Dr. Munawar Aziz MCPS*
A person came to my clinic asking me to recommend a gastroenterologist (a doctor who specializes in diseases of the stomach and intestines) who could treat his minor gastric issue. Initially, I looked at him thinking he might be joking because why should someone with a minor issue consult such a specialist? but his expression was quite serious.
This reflects one of the dilemmas faced by a qualified specialist Family Physician, known in the UK as a specialist GP. They are trained to deal with such cases in primary care and know when to refer to a particular doctor or to a specific medical facility.
Dr. Munawar Aziz
A Family Physician is a medical doctor qualified to treat human beings ranging from a one-day old baby to a ninety plus years old senior, whether male, female, or even transgender. His role also extends to participating in his patient’s family functions such as marriages etc., and advising on issues like schooling for their children and other day to day matters.
In well-established health care systems throughout the world, the primary care physician is the backbone of the system. It is the Family Physician or GP who decides when and to whom the patient should be referred if he or she feels the case is beyond their jurisdiction and requires specialized care, not the patient, who often ends up in the wrong place.
For example, I have come across patients being treated by ENT specialists for thyroid issues, simply because the patient assumed it fell under the ENT’s jurisdiction. If the ENT specialist refuses and advises the patient to consult an endocrinologist, the patient often feels offended, thinking, “This doctor doesn’t know anything about my illness, hence he is referring me.”
Similarly, a person suffering from Herpes Zoster(a severe viral skin disease) may be confused about whether to see a skin specialist or a physician. This creates a vicious circle of confusion and lack of trust.
The best option is always to report first to a primary health care provider and let him or her decide what course of action should be taken.
Talking of the private sector, it bears the major burden of patients, thereby relieving secondary and tertiary care hospitals in the public sector. Unfortunately, in our country, Family Physicians rather than being taken on board by senior faculty are often ignored and looked down upon in majority of cases.
It is a sad fact that in today’s society, which revolves around money, many health care providers give more preference to monetary gains than to their once dignified profession. The creation of a utopian state is still far away. Yet one should begin taking steps toward its creation. It is a difficult task, but not impossible.
NB: A utopian state is defined as “a hypothetical, idealized society characterized by perfect conditions, social harmony, equality, and freedom from suffering or evil” such as corruption and greed.
- Dr. Munawar Aziz
Abbottabad, Pakistan.
aziz.munawar@gmail.com
One great advantage for the family doctor is that he knows the medical history of the whole family. To be the next door neighbor is a added advantage. For the patient. Ok
Having lived and studied in the UK many years ago , I realize the importance of the GP ; in the British NHS system , it’s the GP who refers patients to specialists if required and calls for various medical tests etc . Unfortunately, due to our collective failure to institute a proper public medical service after do many decades post-independence , we still lack a grassroots-up structure. And those who can afford it are seeking specialists for no rhyme or reason . I wonder if we will ever change , if we can improve and provide socio-economic development to the teeming masses ? We are a Dystopia, and far from attaining a Utopia .
The role of a Family Physician has been explained in detail. The masses are not educated properly to go to the basic health units and then seek referral to a proper specialist if cannot be treated at the facility.
The dilemma is that people who have money prefer to go to a specialist and hospitals who charge heavily to satisfy their ego. It is not only in medical but all sectors of life. Brands have crept into our society and same is happening in education and health sectors which are supposed to be the backbone of an economy. Elite hospitals and schools have mushroomed all over the country. Specialists have also opened up clinics for the moneyed class. Utopia is a far cry and unachievable pursuit.
Excellent article.
A brilliantly articulated article, as always, and vital defense of the Family Physician’s role. Sir, You perfectly highlighted their irreplaceable position as the compassionate, knowledgeable cornerstone of a functional healthcare system.
The friends’ insightful comments wonderfully built upon the article, adding valuable real-world context about patient relationships, systemic failures, and societal pressures that make the GP’s role both crucial and challenging.
A thoughtful and engaged discussion.
Thank you very much. Eagerly waiting for the book of these article for me any my kids to learn and enjoy…
Fazeel