The Doctor-Patient
Relationship in India: An Evolving Dynamic Rooted in Tradition and Modernity
The doctor-patient relationship is fundamental to the
success of any healthcare system. In India, this relationship is uniquely
influenced by both modern healthcare practices and ancient healing traditions
like Ayurveda, Siddha, and Unani. This paper provides a comprehensive
examination of the doctor-patient dynamic in India, emphasising the strengths
of traditional Indian medicine, and exploring how it informs contemporary
healthcare practices. It highlights India’s progress in healthcare delivery,
the intersection of ancient healing systems with modern medicine, and presents
data from WHO and other relevant sources, illustrating India’s evolving
commitment to holistic health.
how Doctors should be perceived:
व्याधेस्तत्त्वपरिज्ञानं वेदनायाश्च निग्रहः।
एतद्वैद्यस्य वैद्यत्वं न वैद्यः प्रभुरायुषः
।
how Doctors should perceive:
मैत्री कारुण्यमातेर्षु शक्ये प्रीतिरुपेक्षणम्
।
प्रकृतिस्थेषु भूतेषु वैद्यवृत्तिश्चतुर्विधा
चरक सूत्र ९/२६
Healthcare systems globally are predicated on the bond
between doctors and patients, a relationship that directly impacts diagnosis,
treatment, and recovery. In India, the doctor-patient relationship is
particularly nuanced, shaped by millennia-old traditional medical systems
alongside advancements in modern healthcare. India’s healthcare framework
presents a compelling case study of how traditional wisdom, such as that found
in Ayurveda and Siddha, continues to play a role in patient care today. This
paper argues that India’s approach to healthcare—rooted in holistic treatment,
personalised care, and a deep understanding of the human body’s
equilibrium—provides a model for improving healthcare outcomes globally.
India’s Healthcare
Investment and Infrastructure: A Progressive Approach
India has seen substantial improvements in its healthcare
infrastructure, although its public expenditure on health remains relatively
low at around 3.01% of GDP in 2021. Despite this, India’s healthcare sector is
the fastest-growing in the world, driven by government initiatives and a
burgeoning private healthcare industry. The World Health Organization (WHO)
estimates that India’s private sector now handles nearly 70% of outpatient care
and 60% of hospital care, making it a key player in expanding access to
healthcare services.
The introduction of Ayushman Bharat, a government healthcare
scheme launched in 2018, is an example of India’s proactive steps toward
increasing access to healthcare. As the largest healthcare initiative globally,
it aims to provide free healthcare to over 500 million people. While modern
medicine is an integral part of Ayushman Bharat, the initiative also encourages
the integration of India’s traditional medicine systems. This blending of
modern and traditional healthcare systems represents a significant opportunity
to improve doctor-patient relationships by offering a holistic approach that
resonates with patients’ cultural expectations.
The Positive Impact
of India’s Ancient Medical Principles
India’s healthcare system is one of the oldest in the world,
with its roots extending back thousands of years. Ancient texts such as the
Charaka Samhita (circa 1st century BCE) and the Sushruta Samhita (circa 6th
century BCE) provides a detailed understanding of disease prevention, patient
care, and treatment that is still relevant today. These texts are grounded in
the principle that the human body is a holistic system and that wellness arises
from balancing the body’s physical, mental, and spiritual elements. This
patient-centric model is at the core of both ancient and modern Indian medical
practices.
Ayurveda, in particular, emphasises a holistic approach to
healing, where the patient’s lifestyle, diet, emotional state, and
environmental factors are all considered part of the treatment plan. This
principle is aligned with contemporary movements toward personalised medicine,
which tailors treatment to the individual’s needs. Ayurvedic treatment has also
been used in India for chronic conditions such as arthritis, diabetes, and
digestive disorders. A 2019 study conducted by the National Ayurvedic Medical
Association showed that over 60% of patients using Ayurvedic treatments
experienced improved outcomes when combining it with conventional medical care.
Yoga and meditation, integral components of Indian medical
philosophy, have also gained global recognition for their benefits in reducing
stress, improving mental health, and increasing overall well-being. The Indian
government has actively promoted the use of Yoga as part of its healthcare
strategy, with the International Day of Yoga on June 21st acting as a global
reminder of India’s contribution to holistic health practices.
Integrating Modern
and Traditional Systems: A Case Study Approach
India’s healthcare system provides a successful example of
integrating modern medicine with ancient healing systems. The Ministry of AYUSH
(Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) has played a
crucial role in this integration. Formed in 2014, this ministry is dedicated to
promoting these traditional practices on a national scale and ensuring that
they work in harmony with modern medicine. The government has also increased
funding for research into AYUSH therapies, particularly focusing on their
effectiveness in treating chronic and lifestyle-related diseases, which have
become increasingly common in India due to changing dietary and lifestyle
patterns.
A key example of this integration is cancer treatment at the
All India Institute of Ayurveda (AIIA) in Delhi, where oncologists combine
modern treatments like chemotherapy with Ayurvedic therapies aimed at reducing
side effects and improving the quality of life for cancer patients. Research
conducted at AIIA shows that patients who underwent both types of treatment
reported higher satisfaction levels, better mental health, and faster recovery
compared to those receiving only conventional treatment.
The Evolution of the
Doctor-Patient Relationship in Modern India
In contemporary India, the doctor-patient relationship is
evolving. While traditional reverence for doctors remains strong, patients are
becoming more proactive in their healthcare decisions, demanding better
communication, transparency, and empathy. Studies conducted by the Indian
Journal of Medical Ethics show that 85% of Indian patients prioritise clear
communication and personalised care in their interactions with doctors. This
shift reflects changing expectations within a rapidly modernising healthcare
landscape.
Healthcare institutions have also recognized this shift and
are now placing greater emphasis on improving doctor-patient communication
through training programs. The Indian Medical Association (IMA) has been
working with medical schools to incorporate courses on empathy and
communication, essential for building trust and improving healthcare outcomes.
A survey conducted in 2020 by the IMA found that 78% of doctors who underwent
communication training reported improved patient satisfaction levels.
This emphasis on communication aligns with India’s
traditional focus on the patient as an individual, rather than just a case of
symptoms. The ancient Indian principle of “Sattva” (mental clarity) in Ayurveda
suggests that effective treatment begins with understanding the patient’s
psychological and emotional state, an approach now being embraced in modern
healthcare practices.
The Role of
Healthcare Providers in Rural India
India’s rural population, comprising 65.97% of the total
population, presents unique challenges and opportunities for the doctor-patient
relationship. Rural areas are often underserved by healthcare providers due to
geographical barriers and limited infrastructure. However, traditional healing
systems have historically flourished in these regions, providing an accessible
form of treatment when modern facilities are unavailable.
Recent efforts by the government have focused on bringing
modern healthcare to rural India through mobile medical units, telemedicine,
and expanding the Ayushman Bharat scheme to remote areas. According to a 2023
WHO report, these efforts have already increased healthcare access in rural
regions by 25%. In particular, telemedicine has helped bridge the gap between
doctors and patients, allowing rural populations to consult with healthcare
providers remotely and receive modern medical advice while still maintaining
the benefits of traditional medicine.
Statistical Insights:
India’s Healthcare Progress
Healthcare Expenditure: According to the World Bank, India’s
healthcare expenditure as a percentage of GDP increased to 3.01% in 2021, with
continued growth expected in light of recent investments under Ayushman Bharat
and other public health programs. Although lower than the global average, the
Indian healthcare sector is projected to grow at 19% annually. Doctor-Patient
Ratio: As of 2023, India has approximately 1 doctor for every 1456 patients, a
number still below the WHO recommendation of 1:1000. However, significant
strides are being made to address this shortage, particularly through
telemedicine and healthcare training initiatives. Traditional Medicine Use:
According to the Ministry of AYUSH, approximately 77% of Indian households use
traditional medicine as part of their overall healthcare regime, either as a
complement or alternative to modern treatments.
Future of
Doctor-Patient Relationships: Toward a Holistic Model
As India continues to strengthen its healthcare system, the
integration of modern and traditional medicine holds enormous potential to
improve the doctor-patient relationship. The future lies in adopting a more
holistic approach, where both forms of medicine are valued equally, and where
the focus remains on the individual patient’s unique needs. In this regard,
India is positioning itself as a global leader in healthcare innovation,
offering a model that not only embraces technological advancements but also
remains rooted in the wisdom of its ancient medical systems.
The Influence of a
Doctor’s Energy, Behavior, and Gestures on the Healing Process
The therapeutic relationship between doctor and patient has
long been recognized as central to the healing process. While medical expertise
is undeniably critical, the way a physician communicates, their demeanour, and
the energy they bring to their interactions with patients can be just as
crucial in influencing health outcomes. A growing body of research suggests
that doctors who exhibit empathy, clarity, and emotional support contribute significantly
to a patient’s recovery and emotional well-being, a principle supported by both
psychological and physiological evidence. This paper delves into how a doctor’s
behaviour, gestures, and overall energy affect healing, with a personal
reflection on my experience with Dr. M. Rajapurkar when I was diagnosed with a
debilitating kidney disease.
The Psychological
Impact of a Doctor’s Demeanour
When patients are diagnosed with life-altering conditions,
such as chronic kidney disease, their mental state can dramatically influence
their physical response to treatment. The emotional toll of facing an uncertain
future often leaves patients feeling isolated, vulnerable, and anxious.
According to the American Psychological Association, patients experiencing positive
emotional interactions with healthcare providers exhibit lower levels of
stress, which can contribute to improved physical outcomes. A doctor’s empathy,
attentiveness, and ability to foster a sense of reassurance are integral in
transforming the clinical encounter from a purely transactional one into a
supportive and therapeutic relationship.
My personal experience with Dr. M. Rajapurkar stands as a
testament to the profound effect that a doctor’s behaviour can have on a
patient’s healing process. At the time, I had been diagnosed with a
debilitating kidney disease. I found myself navigating a labyrinth of medical
jargon, tests, and uncertainties. It is in these moments of vulnerability that
the role of a doctor extends far beyond the technical—what the patient
remembers is not just the treatment but how they were treated as a person. Dr.
Rajapurkar’s approach exemplified this.
A Doctor’s Role in
Alleviating Anxiety Through Communication
One of the central aspects of effective doctor-patient relationships
is communication. Studies have shown that a lack of clear communication can
increase a patient’s anxiety, thereby hampering the healing process. A survey
published by the British Medical Journal in 2020 indicated that 72% of patients
who felt their doctors took the time to explain diagnoses and treatments
reported higher satisfaction with care and were more likely to adhere to
prescribed treatments. These patients also showed signs of quicker recovery and
a lower incidence of stress-related complications.
Dr. M. Rajapurkar, the Head of Department for Nephrology at
MBPUH, and recipient of the esteemed Padma Shri award, in my case, made it a
point to clearly differentiate between the available treatment options. He
demystified the concept of “premium” versus “general”
treatment options, explaining that the same medical procedures, tests, and
treatments would be carried out in both settings, with the only difference
being the cost and the luxuries of a private room. His transparency alleviated
concerns that I might be taken advantage of or seen as just another “cash
cow”—a common fear for patients dealing with chronic conditions in the
healthcare system.
The way he addressed my concerns not only clarified my
options but also contributed to a sense of trust and comfort. When doctors
engage in straightforward, patient-centered communication, they create a space
where the patient feels less burdened by fear and uncertainty, which can
greatly enhance the psychological readiness for treatment and subsequent
recovery.
During one of my consultations with Dr. M. Rajapurkar, the
head of the nephrology department, I was invited to participate in a long-term
research study focused on nephrology treatments. His reputation drew patients
from all across India and even beyond, yet despite his constant stream of
appointments and responsibilities, he never made me feel rushed or
insignificant. He took the time to explain the study thoroughly, outlining that
each time I participated, I would need to endure a needle prick to give blood,
and there would be no immediate benefit for me. The study’s conclusions, he
explained, would take decades to emerge and might not even yield positive
results.
When I mentioned that perhaps my participation might help
someone one day, his response was refreshingly candid. He told me that it was
possible the study might not help anyone at all—it could even end up proving
ineffective. He was clear that it was completely my choice whether to take part
or not, and there was no pressure either way.
What struck me most about this exchange was not just the
transparency but the way Dr. Rajapurkar, despite being the head of a busy
department, treated this moment with the same weight and care as any other. It
was then that I realized something profound about the way he approached his
work: doctors shouldn’t only make time for patients when they’re free. Instead,
it is about what they choose to fill their time with, no matter how busy they
are. In that moment, he chose to make me feel seen and heard, ensuring I
understood every aspect before making any decisions.
in Medicine
Levity and humour, when used appropriately, can have a
powerful impact on a patient’s perception of their illness and its trajectory.
According to a 2019 study published in the Journal of General Internal Medicine
humour used by doctors in clinical settings can reduce anxiety and stress
levels in patients, improve mood, and foster stronger rapport between doctor
and patient. This aligns with broader psychological theories that emphasise the
role of emotional lightness in reducing cortisol levels, improving immune
function, and enhancing patient cooperation with treatment plans.
In my own experience, Dr. Rajapurkar used humour to address
baseless concerns that I had about some test indicators. He gently pointed out
how my worry was unnecessary, doing so in a way that was light-hearted and
uplifting. His ability to add levity to an otherwise sombre situation had an
immediate effect on my emotional state. Rather than feeling overwhelmed by the
gravity of my condition, I felt seen and understood as a person, not just a
patient. The fact that he could ease the weight of my fear made me feel less
alone in the process, fostering a sense of shared humanity that bridged the
traditional distance between doctor and patient.
Gestures and
Non-Verbal Communication in Healing
and facial expressions, plays a crucial role in how patients perceive their
doctor and, by extension, their treatment. Studies in the field of
psychoneuroimmunology have shown that positive non-verbal cues from
doctors—such as maintaining eye contact, open body posture, and gentle
gestures—can lower patients’ blood pressure and heart rate, while also
enhancing their confidence in treatment. Patients who feel genuinely cared for
through such non-verbal interactions are more likely to experience positive
health outcomes.
During my treatment, Dr. Rajapurkar’s mannerisms were calm
and composed. His eye contact, the occasional reassuring smile, and his
attentiveness to even the most mundane concerns conveyed a message that he was
present and invested in my well-being. He did not rush through appointments or
brush aside my questions. These small but significant gestures played a key
role in making me feel that I was in capable and caring hands. This, in turn,
reduced my anxiety and gave me the psychological resilience needed to navigate
the challenges of my illness.
Emotional and
Physiological Outcomes of Positive Doctor-Patient Relationships
psychological comfort—it also correlates with physiological outcomes. Research
shows that patients who report high levels of trust and satisfaction with their
doctor are more likely to adhere to treatment plans and show signs of faster
recovery. According to the World Health Organization (WHO), patient adherence
to treatment regimens can increase by as much as 40% when doctors engage with
empathy and offer emotional support.
In my case, the way Dr. Rajapurkar presented the treatment
options, his transparency, and his consistent reassurance helped me stay
committed to my treatment. This emotional grounding positively impacted my
physical recovery, as I was more motivated to engage in my healing process,
less weighed down by fear, and more hopeful about my future.
Conclusion:
The healing process is not simply a matter of medical intervention;
it is deeply intertwined with the emotional, psychological, and social dynamics
present in the doctor-patient relationship. A doctor’s energy, behaviour, and
gestures—whether through empathetic communication, light-hearted humour, or
attentive gestures—can significantly enhance a patient’s healing journey. My
experience with Dr. M. Rajapurkar highlights the profound impact that such
qualities can have on patient well-being. By fostering a relationship based on
trust, empathy, and transparency, he not only facilitated my medical treatment
but also nurtured the emotional resilience necessary to navigate a challenging
diagnosis. This case exemplifies the critical role of positive doctor-patient
dynamics in achieving better healthcare outcomes, a principle that holds
universal value across medical systems.
References:
1. World Bank. (2021). India: Health Expenditure as a
Percentage of GDP.
2. Indian Medical Association. (2020). Doctor-Patient
Communication Survey.
3. Ministry of AYUSH. (2023). AYUSH in Indian Households: A
National Survey.
4. All India Institute of Ayurveda. (2021). Integrative
Cancer Treatment: A Study on Patient Outcomes.
5. American Psychological Association. (2020). The Impact of
Empathy in Healthcare. [Journal article].
6. British Medical Journal. (2020). **Survey on
Doctor-Patient Communication and Satisfaction.
7. Journal of General Internal Medicine. (2019). The Use of
Humor in Clinical Settings: A Review of Psychological and Physiological Outcomes.
8. World Health Organization. (2022). Adherence to Treatment
and Doctor-Patient Relations. [Report].
9. Psychoneuroimmunology Research Society. (2020).
Non-verbal Communication and Its Impact on Healing.