In recent times, the relationship between patients and doctors has become very complex across the world. India is no exception; in fact, the situation here is even more complicated and unstable. Within moments, a doctor—once regarded as god-like—can become an enemy in the eyes of a patient’s family. Complaints are often heard from patients that the doctor failed to diagnose the illness correctly, leading to deterioration or even death.
The most common complaint is that doctors do not give sufficient time to patients and fail to explain things properly. Dissatisfaction is also seen regarding doctors’ competence, behavior, and, in the private sector, their fees. Many patients, if they do not find relief after one visit, switch to another doctor. Apart from the primary doctor, patients often have complaints about junior doctors, nurses, and other healthcare staff.
Nowadays, such issues are widely discussed on social media platforms like Facebook and podcasts. These discussions are usually one-sided. Many people raise complaints on their pages or express anger in podcasts, while doctors generally refrain from responding. As a result, misunderstanding and mistrust grow between the two sides, and they move like parallel lines that never meet.
This deterioration in the doctor–patient relationship is harmful for both sides, as they are interdependent. Without patients, doctors have no existence; without doctors, patients are helpless.
As a doctor with nearly three decades of direct interaction with patients, it is felt that the medical community should take this issue seriously and work towards solutions.
Being ill is an unexpected and distressing condition. When a patient visits a doctor, they are already physically and mentally disturbed. Most patients lack basic knowledge of the human body or diseases. Additionally, concerns about treatment costs and possible complications weigh heavily on them.
Between the doctor and the patient, the responsibility lies more with the doctor. In the treatment process, besides the primary physician, there are diagnostic specialists such as radiologists, pathologists, and other medical staff. The primary doctor represents all of them.
An example can clarify this: suppose a patient comes with difficulty swallowing. I may refer them to a gastroenterologist for a biopsy. After the biopsy, a pathologist provides the report. It is my responsibility, as the primary doctor, to explain the report to the patient. Reports are not always clearly positive or negative. I may suspect cancer, but the biopsy may not confirm it. In such cases, I must consult the gastroenterologist, pathologist, and radiologist to decide the next steps.
Here, patient cooperation is essential. The patient and their family must remain patient and allow further tests if needed to arrive at the correct diagnosis.
However, such cooperation is often lacking on both sides. Doctors may not give enough time or explain adequately, while patients lose patience quickly and change doctors or hospitals. As a result, a proper doctor–patient relationship cannot develop, leading to waste of time and money and even misguidance.
In complex diseases like cancer, patients need to develop deep trust in their doctors from diagnosis to completion of treatment. Diagnosis can be lengthy and complicated. Sometimes biopsy reports from different laboratories may not match, confusing patients. It is the doctor’s duty to explain these complexities and reassure the patient.
Similarly, treatment options may vary depending on the patient’s condition. In cancer, some may need surgery, others radiotherapy, chemotherapy, or a combination. Explaining these options is the doctor’s responsibility.
If doctors fail to explain, patients often turn to search engines like Google or AI tools. Acting solely on such information can be dangerous.
There is no fixed rule on how much time a doctor should give a patient; it depends on the condition. In India, especially in government hospitals, patient load is so high that doctors cannot spend more than 5–10 minutes per patient even if they wish to. In private hospitals, patient load depends on the doctor’s reputation, and getting an appointment with reputed doctors is often difficult.
Another issue is the lack of a structured referral system. Ideally, patients should move from primary care to secondary and then to specialized care only when needed. In practice, especially in the private sector, patients directly approach specialists, increasing their workload unnecessarily—even for conditions that general practitioners could treat.
Although the number of doctors and specialists in India has increased in recent times, experienced and reputed specialists are still insufficient relative to patient numbers.
Long queues of patients coming from all over India is a common sight in AIIMS, New Delhi. While working as a super-specialist (Medical Oncology) there, I had to see 70–80 patients in OPD sessions, spending less than 10 minutes per patient.
I had a very different experience while undergoing training at a medical college in Oxford, United Kingdom. There each patient was allotted about 45 minutes, and patients arrived after proper referral and confirmed diagnosis only to receive medical treatment of cancer. Referral system is very much streamlined there unlike our country.
Healthcare infrastructure has improved in India, with more institutions and training seats, but many challenges remain. Factors like hospital facilities, number of experienced doctors, cost, and regulation affect patient satisfaction.
Advanced treatment is still largely urban-centric and not easily accessible. Even today, emergency surgical facilities and experienced specialists are limited, even in metro cities, leading to preventable loss of many valuable human lives.
Patients often question doctors’ competence. Complaints arise that junior doctors handle cases, or senior doctors spend little time or do not examine patients properly. Doctors must address this perception. Medical service is a team work. In medical colleges and large referral institutions usually the experienced senior doctors leads the team. Experience is more valuable than theoretical knowledge in medical field. Skills develop over time, and junior doctors should strive to gain experience and learn skill from reputed institutions.
In today’s age of communication, it is not difficult for patients to gather information about experience, competence, and public reviews of doctors and hospitals beforehand.
Regarding cost of treatment and fees of doctors in private and corporate healthcare system, patient concerns are not illogical. However it is not the doctor who decide the entire cost. Fees depend on a doctor’s qualifications, skills, experience, and demand, which is not unreasonable. However, taking medical professon just like any other profitable business is condemnable. Medicine is a service before it is a profession, and doctors must cultivate empathy, compassion, and dedication.
The National Accreditation Board of Hospitals and Healthcare Providers(NABH) focusses on patient centered care, ethical practice and quality improvement. According to NABH guidelines, both doctors and patients have some
rights and some responsibilities/duties, towards each other.
Patient Rights:
- Right to receive treatment with respect and dignity without discrimination
- Right to consent or refuse treatment
- Right to full information about disease, treatment, and cost
- Right to confidentiality
Patient Responsibilities: - To Provide accurate medical information
- To cooperate in treatment
- To follow hospital rules
- To respect healthcare workers
Doctor Responsibilities: - Ensure patient safety and confidentiality
- Obtain informed consent
- Maintain proper documentation
- Explain disease and treatment clearly in understandable language
- Follow medical protocols and legal guidelines
- Treat patients with dignity and respect their choices
Doctor Rights: - Right to work in a safe environment free from violence and abuse
- Right to make evidence-based and ethical medical decisions
Conclusion
Both the parties, patients and doctors must be aware of their rights and responsibilities. Our country is burdened with a very large population with socioeconomic inequality and all types of communicable and noncommunicable diseases. While interacting with each other, mutual trust, respect, effective communication, empathy and tolerance from both sides are essential to build a fruitful relationship.
Dr. Kunjahari Medhi
Senior Director,
Medanta Cancer Institute,
Medanta – The Medicity Hospital, Gurugram