|Year : 2012 | Volume
| Issue : 1 | Page : 1-2
Empowering primary care physicians in India
Editor in Chief, Journal of Family Medicine and Primary Care CMO, Emergency, Institute of Liver and Biliary Sciences, New Delhi, India
|Date of Web Publication||30-Mar-2012|
B-32, Chanakya Place, Part 1, Opp C-1 Janakpuri, New Delhi - 110 059
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar R. Empowering primary care physicians in India. J Family Med Prim Care 2012;1:1-2
Medical education and healthcare delivery system are at cross roads in India. Vital reforms have been pending for decades in the area of medical education due to structural problems in the regulatory mechanism. Recent developments including "National Council for Human Resources in Health Bill 2011" have set a momentum for change. 
| Primary Care in India|| |
Primary care was first emphasized in Sir Bore Commission report in India at the time of independence. Bore committee envisioned a three-tier healthcare delivery system with a well organized referral system. Primary care gained central position in policy making after Alma Ata declaration in 1978.  Primary care is a broad concept and its outcome is dependent on optimal performance of several sectors interwoven within the health system. Healthcare financing is related to governance and polity. , While public health professionals engage with policy making, healthcare planning and management; primary care physicians act as frontline care providers within the primary care teams. Family medicine is the key knowledge discipline, which has a scarcely explored but immense potential to link medical profession at all levels with the primary healthcare delivery system.
| Medical Education and Primary Care|| |
Unfortunately, in India, medical education is entirely based in tertiary care setting and is provided at academic medical colleges. Medical professionals and community health facilities, operating outside of the tertiary care system, have no participation in medical education.  Though the purpose of basic MBBS training is to prepare a competent family medicine doctor, the concept doesn't appear in the undergraduate MBBS curriculum. As an outcome, a large section of medical students, faculty and practitioners are not aware of the advantages of family medicine approach. Therefore, at the point of service delivery, what we often see is an extreme of high-end tertiary care intervention or a minimalistic public health approach.
| Family Medicine and Primary Care|| |
Over the last several decades family medicine has evolved and established itself as a specialty for skilled primary care physicians. Family medicine caters to the community need and desire for personalized, continued and non-fragmented health care. Internationally acceptance of family medicine in academic circles is the standard approach towards organizing health promotion, comprehensive and continuing care for individuals and communities. Family medicine provides structure for community-based management of acute and chronic illnesses irrespective of age, sex and social status. Family medicine also caters to the needs of special groups such as adolescents, elderly and terminally ill persons in community as well as in the home-based setting. Family medicine ensures high quality, standardized, equitable framework for service delivery with emphasis on bio psychosocial nature of illness. ,
| Family Medicine in India: Recent Developments|| |
Multi-skilled competent primary care providers and their knowledge figure prominently in the evolving schemes, themes, and initiatives of our healthcare systems. Though the concept of "family medicine" has received attention in several policy discussions of Government of India including the National Health Policy 2002, recognition and implementation in academic setting is yet to be seen.  Most of the developed nations have evolved advanced structures for academics as well as delivery system based on family medicine; good progress has been observed in neighboring countries of India such as Nepal, Sri Lanka and Pakistan. Recently Medical Council of India (MCI) has also notified curriculum for post graduate MD family medicine.
With the intention of advancing family medicine and primary care research, policies, and practice, we proudly present to you the Journal of Family Medicine and Primary Care (JFMPC). The journal will serve as a pioneer in the South-East Asian region to advance the academic discipline of family medicine. With this overarching goal, the JFMPC:
- Seeks to foster academic communication and interdisciplinary research among primary care providers engaged in various settings. The journal will cover broad spectrum of clinical topics catering to the academic needs of family physicians, urban general practitioners (GPs), rural physicians, national rural health mission (NRHM) doctors, community surgeons, community health workers, providers of community-based maternal and child health, emergency physicians, occupational physicians and public health specialists. The journal will publish original articles on clinical studies, theories, and policies related to the discipline of family medicine and primary care.
- Acts as an interactive forum for primary care providers, policy makers, healthcare administrators, community leaders, social scientists and healthcare funding agencies towards provision of cost effective, personalized, continued, comprehensive, holistic form of health care to individuals, families and communities.
- Invites physicians of first contact as well as other health providers to document reflections of their own practices and experiences towards accumulating a wealth of scientific evidence enriching academics in primary care. We welcome your submissions to accomplish the values and mission of primary care and family medicine as a scientific and practice-based discipline.
- Advocates academic institutionalization of community health services through processing of data and evidence on health interventions focused at individual, family and community level. We also invite discussions and debates on evaluation of training programs, faculty development, curriculum standardization, and development of practice standards and protocols.
- Encourages tradition of scientific writing among primary care providers in India and South Asia. Primary care providers shall function not only as foot soldiers but also as leaders, contributing to the growth of this knowledge discipline; facilitating local clinical governance and accountability. Implementation of the concept of family medicine requires a paradigm shift in the medical education system; from biomedical focus to patient centered approach, and to promote this shift, manuscripts are sought by the JFMPC.
A battery of critically linked interventions is required as stakeholders work together for academic institutionalization of community health services. There is a need to evolve background documentation and consensus on standards for locally relevant practice and teaching of family medicine in India and South Asia. JFMPC seeks to fill these critical gaps. Given the challenging scenario, such a journal is automatically positioned to play manifold roles. Your submissions are welcome!
Author's Note: The findings and conclusions in this article are those of the author and do not necessarily represent the official position of ILBS, New Delhi, India.
| References|| |
|1.||The National Commission For Human Resources in Health Bill, 2011. Available from: http://22.214.171.124/BillsTexts/RSBillTexts/asintroduced/nationl%20com%20humn.pdf [Last cited on 2012 Jan 15]. |
|2.||Declaration of Alma-Ata, International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 Sept, 1978. Available from: http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf [Last cited on 2012 Jan 15]. |
|3.||WHO Document: Commission on Macroeconomic and Health: Primary Health Care in India: Review of Policy, Plan and Committee Reports. Available from: http://www.whoindia.org/LinkFiles/Commision_on_Macroeconomic_and_Health_Primary_Health_Care_in_India_Review_of_Policy_Plan_and_Committee_Reports.pdf [Last cited on 2012 Jan 15]. |
|4.||Improving Health and Education Service Delivery in India through Public-Private Partnerships. PPP KNOWLEDGE SERIES, under the ADB-Government of India PPP Initiative. Available from: http://www.pppinindia.com/pdf/health-education-delivery-india-ppp_adb_dea.pdf [Last cited on 2012 Jan 15]. |
|5.||National Conference on Health Professions Education 2011 - Concluding Statement. The Hindu, 2011 Oct, 19. Available from: http://www.thehindu.com/news/resources/article2551581.ece [Last cited on 2012 Jan 15]. |
|6.||Stephens GG. Family Medicine as Counterculture. Fam Med 1989;21:103-9. |
|7.||Starfield B. Is primary care essential? Lancet 1994;344: 1129-33. |
|8.||National Health Policy 2002. Available from: http://www.mohfw.nic.in/NRHM/Documents/National_Health_policy_2002.pdf. [Last cited on 2012 Jan 15]. |
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|[Pubmed] | [DOI]|