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Are doctors a part of the health care problem in India?

I came across an article written by Dr. Aniruddha Malpani, who is an IVF specialist in India and writes on improving patient knowledge and patient-doctor relationships.  He talks about why doctors sometimes are a hindrance in the healthcare system. He was a part of a panel at the Health 2.0 conference in Bangalore on – How do we deliver healthcare to a billion Indians? when “ it dawned on him that doctors like him are actually part of the problem.”

In India, the doctor- patient ratios is alarming low and this has been talked and written about extensively. The solution seems to be that we need to  open more medical colleges and create more doctors, so that more patients will get better access of health care. Logical.However, according to him “it is because of the medical profession that we have such a dysfunctional illness care system. Remember that doctors only get paid to treat ill patients – and they spend years training and becoming experts in managing sickness. Most doctors would not even be able to recognize a healthy person, because they only see sick patients, day in and day out!”

And he really went after the specialists in the field of health care: “It’s the specialists – who look at life through a very distorted prism, because they only see rare and complex problems. They know a lot about very little, but because they are the leaders – the KOLs – they have an inflated sense of their self-worth and they don’t have any ability to look at the big picture, because they are so focused on individual problems.” Doctors can only see problems – not health! Psychiatrists study mental illness, and know very little about mental health and happiness. He mentions that doctors are useful as technical specialists, but that’s all. To be fair, he does talk about himself too: “as an IVF specialist and am very good at what I do, but the only patients I see day in and day out are infertile couples who need IVF. I never see fertile couples, so it’s quite easy to see how my perspective can get distorted! I am not the best resource to manage infertility problems in the community, and even though I maybe an infertility expert, I need to have the humility to accept this.”

His solution: retired doctors can be a useful source of advice as they have enough maturity to understand how unimportant doctors can be in delivering primary health care. I am not sure I understand what he means by this.

“While it may seem that working under the constraints we face in India (poverty, illiteracy and a shortage of healthcare workers) is a daunting task, it also means that there is a great scope for coming up with novel solutions! There is no question that this is a huge challenge, but it’s a great opportunity as well. However, we cannot afford to be naïve and expect that the solutions are going to come from doctors!”

I do find his comments very interesting and different to say the least.The claim that prevention saves money is as they say “old but gold”.  Better access to health care services and prevention of diseases  would reduce the demand for visits to doctors and hospital care. Aneurin Bevan, the founder of the British National Health Service wrote in 1952, “much sickness and often permanent disability arise from failure to take early action, and this in its turn is due to high costs and the fear of the effects of heavy bills on the family.”

Having said that, I would love to hear what the comments of other specialists in health care on this article. Are doctors a part of the problem?

You can visit Dr. Malpani’s blog at

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