The Forgotten Art of General Practice

Primary care physicians form the base of the healthcare pyramid. Also called Family Physicians, Internists or General Practitioners (GPs), their existence may seem superfluous when there is a brigade of medical specialists in every field of medicine. At the first outlook, they seem to have just basic or preliminary general knowledge about various medical specialities, but these primary care providers serve a very important role in our healthcare system.

In a majority of cases, patients who are referred to specialists can actually be treated by a primary care physician. Patients usually wonder “Why visit the GP when I know I have acidity and can visit a Gastroenterologist?!” or “I had chest pain last night. I must visit the cardiologist immediately”. This dilemma in patients’ minds and information available on the internet has led to the disappearance of the art of General Practice and the popularity of specialist culture!

What Does a General Practitioner Do?

Primary care is provided by physicians who have expertise in family medicine and serve as the first point of contact for patients on their healthcare journey. When a patient visits a primary care physician, they take a thorough medical history, perform a clinical examination to evaluate a patient’s condition and prescribe appropriate medications. General Practitioners can treat many routine conditions, without the need to visit a specialist. This spares patient’s a lot of time, effort and money from consulting a specialist, which in many cases, is unnecessary. 

Some healthcare services offered by General Practitioners include:

• Disease prevention
• Diagnostic services
• Health maintenance
• Patient education
• Acute or chronic care
• Patient Counseling
• Health promotion
• Health awareness camps and workshops
• Vaccinations

Importance of a General Practitioner in Primary Healthcare 

When we look at the healthcare pyramid in India, we notice a constant dearth of doctors, especially in the rural areas, as most doctors and a majority of specialists migrate to cities for better career opportunities. Primary healthcare, which forms the foundation of healthcare in these areas, is said to be provided by General Practitioners in rural and urban poor areas of the country. GPs are meant to be at the centre of the medical community and form the foundation of the health pyramid. They form a crucial link between patients and specialists that some of them might need.  As opposed to specialists who look at a certain issue in greater detail, GPs have a more comprehensive outlook of symptoms a patient presents with. 

Every country in the world aims to have a strong workforce forming the backbone of primary healthcare, which is formed by the GPs. Even in India, the Indian Medical Association aims to involve General Practitioners in community welfare and other healthcare programs to diagnose, prevent and treat communicable diseases, maternal and child healthcare, and refer only advanced cases to secondary or tertiary hospitals. GPs also need to be involved in ‘Health for All’ as a whopping 66% of people depend upon the services of GPs. Did you know only 23% of people in rural areas actually visit a government hospital for their symptoms?

Bypassing the GP and Its Implications!

People who bypass the primary care physicians do so as people have knowledge about their own condition and directly reach the medical specialist. The medical specialist may indeed be more knowledgeable or have greater expertise in a particular field but not all conditions require this level of skill. With the information available on the internet about doctors, patients today are reaching specialists directly. 

Take the example of Mr A. When Mr A detected a lump in his testicle, he researched on the internet and learnt from his colleagues that he needs to consult a urologist or an andrologist. However, instead of showing up for direct consultation at the specialist, he could have contacted his GP, undergone a few routine tests and clinical evaluation and been referred to the right specialist. A GP visit would have saved Mr A a lot of time, a number of doctor visits, relieved his anxiety and given him a brief idea of what his condition may be. Also, having done all the preliminary investigations would have given the specialist a better idea about a probable diagnosis. 

Visiting specialists is usually an expensive affair, more so when patients are unsure about their condition. Also, during emergencies, it is often difficult to get appointments with specialists, which can lead to high chances of morbidity and mortality. A GP, on the other hand, can provide emergency care until advanced treatment arrives.

From a specialist’s perspective, evaluating patients with routine problems that could have been handled by GPs wastes a lot of their time and effort, which could have been used to evaluate other patients who really need their care and attention.

The Takeaway!

The culture of visiting specialists directly has come from increased access to information and a lack of awareness among the masses about ‘how to seek medical care’. Being part of the medical profession, it is our duty to make patients aware that they can seek and find medical care with GPs and need not rush to a specialist for every routine illness. This must also be reinforced by specialists who see a large number of patients who could’ve been treated by their GPs, saving them time and effort, which could have been used to see more critical patients.

General Practitioners must actively spread awareness about seeking primary care among their patients and build trust in their patients about visiting them before consulting with specialists directly. To strengthen our country’s healthcare system, we must have a robust primary healthcare system in place and General Practice cannot be forgotten for long.

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