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EDITORIALS
HOW TO BE A GOOD FAMILYPHYSICIAN IN MODERN DAYS?
Three advices I would like to give to practice as a good family physician:
1. As far as organic diseases are concerned, concentrate on "quality of life". The patients are already afraid of death, do not frighten them more by talking about dying or ways to prevent death. In modern days, death is more likely when politics, nuclear warfare and relation with our neighbouring countries are so bad that only day to day living is worthwhile. Thus, do not make diabetic patients miserable by giving them a very strict diet. Even the standard textbook of medicine mentions that there is nothing like a diabetic diet. They are supposed to have a "normal" diet except omission of sugar.
Similarly a high BP patient should not be given a saltless diet. No restrictions should be placed on the movements or the business/working of a patient of IHD in modern days.
The patient of IHD should live as normal a "quality of life" as anybody else (of course with the help of modern treatment).
Let the asthmatics lead a normal life and do not make them more miserable by advising them not to play outdoor games in order to avoid dust, and not to eat icecreams, etc. These asthmatics can lead a normal life with the help of inhalers!
Do not make the chronic backache patient neurotic by giving him pain killers and making him drug dependent. With a few exercises and do’s and dont’s about backache, he can lead a normal way of life.2. Concentrate on his mental health and talk to the patient. Ask him whether he feels depressed in the morning, whether he has a lot of tension, irritability and anger, whether he feels restlessness or ghabrahat, whether he has sexual weakness, whether he sleeps well or not and attend to these complaints with as much enthusiasm as for his blood sugar or blood pressure.
3. In the diagnosis, concentrate on 3 illnesses:
a. Iatrogenic illness (a detailed history of investigations which might have frightened him, or the drugs which he has been taking or the diet which he has been consuming or the diet which he has been advised).
b. Think yourself whether the patient’s complaint is a normal physiological variation or as a result of a normal wear and tear (spondylosis, osteo-arthritis etc.) associated with the ageing process and modern stress of domestic and business life.
c. Try to diagnose the medical condition which is not known to modern super specialists, e.g. in the case of a cardiac patient, think of GI illness and in the case of a GI patient think of cardiac illness!
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