Malthi was our lower middle class patient profile who works as a receptionist. She lives a one hour bus ride outside of Bangalore with her mother, husband and daughter. She shared her approach to staying well and how she uses the healthcare systems in Bangalore - preferring the personal approach offered by her local doctor, and asking her neighbours for advice.
“Doctors will prescribe good medication that works. They only give you what you need. Medical shops will give you anything.”
This was a theme in India, that pharmacists do not weigh in with any medical opinion, they are simply shops for drugs, it’s the responsibility of the doctor and the patient first to ensure that the request/prescription is accurate.
2. Hybrid approach to healthcare
“I give my baby a paste of ginger, garlic and tulsi each day. When I took my baby to the hospital with loose motions he suggested I try coconut water and syrups”
This was the first time in India we heard that a doctor would suggest a course of action that mixed up different styles of healthcare - herbal/ayurvedic/natural with allopathic. We actually found that suggesting this (i.e. in the Recovery Kit concept) was really unappealing for some doctors in India as it would not be seen as correct or appropriate. It tends to be more indicative of informal, unqualified or old fashioned care than modern, formal reliable care. However, the appeal of a mixed approach is increasingly interesting to some patients and doctors, so we heard.
3. She doesn’t differentiate between ‘medicines’ - and is not invited to try and understand them
On describing a trip to the doctor where she was prescribed antibiotics: “I would not ask the doctor why he has prescribed something. He didn’t tell me what what was wrong with me, he examined me and said this is what i will prescribe”
We found in India this was common - that there was no context shared of what was wrong, the detailed diagnosis or why a prescription was being made. This is because the traditional relationship between doctors and patients is authoritarian, not a partnership. This is being tackled by the more progressive primary care providers, including those we spoke to - but their care tends to be private and they have more time and inclination to educate patients as they go - seeing it as a vital component of compliance.