
The number of quacks in the city has also mushroomed, says Dr Bhargava. "Like ward boys who setting up practice, using tricks they have picked up."
The doctors argue that there are some advantages of consulting a family doctor, which specialists can't offer. "As a family doctor sees patients for years, he or she has thorough knowledge of the entire family. This certainly helps in better diagnosis," feels Dr Kapadia.
"General practitioners treat the patient as a whole entity, rather than concentrating on just one part of the immediate illness," says Dr Bhargava.
Priyanka Vyas (22), a resident of Borivli, says she continues to repose her faith in the good ol' family doctor. "It's about convenience. His clinic is close to my house and he knows my entire family well. Yes, I do consult a specialist, but when I feel it's really necessary," says Vyas.