Like many of my peers in the field of medicine, I had decided to go for a Clinical Elective rotation overseas in the summer vacation of my penultimate year. Fate took me a long way and I ended up in the Cardiology Department of a reputable teaching hospital in England.
It was during my clinical rotation that I had a close encounter with the Healthcare system being run by the National Health Services-NHS and to my surprise it was undoubtedly one of the best Healthcare systems in the world. My experience at the cardiology department is a completely different story but what I found exceptional in the NHS healthcare structure was THE GP SYSTEM.
WHO IS A GP?
GP or a General Practitioner is a Doctor who has expertise in treating common health related problems in the community.
General Practitioners in NHS healthcare setting are ones who have completed 5 years of Medical school and two years of internship/House job. After which they undergo 3 years of training in General Practice, going through various short clinical rotations in the departments of; Medicine & allied specialties, Surgery and allied specialties, EYE, ENT, Pediatrics and Gynecology. Completing their training, the Doctors take their MRCGP examination i.e. Membership of the Royal College of General Practitioners and will then be certified GP’s and licensed to serve the people.
A GP in Pakistan is a term that has a much broader spectrum. A GP in Pakistan can be someone who has completed 5 years of Medical School and a year of internship/House Job and now doesn’t feel like pursuing specialty training, so he will go back to his home town and start working as a GP. Surprisingly doctors with specialties such as; Gastroenterology, Respiratory Medicine and even Surgery, work partly as General Practitioners during their evening clinics.
Although the College of Physician and Surgeons of Pakistan is running a Fellowship training under the banner of Family Medicine which is synonymous with General Practice, but the number of Doctors opting it as a specialty is still alarmingly low.
WHAT DOES A GP DO?
A GP in the NHS system doesn’t work in a hospital, rather works in special healthcare care facility called a “GP Surgery”.
Every city and town will have adequate number of GP surgeries that are comparable with the population of the area. The people of the city or town will be allocated a GP in their area and except in cases of accidents and emergency, will always visit their GP first who if feels necessary will refer them to Consultants.
Apart from treating routine and common ailments, the GP carries out vaccinations, does minor surgeries and provide advice on diet and addictions.
Additionally GP’s make home visits and provide medical advice and palliative care to the terminally ill patients.
WHAT IS THE BENEFIT OF A GP SYSTEM?
In a country like Pakistan, where the numbers of hospitals compared to the population are extremely inadequate, the GP system can play a very pivotal role. Majority cases presenting in the Out Patient Department (OPD) of various specialties are ones that can easily be dealt by a well qualified GP and with GP’s in our healthcare system the excessive burden on the hospital can be reduced by many folds and may also help to bank limited resources that hospitals have.
General Practitioners are doctors who have been trained in various specialties and can deal with a variety of common and minor ailments involving various systems of the body. The medical negligence that is on the rise due to doctors trained in other specialties coming forward and treating people can be markedly reduced by integration of GP’s in our healthcare system.
In a country like Pakistan, where luxuries of mass transit are prioritized over basic healthcare, it is in vain to expect a well developed GP system anytime soon. Though what the Government and Health Department can do is develop a separate Family Medicine/General Practice department with appointment of well trained GP’s in all tertiary care hospitals around the city
The department can function as a first line in diagnosing and separating patients with common ailments and those who need specialty care. This will help reduce the burden on other departments and improve the efficiency of the system and save resources.
