Veterans blame it on the perception that private practice does not pay
While recognising the importance of general health practitioners or family doctors, a committee set up by the Insurance Regulatory and Development Authority (IRDA) in 2007 said:
“Traditionally, the family doctor or family practitioner played a significant role in providing health care. The growth in medical specialisation, medical technology, and greater mobility of population, have significantly reduced his role. Institutionalisation of the family doctor/general practitioner is imperative in the context of health care for senior citizens…” (Executive Summary, K.S. Sastry Committee Report, No. 18).
It recommended: “The institution of family clinic should be encouraged…” (Chapter 12, No. 12.26).
According to G.K. Bhat Sankabithilu, president, Family Doctors' Association, Mangalore, the tribe of allopathic family doctors in the city and its surrounding is decreasing.
The fresh breed of MBBS doctors are not coming forward for setting up practice as general practitioners by setting up their clinics. Some new breed MBBS graduates practise only for part-time in evenings.
Dr. Bhat says there are about 100 fulltime allopathic family doctors in the city and its surroundings.
They were all old-time doctors who started practising three decades ago.
Of them, about 70 per cent are members of the association having only allopathic practitioners.
He says a majority of MBBS graduates are becoming specialists and “super specialists” by going for higher education. There is a perception that it is not possible to lead a decent life by becoming a general practitioner. Dr. Bhat says it is unfortunate that many MBBS graduates are going for higher education keeping commercial interests in mind.
Annayya Kulal, vice-president, Dakshina Kannada chapter of the Indian Medical Association (IMA), who agrees with Dr. Bhat, says he (Dr. Kulal) started his general practice as a family doctor in Mangalore 1997. “Only two from my batch took to general practice,” he says.
Many hospitals recruit BAMS graduates as duty doctors as MBBS degree holders are not willing to work for a salary of Rs. 25,000.
Dr. Bhat says here are four types of patients. Those who have never met general practitioners and directly approach specialists; those who depend on family doctors; those who meet general practitioners only if it is inevitable; and the poor who go to government hospitals and primary health centres.
Dr. Bhat says general practitioners treat any chronic disease except heart ailments and those needing surgeries. Many diseases can be diagnosed without laboratory investigations.
It is not correct to look down upon general practitioners.
O. Srirangappa, District Health and Family Welfare Officer, says the exact number of general practitioners in the district will be known only after one-and-half months when all doctors having clinics register themselves under the Karnataka Private Medical Establishment Act, 2007.
Lack of candidates
Dr. Srirangappa says the Health Department is finding it difficult to get MBBS doctors to serve in rural areas.
Another senior doctor with the department says new MBBS doctors are not coming forward to work as fulltime general practitioners in the city.
“This is a reality,” he says.
However, Sridhar Kamath, president, South Kanara Chemists' and Druggists' Association, says general practitioners were not on the decline.
Keywords: family doctors