Why We Need Family Physicians!

Some days ago, the parents of a friend of mine were faced with a complicated cardiac situation for which they saw three cardiac surgeons and three cardiologists based on recommendations from friends and family. They received six different opinions that included surgeons recommending no surgery and cardiologists advising surgery. Finally, they decided to get surgery done and went with the person they felt exuded the most confidence – the decision was based on gut-feel and some background check of his curriculum vitae, but at no time, was another medical expert’s advice followed…all the research and work was done by the lay parents themselves and it was their good fortune that all went well!

This kind of decision-making is as insane as asking people to choose a spouse based on a photograph and some details on the Internet and one interview. Sometimes you get lucky, but you have an equal chance of getting screwed.

In recent times, some experts have compared the practice of medicine to a travel agency with the argument that as more and more information becomes easily available on the Internet allowing us to bypass travel agents, so also, we may be able to manage our own health problems without guides and experts once we have enough information regarding diseases, treatment options, hospitals and doctors.

Which is all so much rubbish!

Our body and its workings are too complex for most people to understand how things work and to be able to take decisions regarding the options to be exercised when things go wrong. Just because you know that a painful degenerated knee can get better with a knee replacement does not mean that you will know the correct timing for surgery, the best method of knee replacement and the right surgeon to go to, even after you have gone and seen six of them, asked everyone around you and read up everything available at hand.

Or for that matter, if you have a small prostate cancer. The options for treatment range from doing nothing depending on your age to getting surgery done or cryotherapy or ultrasound or thermal ablation with or without hormonal treatment. Irrespective of how much research you do, without someone guiding you and helping you sort through all the options available, you will have no way of knowing how to match the correct treatment option with the experience and expertise of the surgeon and physician, in the given clinical setting, appropriate for your particular situation and socio-economic condition.

That guiding hand should ideally be your family physician’s…someone who will not only be able to help you with these decisions, but also be a bridge between you and your specialist, and be available when needed, to tackle minor disease or treatment related issues that may arise on a daily basis, for which your specialist may have no time or patience.

It is sad that fewer doctors today are becoming family physicians. The trust deficit between patients and doctors also does not make things easier. And unfortunately, many people truly believe they have the ability to take informed, rational health decisions after doing their own research as if they were out to buy a new car.

This is so dangerous. You could at best make lifestyle choices on your own to keep your body healthy; but when you have a problem, you will be lost without an expert and a guiding hand.

A good family physician is an invaluable companion in both simple and complicated medical situations…and as a bonus can also double up as a friend, philosopher and guide! Cultivate one!

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