Needed: Return of the Family Physician!

Born-again family physicians
PROF DR BM HEGDE | 07/05/2013

Doctors are frustrated, patients are angry, hospitals in the west are going broke, insurance companies that are there only to make money are also declaring Chapter eleven by the day. Time to get back to the old, trusted tradition of family doctors?

Time was when a patient came to the doctor with all faith (faith heals) and felt that doctor is God and would do his/her best for the hapless patient. Not anymore! Today the doctor is a seller ofmedical technology and the patient a buyer. Consumerism rules the roost, making doctors practise expensive defensive medicine. Doctors are frustrated, patients are angry, hospitals in the west are going broke, insurance companies that are there only to make money are also declaring Chapter eleven by the day. The administrators seem to be groping in the dark with no clear end in sight. Reminds one of the First Law of Thermodynamics which states that “anything that disintegrates eventually disappears.” 

Time was when medicine was practised only in the patient’s homes. Hospitals were not there. The family physician made his diagnosis at the bedside and did what he could with very little technology. Some indications today point to the fact that there has not been any marked improvement in the per capita deaths today compared to the good old days except that the dying could feel that their life has been prolonged today because of the way they are being intervened in the last ten days of their lives. Death has lost its dignity.  Ninety per cent of the medical care budget in the USA goes to keep seriously ill patients alive in the last ten days of their sojourn on this planet.

Only in rare cases a specialist might be needed to intervene at the behest of the family physician. Such specialists must be classed as medical technologists and not true doctors. They should have very little to do with diagnosis of illnesses. A specialist should be like a laboratory supplying the investigation data to the family doctor when in doubt. He could also assist the family doctor to manage the illness using his tools only when needed.

Nutrition and exercise physiology must also be taught in detail. Spirituality, not religion, in its true form should be taught. Spirituality is the same in every religion-sharing and caring, its role in healing has to be stressed in this course. Many studies recently have proved that spirituality does help in disease set up. The new science of CHAOS and fractals using non-linear mathematics should be a part of the curriculum although detailed instructions in this area might be beyond the reach of most medical graduates. This latter is very essential as time evolution in a dynamic system like the human body does not depend on reductionist rules. The time evolution follows the holistic laws of uncertainty. A touch of quantum physics could be taught for the doctor to understand the sub-atomic world and thereby understand the role played by human consciousness in illness and healing. Yoga and meditation should be a part of this course.

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