Push to create cadre of family doctors for rural India
In an effort to address the need for middle-level doctors in rural areas, the National Health Systems Resource Centre (NHSRC) will soon submit the recommendations of its task force on promoting the discipline of family medicine. NHRSC is the technical support institution for government's flagship rural health programme, the National Rural Health Mission.
The recommendations that have been drafted were discussed at the first national conference on family medicine and primary care, organised on April 20 and 21 by the Academy of Family Physicians of India (AFPI), in association with the National Rural Health Mission (NRHM). The conference, titled “Preparing multi-skilled and competent primary care physicians: consensus on family medicine in India”, emphasised on the need for general doctors, in times when everyone is focusing on specialities and super-specialities. A practitioner of family medicine, also called general physician or family doctor, does not have any specialisation but is equipped to address basic health issues related to any discipline.
"Details are being worked out, but the three main recommendations include the introduction of the concept in the MBBS curriculum; recognition of the course on family medicine by Medical Council of India; and creation of a post of family medicine practitioner at all community health centres," said Raman Kumar, president of AFPI.
Vishwas Mehta, joint secretary of health ministry, said that he and other officials were surprised to know that the course in family medicine is not recognised by the Medical Council of India. He said that the ministry will push for it as having middle-rung medical officers is crucial to make healthcare accessible in rural India.
"It is important to create posts for these doctors which will act as incentive. There is low enrolment in the course where it is taught, and the seats are not fully occupied," said Prasanth K S, senior consultant for public health administration with NHSRC. Among the prominent medical colleges which offer the course are Christian Medical College, Vellore, and AIIMS-Bhopal.
Pavitra Mohan of Ajeevika Bureau, a non-profit based in Udaipur working among seasonal migrant workers, is sceptical. "We did not set up a task force to ensure that doctors earn degrees in specialisations and super-specialisations. The courses became part of the system as the demand increased. Then why a task force for family medicine? The government should create posts, and automatically there will be people training in the discipline," he says.
Other participants at the conference asked for innovative models of training."There should be different levels of training for people with different qualifications and needs. An established doctor can be trained for six months, while a fresh graduate will need two years. Modules should be formulated accordingly," said a participant.