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One physician is worth many specialists

I've become terrified of falling ill. These days even headaches stress me out, which is not a good thing at all because it just makes the pain worse.

health and fitness Updated: Nov 05, 2011 22:11 IST

I've become terrified of falling ill. These days even headaches stress me out, which is not a good thing at all because it just makes the pain worse.

Strangely enough, more than fear of undiagnosed brain tumours or still unidentified killer infections, what petrifies me is the battery of robotic doctors who prescribe unpronounceable tests with stormtrooper precision and banish me to diagnostic rooms equipped with hi-tech mechanical marvels that all seem to run on technology developed by NASA for its antimatter spaceships for Mars missions. At least that's what I'm usually told, which results in several zeroes being added to the bill.

It's about then that my headache graduates into a migraine and I start wondering whether I should have popped two aspirins instead of one and stayed home. After five hours of tests for ailments I compulsively google information for as I wait for my turn at the scanning pods, I'm told to do just that: pop two aspirins and go to work in the morning.

How did I end up wasting so much time and money? Easy. I chose to go to superspecialists instead of a friendly neighbourhood family physician - or internists, as they are now called - who would have asked me to take two aspirins and call him in the morning.

Most Batman fans know this already, but it's worth repeating: "Super" does not always mean better. All superspecialists are internists first -- they do an MD in medicine before they become specialists -- but quite a few get rusty on the basics as they increasingly see patients with disorders related to one branch of medicine. It makes little sense to go to a superspecialist at the first appearance of a symptom because they may just have become wired to focus on their own specialty.

An old-style family physician, on the other hand, treats symptoms holistically and refers you to a specialist only if necessary. Going to the same physician for ailments also adds to his understanding of your medical history - such as past diseases, other medications you are on, allergies, etc - which makes continuing care personalised and easier for both you and your physician. Your family physician is also more likely to take calls and discuss your over-all medical history with a specialist, if needed.

Most hospitals do recognise the role of a general physician and have a department of internal medicine. Still, patients usually end up going to a specialist who they assume will know better, or simply because they want to save on consultation fee.

Don't get me wrong. Specialisation, no doubt, gives physicians better understanding of a particular branch of medicine, but if symptoms overlap - for example, a headache could be caused by high blood pressure, eyestrain, stress, infection, tumour, neurological anomalies, among others - with more than one specialities, you may end up undergoing unnecessary tests.

So, you may lose both time and money by going directly to a specialist. Referral is needed only in 5-10% cases as internists are equipped to handle 90% of everyday aches, sniffled and ailments.

Choose a physician who practises close to your home and is on call. Since house calls are often not possible, (s)he should be on the phone to guide you through emergencies. And whatever you do, don't go for someone you're in awe of as you need to be comfortable discussing your problems with him/her. That done, you can rest easy in the knowledge that someone out there is watching out for your health.