Expensive Hospitals, Specialists Edge Out Family Doctors

Several older patients recall a time when the family doctor was the first call for illness, anxiety, or routine care. This familiarity had been common even in popular cinema, where the doctor would appear with his Gladstone bag and announce the "news." This has steadily given way to hospital corridors, queues for specialists, waiting in halls, and test-heavy consultations; largely making the treatment expensive.

"I used to go to the same doctor for years. He knew what medicines suited me and what didn't. He eventually became my wife's and children's doctor too," said a 62-year-old retired bank employee Nanda Kishore. "But no more; now, every problem means a hospital visit and scans."

Dr Khushwant Singh, a general and family physician practising for close to three and a half decades at Punjagutta Polyclinic, said treating thousands of patients over the years has shown him how the loss of first-contact care has altered treatment patterns.

"Patients now end up in hospitals without basic clinical evaluation. This leads to unnecessary tests, scans, antibiotics, and sometimes invasive procedures," he pointed out.

According to Dr Khushwant Singh, the family doctor model once acted as a

clinical filter. "A family physician knows the patient's medical history, medications, stress levels, and lifestyle. That context helps decide what is genuinely needed and what can be avoided," he observed.

Patients today often choose specialists on their own, based on online

searches or informal recommendations, bypassing primary care entirely.

Vinita Chella, a 41-year-old IT professional, said she consulted three specialists for recurring headaches before a family physician addressed sleep, screen time, and anxiety.

"No one asked about routine or stress earlier. They barely even looked at me for a minute. It was straight to the tests," she said.

The Covid-19 period, Dr Singh said, brought these gaps into sharper focus. "During the pandemic, many patients went through hospitalisation, antibiotics, and repeated tests; when homecare and monitoring could have been sufficient. Many Covid patients recovered completely without aggressive treatment," he stated. He disclosed that indiscriminate antibiotic use during that period has worsened antimicrobial resistance.

Dr Giridhar Prasad K., senior consultant at a corporate hospital here, said hospitals were increasingly seeing patients who do not require specialist care. "Many cases should ideally be assessed and guided by a family doctor. When that layer is missing, hospitals become the default entry point and investigations follow quickly," he said.

He flagged concerns over avoidable radiation exposure. "Imaging tests are ordered casually. Patients are rarely informed about cumulative radiation. A family doctor can decide when a scan is necessary," he emphasised.

A 2025 cross-sectional study from Bengaluru found that people with a family physician are around 70 per cent less likely to rely on online consultations and 64 per cent are less likely to depend on family members for medical decisions during emergencies.

The study reported clearer referral pathways, with patients guided by family physicians showing structured clinician-to-clinician referrals, indicating stronger continuity of care and reduced drift towards hospital-first treatment.

Dr Srinivas Gundagani, vice-chairman of the Telangana Medical Council, said government intervention is key. "Expanding MD Family Medicine programmes, strengthening primary health centres, and implementing referral systems can reduce irrational drug use and unnecessary investigations," he said, referring to National Medical Commission's recommendations in this regard.