What is the role of GP or family doctor in today's world of "super-specialist" healthcare?
In today's world there is a super-specialist for anterior chamber of the eye and posterior chamber, we have medical and surgical gastroenterology, nephrology and urology, cardiology and cardio-thoracic surgery and so on. How much time does a specialist spend with a patient listening to his problems as against the time spent by the patient in all the investigations?
“If you listen to your patient long enough, he/she will tell you what is wrong with him/her,” wrote Lord Platt, a great British brain in clinical medicine, as far back as 1949.
In the present era of high-tech imaging, scanners, computerized devices - a prospective study showed that all the examinations that the doctor does refines the final diagnosis only four per cent and all the tests, including the PET, would only further refine it by eight per cent, while eighty per cent of the accurate final diagnosis and one hundred percent of the future management strategies could be arrived at, at the end of listening to the patient and reading the family physicians referral letter.
In a comparative study in the United States, Shi demonstrated that availability of primary care physicians correlated positively to favourable health outcomes .In contrast, health systems dominated by specialists, such as that of the United States, have higher total health care costs and reduced access to health care by the vulnerable populations. The high cost is attributed to proportionately low numbers of primary care physicians and consequent impairment of the gate-keeping function.
Primary care physicians are more likely than specialists to provide continuity and comprehensive care resulting in improved health such as less hospitalization less utilization of specialist and emergency centres and less chance of being subjected to inappropriate health interventions. (http://www.euro.who.int/__data/assets/pdf_file/0004/74704/E82997.pdf)
If at all we get back our traditional "family physician" who had time to listen to your woes, half the diseases would be cured by just talking to him. What do you say?
Very well narrated. Being a Primary Care Physician (a GP trained and practised in NHS UK) myself, I always felt that whatever you have written is so simple to practise, but is rarely followed by majority of clinicians in our country due to various reasons. In developed nations - where GP/Family Physician is the first port of contact for all patients - the relationship that builds up between them helps in better understanding of the clinical need of the patient and thereby better clinical outcome. We all need to think and bring back our 'Family Doctors'.
ReplyDeleteHey, very apt rendition of what's happening.
ReplyDeletePretty simple to understand what you write :)
Radhakrishna
In our country a GP also gets terribly busy and starts behaving like specialist.We need more good GP's
ReplyDeleteVishal Singh
www.livehospital.net
Dear Sir,
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Regards,
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maddy.stc@gmailcom