The current state of health of medical care in India

The current state of health of medical care in India is a cause for optimism and concern in equal measure. In the coming year it will be interesting to see which of the competing forces will prevail.

On one hand, there are the forces to the good, which will play a role.

These include an increased health awareness enabled by technology. In the medical domain, there is a standardization of guidelines, and acceptance of evidence from data obtained within the country. The startup ecosystem in India has been enabled by programs, such as Startup India. The resultant indigenization of technology makes it affordable for our country and adds to the country’s high-tech export portfolio.

India remains “the pharmacy of the world”, hence costs can be controlled, but concerted action by the government level is needed to ensure it stays that way. Academic medicine has been bolstered by setting up of National Medical Institutes like AIIMS and Tata Memorial Cancer centres all over the country The role played by private hospitals in tertiary care is acknowledged, hence formal teaching of trainees there is duly accredited. The vast repository of knowledge in traditional ayurvedic sciences is finding its rightful place, albeit with some awkwardness in positioning. Insurance coverage, either by the state or private players, has led to an availability of tertiary care for all those in need. Those of us who commenced practice in the previous century, will understand the implications of these changes, which have enabled us to deliver scientific medicine on par with standards worldwide. The large influx of patients from abroad (rather dismissively and unfairly labelled as medical tourism) bears testimony to this rising standard.

But on the other hand, the increasing influence of political populism with short-term interests, unhealthy focus on profitability, paucity of public health initiatives, given the disparate social structure and the digital divide of the country, and the role played by social media, the direct access it provides to the gullible patient populace has dampened the overall atmosphere, leading to physician burn out, and a drop in public confidence in the profession. The threat of litigation and physical violence cannot augur well for morale of the caregivers. The availability of less stressful, higher paying options has led to a drop in the quality of people seeking admission in medical and para-medical schools, and the skewed ratio in favor of employees in healthcare, who are not involved in patient care, is a cause for concern. There are unfair restrictions in the access to cutting-edge drugs, and motivated misinformation about vaccine matters and data implications.

Never before have we as caregivers been more aware of the true nature of problem, the disease, environmental and human factors, and yet felt more helpless in controlling the effort to address it. We are being verily drowned in an ocean of information, rather than being able to use this to solve the problems we face.

In the coming year, the major factors, which will tip the scale in India, are whether caregivers’ voices will find its true place in policy matters in India, whether the ecosystem for startups will gain acceptance in the larger health ecosystem, whether public health will truly be given its importance, and finally whether the nascent attempts to standardize care, follow protocols, and use technology as a true aid to patient care, not as a tool of controlling interests, will succeed.