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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