Thursday, January 27

Healing touch of the family physician

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Family physicians from the vicinity have been the standard norm not only in Calcutta but across the state. Senior citizens will certainly remember these physicians who administered not only routine medications but also self dispensed own medications like red mixtures.

Such was their honour that a senior family member would carry their bag to the car at the time of departure. They were mostly MBBS doctors.

Four decades back the population of Bengal was around five and a half crores which has now increased to more than nine crores. In 1987 the number of registered MBBS doctors in Bengal was around 46,000, it has increased to more than 88,600 recently.

Nostalgia Those family physicians were not only the local guardian of the family, but also enjoyed complete trust and confidence.

The emotional and personal bonds were exemplary. In that era clinical assessment was more important than investigations.

No doubt, it was more on trust than evidence. The majority were MBBS doctors instead of specialists or superspecialists as of today.

Social ostracisation Unlike the family physicians of yesteryears, the medical profession today has moved away from all walks of society. The deep-rooted personal contact of the family physicians was exemplary, seldom heard now.

The isolation is almost complete and today there are more specialists and super-specialists than general doctors. No doubt, the Consumer Act of 1986, amended in 2019 has not really helped the system.

Deteriorating doctor-patient relationships and unexpected violence has taken centre stage which were unheard of earlier. The family physicians also gradually became irrelevant. Unfortunately, they received no support from the people whom they served diligently. Some of these physicians had small nursing homes or establishments which had to be closed down for obvious reasons. It was probably the time for the large corporates to take over.

Corporate invasion Prior to the 1990s corporate hospitals in Minto Park and Alipore were probably the only destination and the health hub along the Bypass was yet to develop.

During the mid 90s the large corporates started to develop along the Bypass. The concept of evidence-based advanced medical care came to the fore. It received complete support of the people. They also received support from the insurance companies which were not so keen to support the smaller establishments.

The relationship turned more commercial than personal or familial.

Emergencies were more adequately managed and there was more evidence, more science, but less on trust. The life expectancy four decades earlier was around 54 years whereas now it is around 69 years.

Among other reasons, adequate medical treatment is an important cause. Although, the limitations of the family physicians came to the fore but the elderly geriatric population suffered the lack of a person whom they could trust fully.

Suggestions Those family physicians may have been marketed out but they need to be incorporated in the system as the benefits are many. The rapid deteriorating doctor-patient relationship is hurting the society as well, which needs to be rectified.

The corporates and government may adopt family physicians in their locality in a effective manner restoring social security and trust. Today, hardly any senior doctor visits homes regularly for the ailing patient, probably because of the question of social security.

There should also be adequate opportunity for smaller health establishments to flourish and perform with honour.

But can humanness make an effective return in the corporate world, a question that needs to be answered! HEALING POTION GAUTAM MUKHOPADHYAY .. Gautam Mukhopadhyay is secretary of the Bengal Oncology Foundation and clinical director of the department of surgical oncology, Peerless Hospital

Source: Telegraph

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