In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction.
This book offers an easy-to-read, yet comprehensive introduction to practical issues in doctor–patient relationships in a typical low- and middle-income country setting in India, examining in detail the reasons for erosion of trust and providing guidance on potential research areas in the field. It strikes a balance between empirical work and theoretical normative analysis, while adopting mixed-method research in exploring important constructs in the doctor–patient relationship, such as trust, solidarity, advocacy, patient-centeredness, privacy, and confidentiality. Since the concept of trust has direct implications for the ethical practice of medicine, the book is a valuable resource for academics and researchers in the field of medical, clinical, and applied ethics.
There are significant variations in how healthcare systems and health professionals are regulated globally. One feature that they increasingly have in common is an emphasis on the value of including members of the public in quality assurance processes. While many argue that this will help better serve the public interest, others question how far the changing regulatory reform agenda is still dominated by medical interests. Bringing together leading academics worldwide, this collection compares and critically examines the ways in which different countries are regulating healthcare in general, and health professions in particular, in the interest of users and the wider public. It is the first book in the Sociology of Health Professions series.
It has been recognised by governments and healthcare organisations worldwide that for Universal Healthcare in pursuit of Health for All under the Sustainable Development Goals to be achieved, effective primary care that is integrated, accessible, and affordable for everyone is essential. This practical guide is the first designed specifically to support those planning and conducting family medicine/primary care education within medical schools around the world. It offers medical educators a collection of concise easy to follow chapters, guiding the reader through the curriculum requirements with key references for further detail. Plain English and practical, deliverable advice, adaptable to different contexts, ensures the content is accessible to those educating medical students in any country, while the structure within sections ensures that family medicine doctors and educators can dip into chapters relevant to their roles, for example curriculum design for academic educators or teaching methods for those educating in clinical practice. Key Features ■ The first “how-to” guide dedicated to effective integration of family medicine teaching into medical school curricula ■ Offers a strong evidence-based framework for integrating family medicine into medical schools ■ Wide in scope, for academics and educationalists at all levels and in all geographies, reflecting and embracing the experience and variation in family medicine across the globe to produce pragmatic and effective information on which medical schools can base change ■ Step-by-step introduction to the processes of literature review (establishing the existing knowledge base), choosing a topic, research questions, and methodology, conducting research, and disseminating results ■ Supported by the WONCA Working Party on Education The book is edited and authored by members of the World Organization of Family Doctors (WONCA) Working Party on Education, which is ideally placed to offer a strong platform for medical schools to integrate family medicine whatever the local context, enabling all future doctors, whatever their career aspiration, to understand the importance of family medicine to health systems and holistic medicine and encourage family medicine doctors to inspire students to consider a career in the field.
Indian doctors enjoyed the 'God status' since ancient times, rapidly losing their reputation in recent times. Practising Medicine was once regarded as noble profession, but now it is under constant criticism from everywhere. On one hand, attacks on doctors are on rise and on the other hand, doctors are feeling medical profession is becoming a thankless job. In this ever increasing gap in patient -doctor relationship, both sides end up on losing side.'No Country For Doctors' is a medical fiction novel which critically looks into the root cause of this problem. It narrates the systematic erosion of ethics of medical profession by corrupt system. The novel is a fine blend of love story, conflicts of regional languages of India with English, and various medical issues that haunt the system from inside and outside. A very rare topic has been dealt by the writer, where medical issues are coved not only in depth, but also with finer details. The novel is narrated in a unique style, where each chapter engages the readers as a separate story, yet, all these stories in a linear narrative shape the novel beautifully.The novel is inspired by real life incidents; hence the readers invariably end up in identifying themselves in one of the characters. The readers can connect incidents in their life with happenings of the novel, ultimately become a part of the narrative when they complete the reading. This novel helps the readers to achieve a understanding of medical profession. This experience will make them empathize with medical professionals in future. Prologue Doctors in India were always revered and held high on the pedestal that they literally enjoyed the status of 'God'. Practicing medicine was considered a very noble profession. Alas! The scenario has changed drastically in recent times. Every other day the news channels broadcast attacks on doctors; criticism is on the rise leading to the doctors feeling that their job is a thankless one. It is really unfortunate to see this wide gap emerging in the relationship of a doctor and a patient. It is important to note that it is a no win situation for both. This story is a fictional narrative of the medical profession through the life of the protagonist Dr.Vishwa. A boy's journey from a remote village in Karnataka, India to the world of medicine with its dynamic undulations and bitter sweet experiences inspired by real life incidents is intricately weaved into a hard hitting novel. The author, a medical practitioner himself has provided insight into the various medical profession related issues with in-depth and fine details, especially the systematic erosion of medical ethics by the corrupt system. The Indian education system, politics, poverty, people, emotions, conflict of regional languages, English language requisition and of course the medical world is described in real time through the chapters. Here the uniqueness lies in each chapter engaging the reader with a complete story in itself; however the flow of narrative from one chapter to other intertwines to make this a distinctive novel. The real life inspired sequence of events in this novel will surely make the readers identify with the characters, emotions and incidents at one point or the other making them an integral part of the narrative. The author wants to emphasize that he absolutely has no intentions of hurting the sentiments of our citizens with regard to caste, creed, community, religion, language, professions and existing systems in our society. This novel is solely a sincere attempt to restore the faith of people in doctors by facilitating an empathetic understanding of the challenges that exist in the medical profession. Trust you will enjoy Dr.Vishwa's roller coaster ride through life... Satyameva Jayate!!!
This book explores how social discrimination in South Asia contributes to health disparities and impedes well-being. Specifically, it addresses how marginalization shapes health outcomes, both under normal circumstances and specifically during the COVID-19 pandemic. Coming from diverse backgrounds and representing different academic disciplines, the authors have contributed a range of chapters drawing from quantitative and ethnographic material across South Asia. Chapters address reservation politics, tribal lifeways, Dalit exclusions from governmental institutions, Muslim ghettoization, gendered domestic violence, social determinants of health among migrant workers, and the pandemic fallout across South Asian society, among other subjects. Scholars draw on decades of experience and firsthand ethnographic fieldwork among affected communities. The chapters provide an innovative analysis, often in real time, of the human toll of casteism, classism, patriarchy, and religious intolerance—many set against the spectre of COVID-19. Many authors not only present social critiques but also offer specific policy recommendations. The book is of great interest to social scientists, public health practitioners, and policy advocates interested in addressing systemic inequalities and ensuring that future pandemics are not disproportionately felt by the most vulnerable.
Does trust still matter in health care and who does it matter to? Have trust relations changed in the 'New' NHS? What does trust mean to patients, clinicians and managers? In the NHS trust has traditionally played an important part in the relationships between its three key actors: the state, health care practitioners and patients. However, in recent years the environments in which these relationships operate have been subject to considerable change as the NHS has been modernised. Patients are now expected to play a more active role, both in self-managing their illness and in choice of care provider and clinicians are expected to work in teams and in partnership with managers. This unique book explores the importance of trust, how it is lost and won and the extent to which trust relationships in health care may have changed. The book combines theoretical and empirical analysis, while also examining the role of policy. Calnan and Rowe analyse data collected from interviews with patients, health care professionals and managers in primary care and acute care settings. Among the issues covered are: The importance of trust to their relationships What constitutes high and low trust behaviour The changing nature of trust relations between patients, clinicians and managers How trust can be built and sustained How interpersonal trust affects institutional trust Trust Matters in Health Care is key reading for policy makers, health care professionals and managers in the public and private sector, and a useful resource for educators and students within health and social care and management studies.
