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Use patient power to tackle medical corruption in India

BMJ 2014; 349 doi: (Published 14 August 2014) Cite this as: BMJ 2014;349:g5156
  1. Aniruddha Malpani, medical director, Health Education Library for People, Ashish, Tardeo, Mumbai 400 034, India
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Educated and empowered patients make it much harder for corrupt practices to occur in the health system, writes Aniruddha Malpani

Corruption (the abuse of power for private gain) seems to be a problem that afflicts healthcare systems the world over. A recent article in The BMJ described some of the problems in India.1

It’s true that the Indian healthcare system is ailing. We have too many patients and not enough doctors to provide personalised care. The result is that patients see themselves as helpless, and some doctors and officials exploit this power imbalance to make money by unfair means.

Traditional solutions have not worked. Regulation is doomed to fail because the regulators themselves are often corrupt.2 Exhorting doctors to become more ethical is not helpful—good doctors don’t need to be told, and bad doctors will not improve because we preach to them.3

Contributing to the stalemate is that we continue to consider the number of patients in India as a problem. Actually, they are part of the solution: patients are the largest untapped healthcare resource.

Healthcare needs to learn from the revolution that has occurred in microfinancing.4 When given money and the freedom to use it as they see fit, even very poor people have come up with remarkably innovative ideas that could never have been planned, designed, or anticipated by bankers—the …

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