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| LETTER TO EDITOR |
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| Year : 2019 | Volume
: 8
| Issue : 5 | Page : 1812-1813 |
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Save family medicine to protect health of the third world
Amrita Ghosh1, Ranabir Pal2
1 Department of Biochemistry, Medical College, Kolkata, West Bengal, India
2 Department of Community Medicine, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
| Date of Web Publication | 31-May-2019 |
Correspondence Address:
Dr. Ranabir Pal
Department of Community Medicine, MGM Medical College and LSK Hospital, Kishanganj, Bihar
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jfmpc.jfmpc_211_19
How to cite this article:
Ghosh A, Pal R. Save family medicine to protect health of the third world. J Family Med Prim Care 2019;8:1812-3 |
Sir,
In reference to the editorial published in current issue of 'Journal of Family Medicine and Primary Care',[1] we would like to supplement the theme with our comments.
We Indians feel proud that Sir Joseph Bhore in the 'Bhore Committee 1946' (Health Survey and Development Committee) report familiarized us for the first time with the concept of comprehensive health care that will integrate preventive and curative healthcare at all the administrative levels within the purview of primary health care well ahead of time in the history of public health in India.[2] After more than 30 years of this, 'Health for All by 2000 (HFA2000)' was pronounced by WHO in Alma Atta declaration to endorse the primary health care as the international concept without any reference to ideas of Sir Joseph Bhore.[3] With the ushering of new millennium improvement of health again reached centre stage by Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) to reinforce the success stories of HFA2000.[4],[5] Recent documents from WHO also hail the concept of primary health care; 'roadmap for action, 2014–2019'[6] planned to integrate equity, gender, human rights and social determinants into the work of WHO. Furthermore, WHO unveiled reforms towards achieving the ambitious 'triple billion' targets 2019 as WHO's strategic 5-year plan [7]: one billion more people benefitting from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.
Globally, primary health care has been acclaimed as the central to all the medical disciplines focussing on the family which is the basic unit of community. Following exposure to innumerable risk factors living inside family environment 'natural history of disease' progresses through ups and downs at their family environment through pathogenesis and its reversal by salutogenesis. History moves spirally instead of circularly. Even with tremendous development of medical science and technology converting health systems more complex and expensive, primary healthcare still remains ' first contact care' for the global citizens. Furthermore, at the grassroots levels, family medicine experts are fighting against all odds to re-establish the importance of primary health care globally in general and India in particular.
Moreover, it was noted that in this proposed curriculum of Medical Council of India (MCI), 2939 competencies are proposed for MBBS doctors.[8] Given the teaching-learning practice with rapidly increasing MBBS seats without corresponding increase in medical teachers has led to disaster of overall undergraduate (UG) students–teacher ratio of 11:1; 61880 'medical students' yearly intake being trained by 31525 'medical teachers' over five and a half years course (including one year of hand-on-training as internship) in 492 medical colleges across India.[9] MCI has put emphasis on practical instruction and demonstration in small groups for which 10 students per teacher needed exclusively for UG level; for postgraduate levels 2–3 students per teacher needed exclusively in addition to UG requirements.[10]
Finally, there is a commoner saying 'if you cannot convince them, confuse them!'. Recently, instead of 'health for all', we are now getting an hallucinogenic propaganda from the stakeholders of health as 'health insurance for all' as if insurance can only ensure health. We need to remember the universal truth that health is not a purchasable commodity in the market. We have to help grow generalist with the training of 'family medicine' and ingraining of primary care in the healthcare curriculum to protect health of the third world.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Kumar R. The tyranny of the Medical Council of India's new (2019) MBBS curriculum: Abolition of the academic discipline of family physicians and general practitioners from the medical education system of India. J Family Med Prim Care 2019;8:323-5.  [ PUBMED] [Full text] |
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