Challenges Faced by Medical Practitioners

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Challenges faced by Health care Providers in Healthcare Delivery System - Prof. Hem Chandra

Prof. Hem Chandra
Head of Department of Hospital Administration & Medical Superintendent
Sanjay Gandhi PGIMS, Lucknow, UP


Healthcare has become one of India’s largest sectors – both in terms of revenue and employment. Indian healthcare market today is worth US $ 100 billion and is expected to grow to US $ 280 billion by 2020, a Compound Annual Growth Rate (CAGR) of 22.9 per cent. World Bank data shows that public health expenditure in India is abysmally low at 1.4% of GDP as of 2014, compared to a world average of 6%. The estimates show that high out of pocket expenditure on healthcare has serious percussions for household wellbeing in India, as it plunges a sizeable section of the society even the well-off to abysmal poverty levels. It pushes 3.5 percent (50.6 million) people below poverty line and also causes further deepening of poverty for already poor people.

Healthcare comprises of providers, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The Healthcare providers comprise of clinicians, nurses, paramedical staff and other staff. The healthcare sector is one such area where the highly-qualified doctors and the uneducated sanitary staff work together for the patient care.

Indian health sector has a new threat – the rise of non-communicable diseases in middle and low income groups. India is facing a double burden of communicable and non-communicable Diseases. India’s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of the Indian society. Despite progress in improving access to healthcare, inequalities by socioeconomic status, geography and gender continue to persist.
Healthcare professionals practice in an environment that is complex, with many regulations, laws and standards of practice.The Doctor Patient relationship in our country has undergone a sea change in the last decade. The fortunate Doctors and healthcare providers of the past were treated like God and earned respect. Commercialization and globalization on all spheres of life has not even spared the medical profession as well. As a result, the doctor-patient relationship has deteriorated considerably. Increasing cost of medical care has been a threat to healthy doctor patient relationship.

The adoption of advanced technology in the medical field has increased the cost of infrastructure and there by cost of healthcare services. The rapid changes in the diagnostics with introduction of latest technology and changes in the disease patterns has been the cause of concern. These changes made diagnosis of certain diseases difficult and also non-affordable for the patients.

The cases of alleged medical negligence have increased in the recent past, claiming redressal for the suffering caused due to medical negligence, vitiated consent, and a breach of confidentiality arising out of the doctor-patient relationship. It must also be said that frivolous complaints against doctors have increased by leaps and bounds in our country particularly after the medical profession was placed within the purview of the Consumer Protection Act.
Quality is the buzzword of healthcare now-a-days. Despite continuing evidence of problems in patient safety and gaps between the care patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results. Once medicine truly advanced and technology started to integrate into the industry, people began to wonder whether the experience was as good as they believed. When patient experience began to be measured, physicians experienced quite a wake-up call. Meeting the patient expectations was difficult as healthcare service is intangible.

The healthcare providers work in the environment of potential hazards which include hospital acquired infections, biomedical waste and radiation hazards. There are many laws which protect the healthcare provider while working legally and ethically. The healthcare professionals should adapt to the changing pattern of the society. The private hospitals should incorporate the treatment of the poor and underprivileged as part of their Corporate Social Responsibility.

India’s health policy ensure optimal utilization of health manpower and resources, enhance availability of primary health care/ paramedical staff, set out strategies to cope with rising pressure on tertiary health care institutions and bring about awareness for a better quality of health care comprising environment and occupational health.