Views of physicians on the establishment of a department of family medicine in South India: A qualitative study.

OBJECTIVE: To explore the experiences and perceptions of physicians involved in establishing a department of Family Medicine in South India. METHODS: In this study, descriptive qualitative methodology was used. Nine family physicians and one community medicine physician were interviewed. The data were subjected to thematic analysis. FINDINGS: The establishment of a department of Family Medicine in South India in response to the local health-care demands needed support from the institution, visionary leaders and alumni of the institution. The key challenges perceived were lack of mentorship, lack of identity and misunderstanding of the work of family physicians. CONCLUSION: This study replicates earlier studies on the role of local health-care needs and visionary leaders in striving towards family medicine-based clinical services that further evolved into training and research opportunities in family medicine. The study identified the challenges and supportive forces behind the initiation of a department of Family Medicine and the role of family physicians in strengthening primary health care.

Neuroleptic malignant syndrome.

Neuroleptic malignant syndrome (NMS) is a life-threatening emergency that is often seen as a complication of antipsychotic agents. It is characterized by a tetrad of motor, behavioral, autonomic, and laboratory abnormalities. We report a case of a 34-year-old man with a history of newly diagnosed Type 2 diabetes mellitus, mental retardation, and behavioral abnormalities who developed NMS after starting on antipsychotic agents. He presented with high temperature, muscle rigidity, tachycardia, and elevated blood pressure. After a week of hospital treatment in the general ward of a secondary care unit, he was discharged in a hemodynamically and mentally stable state.

Role of Family Medicine Education in India's Step Toward Universal Health Coverage.

India's commitment to universal health coverage has grown stronger with the submission of High Level Expert Group report by the Planning Commission in 2012. With this report comes the commitment to increase the primary health-care workforce to meet the population needs. However, the focus should not be just to increase the number of health workers, but to produce better health workers. Doctors, nurses and community health workers trained in primary and secondary health-care facilities can make a significant contribution in responding to the needs of the local community. The role of family medicine education is worth exploring in this context to equip the primary care health workers with the competencies of providing person-centered, comprehensive and continuous care.

International classification of primary care: an Indian experience.

BACKGROUND: India is in the process of transition to universal health coverage for Indian citizens. The focus is to strengthen the primary and secondary level services. Coupled with this national scenario, the development of Family medicine as a distinct discipline is in a crucial stage. There is a nation-wide urge to build family medicine training units and service centers across the country to fulfill the unmet health needs of the population. OBJECTIVES: This study aimed to bring out reasons for encounter (RFE) and morbidity pattern of patients seen in a family physician run urban health center in South India. METHODS: The study was conducted in an urban health center of a tertiary care hospital. Clinicians entered the data using International Classification of Primary Care (ICPC) codes. Data included were demographics, 3 RFE, 3 diagnoses, 3 outcomes of care that include prescriptions, investigations, procedures, and referrals made. RESULTS: During 47,590 patient encounters, 59,647 RFE, 62,283 diagnoses and 68269 outcomes of care were recorded. The majority of RFEs and diagnoses are in the following ICPC chapters: Endocrinology (38.6%), cardiovascular (35.91%), respiratory (20.26%), digestive (7.68% and musculo-skeletal (6.8%). The most frequent outcome of care was prescriptions, followed by counseling and nebulization. CONCLUSION: This study is the first to report on the RFE in India. This study demonstrated the breadth of clinical conditions seen by family physicians across all ages and in both genders. This study attempts to highlight the need for family physician based services as a training ground for trainees.