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MadhaviJayarajan
By Dr. Devashish Saini, Founder - Ross Clinics
Many private providers within the health market are trying to bring back a Family Medicine practice model to promote primary health care. Ross Clinics, a CHMI-profiled program, is my contribution to this effort. Family medicine can be defined as comprehensive primary care that is holistic in its approach, is patient centric, community focused and provides compassionate and continuing care. A family doctor is a friend, a mentor and a confidant of the family and builds lasting relationships, guiding them through their medical issues. Ross Clinics, established in 2011, is a chain of health clinics with a focus on delivering primary care and making it affordable and accessible to all its target communities. With 5 full-service clinics and 5 satellite clinics, Ross Clinics operates its for-profit operations in six locations in Gurgaon and Manesar, India.
Providing good quality primary health care services at affordable costs has been a challenge for most entrepreneurs in this space. The question “Am I a good enough doctor?” is one family physicians struggle with every day, as we confront a wide variety of symptoms and clinical presentations, which, more often than not, do not fit any text book diagnoses. Some patients get better while others do not, and sometimes, counter-intuitively, the patients who don't get better become your greatest fans.
It isn’t often that we doctors and entrepreneurs are assessed by a third party. Our understanding of the quality of our services comes from our internal monitoring mechanisms and customer feedback. Sometimes this makes us wonder whether we are good enough! I was thrilled to get an opportunity to be evaluated during the summer of 2014 at CMC Vellore, where I and about 150 other doctors underwent a rigorous 3-day examination to test our mettle.
Cristian Medical College (CMC) Vellore, India, has been running a path-breaking distance learning program in Family Medicine for practicing and aspiring Family Physicians for the past 7 years. Learning happens at the doctor's home or clinic over the course of 2 years, and these physicians spend about 30 days at a hospital close to them, to update their clinical skills. At the end of each year they report for theory and practical examinations in Vellore, a small city in the South Indian state of Tamil Nadu.
Like me, many others in India are attempting to promote the Family Medicine model - Nationwide Primary Healthcare Services, Mera Doctor, Modern Family Doctor, Swasth and Alpha Clinics to name a few. As an entrepreneur operating in the health space, trying to revive a practice model that has been forgotten, it is a luxury to take time off and attend sessions such as the one at CMC. Before flying to Vellore, there were a lot of preparations to be made. The clinic had to be handed over to another capable doctor, who would hopefully be able to satisfy our patients, who generally barge into the clinic without prior appointments, and demand to see their family doctor. The team had to be given explicit instructions on things to be done in my absence. On the whole I had to explain to about fifty people, including my regular home visit patients, that I was going away for a few days to take an exam.
CMC, also profiled in the CHMI database, began over a century ago, when an American lady by the name of Ida Scudder decided to start an institution of medical excellence in this unknown town. The institution has now grown to a 1000-bed hospital which attracts patients from as far as Bhutan and West Bengal. Even then, the hospital is well-grounded in community-based care and patient service. The Master of Medicine in Family Medicine follows this tradition, in its vision to create multi-functional Family Physicians who would be able to "Refer Less, Resolve More," providing cost-effective, comprehensive, patient-centred care in the context of the family and the environment. It is this approach that the academic world needs to adopt to help revive the concept of family medicine. Unlike encouraging rote learning and memorising esoteric facts, which most institutions do, we need more CMCs and more Master in Medicine in Family Medicine Programmes that have comprehensive structures and curricula on ‘how to mould a good family physician’.
As I and the other doctors head back to our hectic lives, a small part of our sub-conscious will keep looking for the email that will tell us whether or not we have passed this most grueling test of bravery, wits, patience, skill and knowledge. But whether we do or not, I would like to believe that we will be good doctors so long as we remember "to cure some times, to relieve often, and to comfort always."
