Bringing Back the Family Physician
Until a couple of decades back, the family physician was the default reference when a person mentioned ‘Going to see a doctor’.
Why was this so?
To answer this question, I have to first talk about two major aspects that impact our health: Our genetics and our own lifestyle/health choices.
You see, there is no one way for anyone to determine which genetic traits of your parents or grandparents will come to be part of you. In some cases, a parent may have diabetes but the child may not inherit it. Conversely, a person may develop lifestyle disorders that are not known to be part of the family’s health history on both sides. This is because our lifestyle choices also play a major role in determining our health in the long run.
There is no one formula that can determine how lifestyle can be correlated with the risk element from genetic conditions to ‘map’ out your health. Hence, having an overall idea of what to look out for is important.
Knowing What To Look Out For
One of the ways in which we keep track of our health (in a general sense) is through regular check-ups. When we view the results of a check-up in light of the larger familial health history, they give us an clearer picture. For example, a slight increase in blood sugar levels may not seem like a reason for a closer look. However, when seen in the light of chronic diabetes among one or more close family members, it may present a reason for deeper investigation.
This is where the Family Physician played an important role.
As a doctor who treated all family members, he / she was privy to a holistic picture that was drawn from treating each familial member (across ages). Thus, any symptom was not treated with the view of mitigating it alone, but also in the light of whether it was a sign of larger risk factors.
That is why the family physician was the first step in the treatment order.
In recent times, there has been a shift – a person facing a health issue prefers to see a specialist right away. The reason quoted: ‘In any case, the specialist will be seen at some point, so why not save time and effort by going to them right away?’
Here are my responses to this and other commonly raised questions.
We all have unique health needs. How is family medicine relevant for our individual needs?
Each of us does have a unique physiological make-up, but our health and well-being is influenced to a great extent by genetics. We are influenced by health factors from two people’s families. The impact of medical histories on both sides need to be taken into account when understanding our own health. A doctor who has a longstanding rapport with the full family has a bird’s eye view of each person’s individual and genetic case history, including the psychological aspect – and approaches any issue raised with a view of the larger picture.
I know what problem I have. I can consult the right specialist without having to spend time going through a family physician, right?
Symptoms and corresponding body parts are not always connected in a straight line. For example, heart palpitations may arise due to several factors, which may not always require a consultation with a cardiologist. Thus, isolating the root cause is critical. Family physicians could understand and address up to 90% of health issues. Due to longstanding association, they were aware of which problems arose due to regular triggers, and which ones required greater attention. They were also well aware of which specialist to turn the case to, when the need arose.
Aren’t family physicians and GPs the same?
A family physician is pretty much like a general physician (GP), but has the added profile of treating members of a family across age lines (from paediatric to geriatric). Access to the health histories of all familial members enables family physicians to spot issues early on and provide guidance on preventive measures. When a doctor has the awareness that there is a genetic component in terms of issues like diabetes, high blood pressure, cholesterol, hormonal issues, etc., they will pay closer attention to reports and tell-tale symptoms – and chart out a course correction plan early on.
