Making the Case for a Family Doctor

Kriti (name changed) is a typical young professional working in the booming software industry in India. She lives in an affluent neighborhood that is serviced by the best amenities possible including health care services that range from clinics, secondary hospitals and super-specialty centers. Nonetheless, each time she faces a health concern, Kriti has to battle indecision – which doctor/ specialist will be right for her problem, how expensive will the services be, will the doctor have time to hear about her entire family history before he/she prescribes her a treatment, etc.

A lot of Kriti’s problems would be sorted if she could access a family physician. The family physician would perform a preliminary investigation helping Kriti diagnose the problem and also prescribe the preliminary treatment. Her physician may know her medical and family history better and could use that information in proposing a line of treatment more suited to her specific case. While the specialist might only look at the specific cause of concern, the physician may view Kriti’s health concerns from a holistic point of view and provide a more comprehensive line of treatment. If need be, he could also direct Kriti to the right specialist. On top of all that, seeing her local physician might cost Kriti less than going to the hospital.

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The problem is that the presence of general physicians has significantly dropped. Fewer medical graduates want to follow the stream of family medicine as opposed to super-specializations like cardiology, neurology and urology etc. More and more people are changing cities frequently for their jobs making it difficult to have a dedicated family doctor. Further with a rise in income levels and increased accessibility of specialists, there has been a surge in demand for their services. With a diminishing supply of providers, and an inconsistent demand for general practice, the breed of family physicians is nearing extinction in India.

But a handful of providers refuse to accept this change. [Nationwide Healthcare]( in Bangalore, [Ross clinics]( in Gurgaon and Healthspring in Mumbai are amongst some of the providers trying to revive the family physician model. They are all multi-clinic chains servicing communities in urban and peri-urban areas and working to reestablish the trust for a family physician as the first point of contact for any health concern. More importantly, they are reinforcing the importance of preventive rather than curative care. They are all in the first few years of their operation, and while it may be hard to assess their success at this stage, they offer an interesting study as innovative health care models that are striving to improve the population’s health indices.

ACCESS Health International (AHI) is taking an active interest in these models and others similar to them. AHI is conducting a study of these models to understand their delivery model, document their success stories, and identify challenges they face including support for replicating and scaling up. Going forward, it will be working to build a community of practice that will facilitate a collaborative environment amidst the different players interested in the field. The study is being conducted by Lipika Ahuja, an intern with AHI, and Annapurna Chavali, Consultant at AHI.