July 1st is celebrated each year as Doctors' Day in India. This day has been chosen as a mark of respect to the contributions made by Dr. Bidhan Chandra Roy, who left an indelible mark in the history of medical profession in India. July 1st was his birthday as well as the day of his demise in the year 1882 and 1962 respectively. Dr. Roy was not only a physician par excellence, but also a freedom fighter, a leader and Chief Minister of west Bengal for 14 years. It is a significant day for physicians, as it provides them an opportunity to reflect on their career and remind themselves of the core values of medicine.

Health care sector is one of the largest sectors in India today, in terms of both employment and revenue. According to a report by Deloitte Touché Tohmatsu India, the industry size is expected to reach $280 billion by the year 2020. [1] However, regardless of the growth, the health care sector has been facing numerous challenges at present, with the World Health Organization’s 2000 World Health Report also ranking India’s healthcare system at 112 out of 190 countries. In the past few years, this profession is suffering from declining patient-doctor trust.

Recent media reports of incidents of violence and unethical practices by few hospitals/doctors have severely damaged the trust between patients and health care professionals. During the time of Late Dr. B. C. Roy, patients and their families had a trust on their doctors (family physician or general practitioner). Even when a patient died, it was considered as destiny, bad luck or an unfortunate episode. The relationship between patients and family doctors was sacred and pure. [2] During the late 1960s, the focus was gradually transformed from the typical general practitioner doctors towards specialists. People from nearby areas would travel just to visit the specialist clinic but gradually those people were labeled as patients and just another name on the doctor’s waiting list. Gone were the days when the family doctors would know the individual they were treating and cared for them like their own family. In 1958, an editorial in Indian Medical Council (IMC) cautioned the health care professionals about this troubling trend but the doctors were more focused on the urban life’s comforts and money. [3]

During the late 1980s and onwards, there was exponential growth in the medical field, both technologically and scientifically, and this is when this field experienced a dramatic turn. Computer tomography, MRI, tumor markers, endoscopes, ultrasound, and invasive cardiology took this field by storm. The patients started becoming more demanding as they also became more aware. The typical perception of medical field as the noblest profession started changing. Moreover, gradually commercialization and corporatization started taking over this field. [4] The Indian Medical Association (IMA), and the Association of Physician of India (API) grew more and more concerned about the loss of compassion and human touch from the health care professionals and the loss of trust on patients’ part. [5] with increasing number of private medical colleges (run by politicians or businessman), fresh medical graduates entered the medical field having paid handsome capitation fee with the aim of earning good money to make up for it fast.

Due to insufficient health budget and poor infrastructure of public hospitals in India, coupled with overcrowding multiple chains of corporate hospitals came in to picture and marketing teams of these have tied up with general doctors who recommend to health care professionals working there often because of financial benefits. All of this has led to a major mistrust among patients towards healthcare professionals. With more malpractice and negligence cases being reported & often misreported or sensationalized the patients and their family members have started getting increasingly aggressive.

The trust and respect for doctors is declining today and there have been numerous cases of violence against doctors by patients’ families and hospitals have been vandalized. Media is reporting these cases by portraying doctors as the culprits. Many blame such incidents to failure of health systems. This has made doctors fear for their lives. As a result, health care professionals make it a point to order all possible tests for the patient so that they are not labeled as negligent. The outcome? Increased bill for the patient or their family to pay later.

With the easy availability of internet, many patients consult Dr. Google before their visit to their physician. Now, the attitudes towards malpractice and negligence are changing. While people are becoming more aware and are fighting for their rights, there is corruption everywhere in the changing society. Corruption in medical field can make a major difference between life and death. Due to negligence of a very few doctors or hospitals and their unethical practices, all good doctors are also suffering. Moreover, only 2% of India’s annual budget is dedicated to health. This has further created shortage of proper resources and equipment in this field. The medical equipment has also become expensive and costly to maintain, which has resulted in defects and issues with gadgets in many government (public) hospitals. [6]

The private sector consists of 58% of the hospitals in the county and most healthcare expenses are paid out of pocket by patients and their families, rather than through insurance. In absence of good care in government run hospitals, most of the patients get treated at private hospitals and spend money from their pocket. Govt. does not provide any significant benefits to private hospitals and these hospitals are also under constant scrutiny by the patients and their family members. [7] One slip-up in communication can cost them their professional dignity, since the loved ones of the patient don’t take a second in blaming the doctors for whatever goes wrong. While there may be very few bad apples in the medical profession, there are still many able and compassionate doctors in India. [8] However, the way the healthcare professionals are being treated today is rather appalling.

In order to overcome these problems, it is essential that appropriate steps and measures are taken. Firstly, medical students as well as professionals should be given experiential and innovative learning approaches for the importance and ways of following medical ethics and continued professional development (CPD). [9] The medical students and the professional health care providers must also go through regular training regarding forming stronger and trustworthy relationships with patients.

Moreover, hospitals and other health care institutions must have strict regulations regarding the documentations of all treatments and their justification. Those must be monitored and any unusual activity must be investigated. Other than that, government must make proper laws that not only protect the patients in cases of malpractice and negligence incidents but also to protect doctors from getting abused or mistreated by the patient and/or their loved ones. Indeed, in India, medical profession is on crossroads. It is not easy to predict what would happen in the future. There are some patients who are opting for alternative medicines, like ayurveda, homeopathy, and acupuncture, as they can’t afford costly allopathic medical treatment. It is high time that the government and concerned authorities take a closer look at the situation in medical field and take appropriate measures to improve this profession. Here’s hoping on this National Doctor’s Day that medical profession in India restores the glory that it enjoyed in the golden era in the coming future.