A project on the history of the patient-doctor relationship in contemporary India:
My name is Kiran Kumbhar. I am an MBBS graduate from BJ Govt Medical College, Pune (2010), and have previously worked in Pune, Ratnagiri, Mumbai, and Delhi as medical officer and non-PG resident doctor. Currently I am a PhD student at Harvard University, Cambridge, studying the history of medicine in post-independence India.
Over the next two years, as part of my PhD thesis and research, I will be exploring in detail the evolution of medical practice and of the patient-doctor relationship in India since the 1940s. My proposed thesis mainly pertains to charting the history of the social and cultural aspects of the relationship and interactions between the society and the medical profession. I was drawn to this topic because I share, with many other citizens and healthcare professionals, a concern over the highly charged milieu of doctor-patient encounters in India today, encounters which sometimes culminate in assaults and violence. It will be difficult to imagine sustainable solutions to the current trust crisis without understanding better the social and historical background of medical practice and the patient-doctor relationship. This project is one small step towards that understanding.
Historian Nancy Tomes recently published a book on the history of the doctor-patient relationship in the United States, titled Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers. I would like to quote here some lines from her preface to the book, as what she writes about the US relates closely to what I am attempting to do with respect to India:
Some readers will no doubt be disappointed because I do not hold one particular villain accountable — irrational patients, greedy doctors, evil pharmaceutical companies, or heartless insurance companies. But I have a different goal here… In my view, no single-bad- actor explanation suffices to do this. In the absence of quick or easy solutions, we need to describe our problems as fully and accurately as we can. If, as many knowledgeable commentators suggest, we have a health care system “designed to fail,” fixing it will require profound attitude adjustments on everyone’s part; for needed change to occur, the values, expectations, and behaviors of patients and physicians, political and business leaders, all have to be transformed. I hope that this history contributes in some small way to that transformation.
I wish to have as broad and multi-faceted an understanding as possible of the challenges in India. In pursuit of that, I am hereby inviting thoughts and opinions and suggestions from people on the topics of medical practice and the patient-doctor relationship.
You could be a young medical/nursing student, or a ‘layperson’/patient, or a resident doctor, or a medical college professor, or a current or retired doctor/healthcare practitioner; whether you live in India or elsewhere – I am very interested in knowing your thoughts and experiences to broaden my own understanding of medicine and healthcare in India.
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