Specialisation in medical sector is pushing the traditional breed of family physicians to the brink. Approaching the Supreme Court in a Public Interest litigation, the Academy of Family Physicians pointed out that there is no Department for “Family Medicine” in most hospitals while those seeking post-MBBS specialisation in this discipline are not getting avenues for it in medical colleges.
As a result, the petition filed by Suvidutt MS sought directions to the Medical Council of India (MCI) and Ministry of Health and Family Welfare to consider it expedient to provide the support structure in order to preserve the dying breed of family doctors.
The Bench of Justices Arun Mishra and Navin Sinha felt that the issue at hand squarely felt in the sphere of executive determination since it relates to policy decision. While the petitioner’s arguing counsel J Sai Deepak did point out the National Health Policy 2017 where the Centre emphasised the need to popularise MD in Family Medicine or General Practice, he rued the fact that nothing had been done in this regard by the States or the Centre.
Any suggestion to introduce MD and DNB in Family Medicine must come from MCI, the sole medical education regulator in the country. Realising this, the Bench asked the petitioner Academy to pursue their demand with the MCI.
While the battle is not yet over, the 1,000 odd number of doctors pursuing family medicine are feeling cheated. On one hand, the Government’s ambitious scheme of Pradhan Mantri Swasthya Suraksha Yojana is expanding the network of All India Institute of Medical Sciences (AIIMS) across the country to strengthen rural healthcare. These hospitals even have a Department of Community Medicine and Family Medicine”. But the Academy claimed there is not a single faculty or senior resident recruited in them. This information was obtained by them under Right to Information Act. In addition, 60 per cent of primary care specialist posts at community health centres under the National Rural Health Mission (NRHM) are lying vacant for want of family or community medicine practitioners.
Family Medicine is recognised as a post-graduate specialty by MCI under the MCI Post Graduate Regulations 2,000 but they don’t exist as a separate Department in medical colleges and hospitals. Young doctors are thus driven towards specialisation in tertiary medical sector with little or no inclination to pursue a career in family medicine.
The petitioner feel that the Centre is inclined to help them the National Health Policy (NHP) of 2002 underlined the requirement of expertise in the area of ‘Public Health’ and ‘Family Medicine’.
The Report of Working Group of NRHM (2012-17), the Planning Commission recommended Family Medicine to be treated as a specialist discipline to revitalize primary health care. The Parliamentary Standing Committee in its 92nd report submitted in 2016 recommended States to introduce post graduate programmes in Famil Medicine in medical colleges in order to minimise frequent referrals to specialists. But the response of MCI has not been forthcoming. The petitioner hope that the apex court’s order to MCI could become the turning point.