Family doctors inferior to specialists?
By Garth A. Rattray
Every now and then, someone in the public asks me if I am a doctor.
When I confirm their suspicion, they often ask me what kind of doctor I am. I either say, a general practitioner (GP) or a family doctor, or a primary-care physician, depending on my mood (mischievous, argumentative or instructive).
What sometimes follows can be a real downer. Some people appear disappointed and say that they hoped that I was a specialist. Women want to ask gynaecological questions and some men want to ask urological questions. And, almost everyone has some sort of pain, somewhere.
For the sake of my profession and for clarity, I explain that doctors like me see everything and everybody at every age and stage of life. I sometimes jokingly announce that 'specialists' know more and more about less and less until some end up knowing a whole lot about nothing. I sometimes end up answering questions on a wide variety of topics; whereupon they realise that general practitioners/family doctors/primary-care physicians must know a lot about many things.
All practitioners needed
It goes without saying that doctors who practise internal medicine, cardiology, interventional cardiology, neurology, endocrinology, pulmonology, rheumatology, gastro-enterology, otolaryngology, ophthalmology, dermatology, psychiatry, general surgery, neurosurgery, orthopaedic surgery, cardiothoracic surgery, urology, oncology, plastic surgery, gynaecology, obstetrics, paediatrics, neonatology, radiology, immunology, vascular surgery, facio-maxillary surgery, pathology and public health are all necessary in modern-day medical science.
However, the doctors in family medicine are also specialising in that field of medicine. And soon, although several already did so, all Jamaican family medicine practitioners will have to undergo postgraduate training/certification to practise their craft.
In my opinion, doctors (especially family doctors) have three roles in the lives of patients. We should be:
1. Educators - to explain the things related to health/medical problems.
2. Risk managers - to do all we can to help reduce the risk of patients being afflicted by certain illnesses and/or reduce the risk of further damage from existing medical problems.
3. Interventionists - when something actually goes wrong, to mitigate or negate the effects of the malady.
Whenever a patient walks into the office of a family doctor, it can be for anything from the scalp or the soles of the feet and everything in-between. The doctor can expect to be challenged by a problem affecting the body and/or the mind. He/she may even be asked to assist with a problem affecting a spouse or relative, here or abroad. Sometimes a prescription pad is of no use; a listening ear and objective advice may be all that is needed.
Family physicians/general practitioners/primary-care physicians are on the front line of the war against illness and disease. We form the core of the forces against morbidity and premature mortality. In many developed societies, patients must be seen and assessed by a doctor specialising in family medicine before being referred to the appropriate specialist, if needed.
In 2010, the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians declared May 19 World Family Doctor Day to "provide recognition to family doctors, to highlight important issues and the work we perform in supporting health care for all people in our local communities, our nations and around the world".
The residual, mistaken view that doctors who are general practitioners/family doctors/primary-care physicians are somehow incomplete or inferior to others who specialise in other fields of medicine is waning in our society. Especially with the emphasis on non-communicable diseases, preventative medicine and early detection, the GP has been taking prominence within the medical community and society at large.