Healing and Harming: The "Noble Profession" of Medicine in Post-Independence India, 1947-2015

Abstract

This dissertation, based on archival research in Marathi, English, and Hindi, explores the history of people’s perceptions of and experiences with biomedical doctors in post-independence India. I analyze and historicize a contemporary dominant narrative among India’s doctors, that the “deterioration” in the patient-doctor relationship has its origins in the intensified privatization and commercialization of healthcare which followed the Indian state’s economic liberalization policies in the 1980s and 1990s. I show that contrary to this understanding, medical practice in India was considerably commercialized, and public dissatisfaction substantial, even in the early post-independence decades (1950s-1970s). I suggest that answers to public distrust in physicians lie less in commercialism and more in the dominance of privileged-caste and -class Indians in the medical profession. This dominance nurtured a caste privilege-based elitist outlook within the mainstream profession and its leadership, and created an insurmountable socioeconomic distance between doctors and the large majority of the public. People in India had trustful relationships less with doctors and more with local, community-based practitioners (who freely practiced many forms of medicine). What doctors deemed as people’s “trust” in them and their profession was often simply a manifestation of people’s general deference toward the elites of the society. This dissonant interpretation has been a constant feature of the narratives around the doctor-society relationship in post-independence India, but has remained largely unacknowledged in the medical and public discourse, and continues to create multiple challenges for healthcare policy today.