Should Family Physician Visits Be Made Compulsory for Patients in India, Before They Visit a Specialist for Routine Symptoms? – Guest Blogger Dr. Pragnesh Vachharajani

In India today, there is an increasing trend of patients consulting a medical specialist instead of seeing their family physician first. This trend is especially being seen in the major cities. With about 70% outdoor patients (adults and kids) consulting specialists directly for common aliments like fever, cough, and cold as soon as the symptoms appear.

It is my assumption that at any given day that most of physicians and pediatrician’s outpatients are more than 50% patients that do not require specialist consultation or care in an outpatient department. For minor aliments already mentioned above to High blood pressure, diabetes, pediatrics vaccinations etc. which can effectively be handled and managed by a family physician but patients keep visiting specialists.

This is a dangerous trend for all. The patients are not aware about probable consequences of this, for example:

  • Increasing cost of healthcare: Obliviously more fees.
  • At times over treatment and over investigations as doctors feel that patient is impatient and his name will be spoiled that even after consulting specialist the patient did not get well soon.
  • Poor adherence to treatment as lack of time at some bigger hospitals give less time for counselling, more crowded outpatient departments and lack of personalized approach.
  • Poor follow up as, regular visit to a specialist burn a hole in pocket, time consuming.
  • Early detection of complication is missed, as follow ups are missed.
  • Close watch on health condition is not possible.
  • Lifestyle modification, which is key in most of the lifestyle diseases now, are poorly adhered too as family physician is not involved in treatment who understands all aspects properly including social as well as financial aspects.
  • Disease diagnosis is delayed, as for minor symptoms patients do not report in time to family physicians.
  • Lack of proper referral advice - as without proper primary examination and history taking, at times many patients end up visiting the wrong specialist or “super” specialist.


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This entry was posted in Blog, Practice Management, Practice Management Featured 2 and tagged , . Volume: .


    Posted Mar 2016 at 3:18 am | Permalink

    Interesting & useful articles on all speciality.

  2. Dr. Valluri Ramarao
    Posted Jun 2016 at 11:49 am | Permalink

    There is lot of chaos among patients since 2 decades trend has changed due to fragmentation of specialty. If a person has a headache he directly consults a neurologist who invariably orders ct scan brain. The public does not bother to know the common cause of headache – Is it sinusitis or defective vision or something else.
    The primary care or first contact doctor can only guide them. The public mind set is changed. They think for every problem a specialist’s opinion is needed. This is all because of government given a rope for private corporate hospitals. There by mushrooming of corporate hospitals who in turn depend quacks who bring cases for them for commission. This is a pathetic situation in present day health care. Reasons for this is government in action other side OTC is another problem many other countries no medicine is dispensed unless there is valid prescription any how congrats. But this is a big topic.

  3. Suresh Wadhwa
    Posted Sep 2016 at 5:35 am | Permalink

    Good article

  4. dr suresh chhatwani
    Posted Jul 2017 at 6:36 pm | Permalink

    Very well said.,above all easy availablity of specialist and Superspecialist compared to 20- 25 years back ,,more trust hospitals and corporate hospitals have made this situation.definately patient will be the sufferer.good suggestion that for insurance companies that primary referal by family physician must.
    thank for blog.

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