Going by the mission statements of most private sector providers, one would believe that the Indian healthcare system is truly patient-centric, with everything being designed around the needs and safety of the patients to treat them with dignity and respect. At the same time, almost everyone I speak to lambasts the providers for their excessive charges and at best, indifferent and at worst, demeaning and patronising care.
Does this mean that the intent is there and the providers are trying, but translating it into practice is challenging? The proponents of this view are looking into solutions to empower patients through information giving and by leveraging advances in informatics and technology including social media.
Or is it that there are two parallel universes- the crude, money-minded, extract-as-much-as-you-can side where healthcare is a ‘business’ run by professional minds, and the increasingly hapless patients looking for holistic care and basic humanity, and the ‘twain shall never meet? This view finds support from various sources talking about corruption in medical education or clinical negligence, for example, with despair at the widening gulf and much hand-wringing.
As it happens, both of the above scenarios hold true in India. Over the last two decades, India has come a long way in improving access to basic hospital care with many private providers across the country and ensuring highly advanced modalities with latest technical equipment and procedures such as major transplants being done at a fraction of the costs in the West. But true patient centric care, whilst the need of the hour, remains an aspiration and is very hard to achieve currently without revolutionary changes.
But who will bell the cat? It will be naive to think that things will improve by themselves or that the change will occur fast enough; no revolution ever happened without a struggle. The challenges for patient-centric care in India are deeply intertwined with societal issues (much like anywhere else in the world); doctors are both victims and perpetrators of the current healthcare system, and relying on them alone is not sufficient. Inequalities, corruption and illiteracy are deep seated and will not be overcome with some technological fixes, wishful thinking or chasing fads. What is needed is a more sophisticated strategy including by creating small exemplars which can in turn grow and coalesce to create the necessary critical mass for the needed revolution.
Healthinkers has started this programme of work to empower patients and the group is striking the right balance between idealism and pragmatism through promoting thought leadership and by deploying technology; these are essential and mutually reinforcing perspectives in putting patients first. Hopefully others will join in and help take the agenda forward.
Doing nothing is not an option – after all we want better care for ourselves, our loved ones and the future generations, and putting patients first makes good business also. Alone none of us can overcome the challenges, but together we can!
Rajan Madhok, a Public Health Doctor in England, is a regular visitor to India.