We hope that Government of India will appoint an expert panel to create an Indian Preventive Task Force (IPTF), whose recommendations should be implemented as part of the free annual physical exam or telemedicine visit at government hospitals and primary care centers.

Advika was in her late 40s. Despite feeling tired and noting some abnormal pains during her monthly cycle, she declined to go to the doctor. Travelling to the doctor was expensive, and she didn’t have the extra funds or time to take a day off work for the trip. Eventually, she started feeling so bad that working was almost impossible. Finally, she went to the doctor, only to find out that she had an advanced stage of cervical cancer.
While we would all wish that her story was rare, the truth is that undiagnosed cancer frequently happens in India. Advanced stages of cancer are less likely to be cured and have a greater chance of relapse. In stage one, for instance, the cure rate is around 85%, but that number falls dramatically for those in stage 3. Cancer patients diagnosed with stage 4 cancer are not likely to survive for more than five years.
The World Health Organization says that cancer is diagnosed in more than 14 million people worldwide annually and kills approximately 8.8 million. What is most shocking is that two-thirds of these deaths are in low-middle income countries where the diagnosis is inadequate.
The Indian system of modern medicine does not promote an annual preventive physical exam for patients even though several private hospitals promote comprehensive executive check-ups for the wealthy. It’s time to change that. Identifying chronic diseases like diabetes, hypertension, and heart diseases early and managing them is a lot more effective than managing and treating their complications.
In the United States, the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. The Task Force works to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services. “The Prevention TaskForce” application assists primary care clinicians in identifying the screening, counseling, and preventive medication services that are appropriate for their patients. The Government of India could implement a similar project and use the lessons learned in the United States and other countries.
Suppose all patients in India have access to complimentary annual preventive physical exam, including routine lab tests and cancer screenings. In that case, this will increase the chances of finding cancer and deadly diseases earlier and enhance the likelihood of a cure. The cost to the taxpayers of India will eventually be far less as we prevent long-term complications of cancer and chronic diseases.
For the individual patient covering the costs of seeing a doctor, the idea of an annual physical examination when they feel fine seems like a waste of financial resources. However, as has become the case in countries worldwide, primary care and annual physical examinations are beginning to disappear. As telehealth and digital medicine options have continued to increase in use, particularly during the pandemic, the idea of a traditional physical exam has come under greater scrutiny. A combination of physical exams and telehealth might be the way of the future in keeping our nation healthy.
The annual physical exam is part of the more extensive discussion about primary care and whether it is necessary. Unfortunately, in the US, India, and other countries worldwide, medicine has become the way you manage the disease, not prevent it. On the other hand, primary care is a way to prevent disease by talking with patients about their potential health risks and giving them practical advice on how to care for their health while considering their unique lifestyle challenges.
Unfortunately, there is little discussion about how focusing on primary care, including the annual physical exam, could positively impact healthcare costs. Far too often, individuals worldwide find themselves waiting to seek medical attention until they are much sicker, simply because they do not have the funds to afford basic preventive primary care or may struggle to stick with prescribed preventive health measures and lifestyle changes due to costs or social status.
While telemedicine offers a way for physicians to connect with their patients cost-effectively, there is something to be said for having a patient in front of you, where you can physically examine them. When a patient disagrees with their doctor, for instance, having a physical exam can give you data that informs the discussion and could help get the patient on board with the treatment options available. A patient looking for antibiotics to treat a respiratory infection might feel better about not needing medication when they know that their lungs are clear and their oxygen saturation levels are within normal range.
Telehealth does offer a means for doctors to understand the home environment of their patients, allowing them to connect more frequently with their patients throughout the year. Virtual visits can also respect the patient’s time, as well as the doctor’s. Plus, technology improves the ways available for doctors to collect biological data from their patients without physically having them in the office.
End-stage renal diseases that leave many Indian patients permanently dependent on dialysis or awaiting transplant can be prevented by managing health conditions that cause kidney damage, such as diabetes and high blood pressure. However, the costs for cancer treatments increase dramatically at later stages, as your medical team deals with cancer and its side effects. In addition, families often see any cancer diagnosis as a substantial financial blow, meaning that they are also willing to choose between treatment and caring for family needs. Annual physical exams, which include routine tests and screenings, could be a way to save individuals and their loved ones the financial and emotional costs of cancers and many other preventable diseases. How can we make this happen in an affordable way using digital technology platforms like telehealth? India, a leader in digital technology, can implement this more efficiently and make healthcare more accessible to the ordinary person, especially in rural areas across the nation.
American Association of Physicians of Indian Origin (AAPI), the largest ethnic physician organization in the United States, representing over 100,000 Indian American physicians, has initiated preventive healthcare screenings in 75 Indian villages to understand the concept of preventive screenings help to diagnose any silent diseases which are causing premature deaths from coronary heart disease and cancers like breast cancer, cervical cancer which are preventable if diagnosed early through these annual screenings as mentioned above.
During the 15th Annual Global Healthcare Summit, AAPI has planned to organize in India at Hotel AVASA in Hyderabad from 5 to 7 January 2022. Physician leaders from the United States and India will have an opportunity to brainstorm and explore ways to focus on the theme, “Transformation of Healthcare through Telehealth and Technology usage during this post-Covid Era”, recommend possible ways to plan and implement preventive medicine that will save resources and precious human lives.
We hope that Government of India will appoint an expert panel of nationally recognized experts in the disciplines of preventive medicine and primary care, including internal medicine, family medicine, geriatrics, pediatrics, preventive medicine, behavioral medicine, public health, obstetrics and gynecology, and nursing to create an Indian Preventive Task Force (IPTF), whose recommendations should be promoted and implemented as part of the free annual physical exam or telemedicine visit at government hospitals and primary care centers. In addition, private hospitals and insurance companies should be encouraged to provide annual physical exams or telehealth visits, following IPTF recommendations for free or at affordable cost. Many of the routine lab tests, vaccinations, blood pressure checks, and some cancer screenings like self-breast examination can be done remotely and event at patient’s home with the help of Asha workers. The annual physical exam is a critical part of quality primary care and must be covered as part of the Indian healthcare system. To shift our healthcare from disease and treatment-centered, we need to elevate the value of primary care, mainly the annual physical exam, and recognize how critical this is to have a healthy nation and a healthier world.
With one of the largest populations in the world, India could lead the world in providing quality health care to all its citizens, and the recent Covid-19 vaccination drive is a great example. However, the biggest democracy in the world needs urgent investment in the health of all its citizens and reform the public healthcare system.
Dr Anupama Gotimukula is the President of the American Association of Physicians of Indian Origin (AAPI), resides in San Antonio, TX. A board-certified Pediatric Anesthesiologist, practicing since 2007, Dr Gotimukula is affiliated with Christus Santa Rosa, Baptist, and Methodist Healthcare systems in San Antonio.
Prof (Dr) Joseph M. Chalil is an Adjunct Professor & Chair of the Complex Health Systems advisory board at Nova Southeastern University’s School of Business; Chairman of the Indo-American Press Club and The Universal News Network publisher. Dr Chalil recently published a best sellre, “Beyond the COVID-19 Pandemic: Envisioning a Better World by Transforming the Future of Healthcare.”