In Bangladesh there is no specific center for delivery of primary health care (PHC) services. So, the patients have to travel long distance to consult with graduate doctors for any illness. Medicine Specialist Dr. Ratindra Nath Mondal first though about the concept of GP. He opened a face book group titled “GP Practice Guideline” in 9th August, 2018 to help and guide the MBBS doctors to do GP. Within a short time the group popularity increased substantially. General Practitioner (GP) post their problems in the group and a group of seniors discuss and answer the problems.
From this group MBBS doctors are encouraged to start GP practice. A dialogue on GP was arranged along with the fresh MBBS doctors . In the discussion, doctors unveiled 2 important reasons of not doing GP – 1) GP is not a faculty in our country, most of them is not aware of GP system 2) There is not GP training, in the MBBS curriculum mainly there is indoor based training, so after completion of MBBS doctors are not confident enough to do GP. After that Bangladesh Society of General Physicians (BSGP) was founded to establish GP practice and referral system. Executive committee was formed by Dr. Ratindra Nath Mondal, Dr. S. M. Ahsanul Kabir Ahsan, Dr. Md. Auhidur Rahman, Dr. Anupam Das, Dr. Farjana Bony, Dr. Farjanul Haque Lia, Dr. Mafuz Morshed Khan, Dr. Noman Hossain, Md. Abdur Rab, Md. Abdur Razzak Sarker and Md. S.K. Saiful Islam.
To address the training issue of MBBS doctors a 4 days General Practice Orientation Convention (GPOC) was planned. The training is 35 hours equivalent teaching of all the GP related subjects (e.g. medicine, surgery, Gynecology & Obstetrics, Pediatrics, Dermatology, ENT, Psychiatry and Ophthalmology). From July, 2021 Daffodil International University and Bangladesh Society of General Physicians jointly started to organize ‘Certificate course in General Practice’ (CCGP), which is the country’s first certificate course in GP. Dr. Ratindra Nath Mondal is course chairman and Dr. S. M. Ahsanul Kabir Ahsan is course Coordinator of the CCGP course. A group of renowned specialists from the each subject were involved in teaching: Medicine- Dr. Ratindra Nath Mondal, Surgery- Dr. Badiul Alam, Gynecology and Obstetrics- Dr. Momena Khatun Rosy, Dermatology- Dr. Md. Rashidul Hasan, Pediatrics- Dr. Md. Syed Wasiullah, Opthalmology- Dr. Md. Masud Hashmee, ENT- Dr. Md. Mashiur Rahman, Psychiatry- Dr. Redwana Hossain, Emergency management session-Dr. Ettihad Amin Ferdous, Ultrasonography Session – Dr. Farzana Hossain Bonny.
The executive committee worked hard to form the structure of GP model and finally country’s first GP model ‘Daktarkhana’ started its journey from 14th February, 2019. Outlook of the GP centers are similar throughout the country. Besides prescription pad, signboard of the chambers are also same. In the training sessions doctors are motivated to open a GP center (Daktarkhana), if anybody agree then we provide the essentials to start GP chamber e.g. prescription pad, banner, marketing leaflet, visiting card, registrar book etc. Daktarkhana aimed to serve approximately whole population of single ward in urban area and 4 squares kilometer in rural area. Structurally Daktarkhana had a room for chamber and waiting space for the patients. Following services were provided from Daktarkhana- consultation, home visit, hypertension screening, DM screening by glucometer, ECG, blood sugar test by glucometer, nebulization, family planning, antenatal check up, ultrasonogram (in some center), pharmacy (in some center). Consultancy of the GP in urban area is 200tk and in rural area 100tk. Shortly Daktarkhana became popular among the people, within 3 years there were 161 centers throughout the country.
To open a GP center (Daktarkahan) one have to register and follow the rules of the BSGP. The whole process was free of cost and no monthly or yearly fee. After opening of Daktarkhana all the GPs are included in messenger group and also in a face book group. In messenger group the GP can ask any question or put an ECG or X-ray for urgent answer. Group of seniors from all the subjects included in the group as an expert to answer the query ASAP, so that the GP can smoothly serve the patient at chamber. Besides as a part of CME lectures are arranged in the face book group and the GP can post routine cases in the face book group for discussion.
This is the short history of GP in Bangladesh, BSGP is working hard to establish one Daktarkhana for every 20000 people and make GP a faculty with structured GP course.