Family Doctors Before Specialists: Why Experts Say It Matters

In today’s world where waking up to a backache can lead to a hurried call to an orthopedist or physiotherapist. One can ask--have we forgotten the very idea of the family doctor?

"In affluent or more informed areas, patients often directly consult specialists -- say, a gastroenterologist for stomach pain-- rather than first approaching a family doctor. But in low-income localities where people don't even closely check if their doctor is an MBBS, BUMS, or of another medical qualification, GPs come first", says Dr Intesar Khatri, a general practitioner on Sewri Cross Road.

He also tells us that approaching a general practitioner is more pocket-friendly than specialist doctors who charge thousands per consultation.

Dr Yogesh Srivastava, a general physician in Antop Hill, draws attention towards a significant factor, “Patients easily open up with family doctors. They feel that comfort and warmth more with us, whom they regularly visit once in 3-4 months”.

"As family physicians, we build relationships with patients over years, which help in understanding their lifestyle and history. We might also understand their family health and heredity issues better than anyone else", notes Srivastava.

“Some have a family doctor for years, they go to them and start from there, which is how it should be all ideally. But many people, due to job-based relocation, don't have a family doctor. They approach a specialist according to their bodily requirements. One of the major plus points here is that you will not waste any time", explains Dr Surendra Ugale, a surgeon specialising in ileal interposition surgery for diabetes.

Ugale cautions that sometimes a GP might sit on a case too long. He shares, “I had one situation where an elderly woman with an umbilical hernia was only given painkillers. By the time she was referred to me, the hernia had become obstructed, and her intestine was gangrenous. Going directly to a specialist can sometimes save time and lives”.

He also observes a growing trend where people consult AI tools first, keeping human doctors out altogether. "Most times ChatGPT is amazingly accurate and unbiased".

Public health researcher Ravi Duggal points out that the number of general practitioners (GPs) is steadily declining as more MBBS pass outs choose to further pursue specialisation.

"The ratio is one lakh MBBS doctors and about 60,000 specialists," he shares before claiming that healthcare, which should be a public good, has been overtaken by commercial interests.

Calling doctors as 'Baniya', a shopkeeper, Duggal says, "What we’re seeing now is the marketization of healthcare and people go shopping for doctors, instead of seeking help from a single one unlike until 70s where family physician concept actually existed, now people go to different doctors like walking from one shop to another".

"I don’t believe one doctor can address all my health concerns, which is why I prefer consulting different specialists, " expresses 31-year-old Amrita Naidu who has a list of doctor contacts saved on her phone for her ongoing treatments.

"I'm consulting an endocrinologist for my PCO and a dermatologist for acne. When it comes to my pet dog, I go to a vet. Different doctors for different problems work better for me", the woman says.

However, R Sridhar, 64, prefers starting with a general physician, but their unavailability makes him visit an MD. "Many of the good old MBBS doctors are retiring or no longer practicing. While specialists are more expensive, sometimes unavoidable, especially on Sundays when most general practitioner clinics are shut", he notes.