By Dr Nitish

Dr Paritosh Tiwari works as a family physician at the district hospital at Bahraich. He did his early years of study from Unnao, a small town in Uttar Pradesh and later studied in SN Medical College, Agra. After completing MBBS, he opted for DNB in family medicine in NIMS medical College, Jaipur. He got selected as a medical officer through UPPSC (Uttar Pradesh Public Service Commission) and has worked for 12 years in public health services. He has also done MHSc. in reproductive and sexual medicine from Annamalai University, Tamil Nadu. He has worked in various kinds of public health settings - at additional primary health care centres, primary health care centres, community health care centres, as deputy DTO in TB clinic and currently as a physician at NCD clinic Bahraich. Here he attends to patients suffering from chronic disease like diabetes, hypertension, cardiovascular disease, stroke, and cancer. He is trained in providing chemotherapy to cancer patients as well.

Q How did you get motivated to explore medical field? And how did that journey start for you?

A: I come from a very small village in Uttar Pradesh. In my childhood days, I have seen many of my near ones die because of doctors not being available in our Village. So, the thought that came to my mind was that if I want to save lives of my family members, I need to become a doctor. With that goal of becoming a doctor, I studied hard, got a lot of support of my parents, cleared my CPMT (Combined Pre-Medical Test) and got admission in Medical College in Agra. I think the day one enters a medical college one’s journey as a medical professional begins.

Q How did you start your medical practice? What were the difficulties you had to face during your initial years?

A: It was always very clear in my mind, that after completing my medical education, I will start my career from an interior and remote part of India where medical facilities are underdeveloped. With this determination, I started practicing at Bahraich which is a small town in Uttar Pradesh and still needs a lot of improvement in health facilities.

When I came to Bahraich the things that surprised me was that nobody knew about DNB Family Medicine. Some of them thought I had a diploma in neurology while the others thought it was some sort of short course. Even the UP health department was unaware of the discipline and DNB family medicine degree. l joined the health department as a medical officer. Every one used to suggest me to write “DNB medicine” instead of “family medicine” but I was determined that I will write what I am. A few of them discouraged me by saying “it is a degree for metro cities you should go and practice in a big city. This small town is not for you.” But I came over all of this and established my name as Dr Paritosh Tiwari MBBS, DNB Family Medicine.

Q In the times of super-specialization & corporate based medical practice, what has helped you sustain your practice?

A: Being a family medicine practitioner I knew what my duties and responsibilities are, and what my importance is to the society. Taking good care of my patients’ health and giving them right suggestions at the right time is my work. I always knew this well and never felt inferior or superior to anybody. The times keep changing and with that the importance of family physicians will also increase.

Q What changes do you find if any, over the years in medical practice?

A: If you consider the time 20 years ago, communication network was not so developed and so was the technology in the medical profession. Diagnosis has now become more accurate with the help of modern equipment, you get faster results, and examination of the patient has improved.

Patients are far more aware of their health condition. Many of them give more importance to their health now. With this, the importance of family physician has increased. People want the regular check-ups for their health, to keep a track of their health. And for that family physicians play an important role. As we look at people in full spectrum, not as a specialist who may be concerned with only one or two parts of the body. We look after our patient as a whole person and suggest further medications or specialist care whenever needed. So yes, medical profession has changed a lot and so have the treatment modalities.

Q What’s your view on having practice management included in medical curriculum?

A: Yes, it should be included in the curriculum as the way of practicing has changed a lot. We need to keep the records of the patients in better ways. It will also give doctors ideas on how to give appointments, organise patients’ data, billing, and process claims etc on the computer. Learning about software tools will help us to compete in the growing health care sector and we can provide better health services to the patients.

Q Can family physicians play a role in improving the doctor-patient relationship? What is your take on it?

A: Family medicine, the name itself tells us that it is not just looking at the patient as an ill person. A family medicine practitioner has a responsibility to look after the health of their patient and warn them of any future problems which may arise. They not only take care of the health but also give better suggestions for the treatments their patient can get. We, family medicine practitioners should attempt to build a relationship with our clients such that we should be the first person to be consulted related to our clients’ health.

Q Can use of technology help in practice of a Family physician? If so, how?

A: As the competition is increasing and patients wants to be more aware of their health issues, a family physician needs to be abreast with the technology that is growing every day. Using obsolete means of maintaining records of the patient can lead to the development of distrust in the patients and patients may feel that the doctor is not up-to-date with their health issues. So for the better understanding of patients’ problems, a proper record of the health issues related to the patient should be maintained. As the patient is more aware of their rights, they should be given proper bills and their data should be managed properly. Their claims, if any, should be settled soon and this way the family physician can also earn the trust of their patients.

Q Spice Route India Movement a part of WONCA (World Organisation of Family Doctors) is motivating young doctors across India to be family doctors and grow the field of family medicine and primary care. As a senior physician, what's your advice for the young & aspiring doctors?

A: I would believe that family medicine has a great scope in India. The health care system is improving day by day and the coming days will need more and more of family physicians. We not only provide the treatment for the disease we provide comprehensive care that includes prevention, acute intervention, chronic disease management, end of life care, and coordination of care. Family physician provides the majority of care for their patients in urban as well as in the rural areas. So in my opinion the future of family physicians is bright and will be better if more of us are there to create a meaningful health care system to the country.