Many
people ask me how and why you become a rural primary care physician? Is it by
choice or a circumstantial decision? So to get answers to these questions let
me share little bit of background of mine. I Dr. Smruti Subhash Nikumbh now
known as Dr. Smruti Mandar Haval is a daughter of Dr. Subhash K. Nikumbh &
Dr. Usha Nikumbh. My parents are specialist in their own subjects (Obstetrics
Gynaecology & Ophthalmology) respectively. They are practising in area
named Chalisgaon, Dist Jalgaon a town with population of 1 lakh to 2 lakh now with
a good rural area surrounding it. When my parents started their practice 32
years back the population was round 40000 and most of the patients used to be farmers,
poor daily wagers with not so good paying capacity. Most of the consultations
used to be charity service. The connectivity was also poor then to the town. Patients
used to come on bullock cart, cycle, walking. Ambulance service was a fancy
thing. Maternal and child mortality was a regular thing. Laboratory facilities
were in very primitive stage.
With so many challenges my parents
started their practice and with their good clinical judgement they managed to improve
overall mortality and morbidity of patients from that area. Health promotion
and awareness was always a part of their consultations. Since childhood I have
observed there moves - conservative approach, no unnecessary surgeries, IV fluids,
antibiotics abuse as that of today’s era.
This entire thing nurtured a
family physician in me and I learnt to live with people of golden heart. This
journey with my parents generate a kind of liking in me for rural health, it’s
up liftment, challenges.
With God’s grace and wish I got
family medicine as my post graduate course and carrier. Also I got married to a
man who has his work place in a small developing town of population 50000 -60000.
For me this new work place is like my own home town 15-20 years back. After looking
back at my 2 years of journey of rural physician I feel my challenges are same
as of my parents but I love my job as patients I deal here are same as of my
childhood pure mind, golden heart with lots of faith in me. They do feel I have
healing hands. Their trust act as placebo in my treatment plan.
For my residency &
undergraduate training I have stayed in urban and metro areas. Those 10 years taught
me how urbanisation changing human psychology. There I mate various types of
patients like Google masters, self-diagnosis specialists, doctor shopping freak
etc. This work culture was just not suitable for me. May be I was still a country
side gal. Hence as soon as I finished my studies I decided to come back to my
roots the rural practice.
Here I diagnose patients with minimal
investigations, cost effective medicines, no much branding of pharmacy
companies. This job gives me lots of satisfaction of work and my dues are
getting clear slowly towards community I live. I also run few projects or
schemes to improve treatment compliance of my patients to their long term
treatment.
These
schemes are
1) Project Kamal Early screening of hypothyroidism and treatment
2 2) Diabetic Mitra Live healthy with diabetes
3)SurekhUsha Kavach Early screening of cardiovascular
diseases and treatment
In these activities we charge
patient nominal fees and make sure that they will receive best discount on each
visit, investigations done by me. Slowly & steadily I am working on up liftment
of health of my community.
Being a female I can relate well
with both male and female patients. Female patients open up about their
problems much better & clear so with that I can help them in best way. I
am a proud # Rural Female GP by choice and I am loving it. Thank you Almighty
for all guidance & strength.
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