At our healthcare innovation enthusiasts meetup this weekend we followed up with an important question for all our attendees. What do you do when you just need simple medical advice? One of our attendees who migrated to Pune only recently surprised us by sharing that he calls his family physician back in his home town Satara. That feedback connected together a series of discussions that we’ve been having here around our direction for Savetime.
Many of us don’t have the equivalent of a family physician. It isn’t that we’re invincible, I guess we simply never made the time. Instead, whenever needed we rely on recommendations from parents, friends, especially those who we think know the city better than we do. While their recommendations work well there’s something missing from the larger picture.
Any diagnosis is founded on at least three key factors – your symptoms, medical history and the prevalent medical environment at that time. We’re all accustomed to asking and answering questions about our physiology so that we can get better treatment. A series of questions can help uncover everything from the smallest to the largest of ailments. That’s how primary care works. We rely on this approach as it would be expensive and even undesirable to prescribe all possible tests for every observed symptom.
What sets apart the family physician is the combination of in-depth knowledge of your medical constitution and training across specialties. In many cases, she is aware of the patients medical make up since birth. When a treatment is ineffective, or a diagnosis incomplete or incorrect, she serves as a key part of the puzzle in prescribing the relevant tests, referring you to the right specialist, or coming up with a new line of questions. Even in the case when you don’t have an ailment, as our meetup attendee pointed out, the family physician is there to answer any questions too trivial for a visit to the clinic.
Recording medical histories digitally can’t fill in the gap left by a family physician entirely. Think of your medical history as if it were a globe. Medical histories depict what the land masses are like. But we still have no clue about the oceans. In other words. What are you like when you’re well? Or, when you’re not seeking medical care? Do you have any conditions that might be mistaken for the symptom of an ailment? Or worse. Do you have a condition that does not have any visible or verifiable symptoms? How does your physiology change throughout your day? Until we figure out how to track and store what easily runs into terabytes of information, the best alternative is always going to be human intuition and a checklist of questions that can help confirm or invalidate the physicians hypothesis.
In popular culture, the television show “House” is a recognizable parallel to this role. The brilliant eccentric Dr. House is the head of diagnostics at a prominent hospital. In order to be on his team (a much sought after position as the show would like us to believe), House requires his doctors to be ok with breaking into the patient’s house to search for clues. As House says, patients Lie about their histories more often than you’d expect, even if they’re dying. While the show is a work of fiction, the practices shown in the show are not entirely so even if they’ve been amplified for dramatic effect. Moreover, House is literally the ‘Sherlock Holmes’ of diagnostics and is presented with incredibly hard medical cases to solve. To have any credibility, coincidence or luck can hardly be convenient crutches for the story writer.
I’m not sure why the family physician isn’t as popular as it has been in the past. Perhaps a busy migratory life discourages the effort that cements this valuable one on one relationship. At this point, a few questions beg to be asked. What if we could reinvent that relationship? Take it with us wherever we go? What if she were accessible 24×7 over phone, sms or email? What if she had the best in class tools and technology to track our physiology? Wouldn’t that be a different, better world?