DOCTOR-PATIENTS RATIO IN INDIA (PAST, PRESENT, FUTURE)

Introduction

India is one of the fastest growing economies in the world and the second most populated country. In spite of rapid development achieved in other fields, the performance when judged on healthcare parameters remains poor.

The Indian medical education system has been able to pull through a major turnaround and has been successfully able to double the numbers of MBBS graduate (modern medicine training) positions during recent decades. With more than 479 medical schools, India has reached the capacity of an annual intake of 67,218 MBBS students at medical colleges regulated by the Medical Council of India.

The ideal patient-doctor ratio recommended by the WHO is 1000:1. Responding to this challenge, there has been a major thrust on increasing the capacity of graduate training programs (MBBS) at medical institutions across India. India has two systems of qualified, professionally trained, and registered medical doctors.

The first one is the system of modern medicine introduced nearly 200 years back during British colonial rule and the other one is a system of traditional Indian system of medicine, previously neglected but now patronized and streamlined by the Government of India.

What is Doctor-Patient Ratio?

• The number of physicians available per every 10,000 inhabitants in a population, at a given year, for a given country, territory, or geographic area.
• The doctor-patient ratio, varies from case to case depending upon various factors like the type of disease, nature of specialization, type of patient-care required i.e. indoor/outdoor.?

Current Situation in India

• ?Considering the number of registered medical practitioners of both modern medicine (MBBS) and traditional medicine (AYUSH), India has already achieved the World Health Organization recommended doctor to population ratio in the year 2018.
• India's doctor-population ratio at?1:854?is better than the World Health Organization's standard of 1:1000
• The Indian healthcare industry is progressing by leaps and bounds with 2500 hospitals to be set up in the next 5 years.?
• With more than 479 medical schools, India has reached the capacity of an annual intake of 67,218 MBBS students at medical colleges regulated by the Medical Council of India.

?Matter of Concern

• We might think that the situation will improve significantly in the future. After all, we have the largest number of medical colleges in the world (595 as of Jan 2022) with an intake of 89395 students in the last year.
• But the population is also growing at 0.92% (1.3 crores) every year and will reach 1.52 billion or 152 crores in 2032.
• If 80% of these students complete their MBBS, and 75% of them remain in India to practice, we will add at least 53000 doctors per year.

How Many Doctors do India Needs Actually?

• India needs to double the number of doctors to meet the world average, which means, we need at least 10 lakh more.
• Compared to the world average of 150 doctors per 100,000 people, India has only 86 doctors registered for practice.
• To fix the shortage over a 10-year period, need to produce at least one lakh additional doctors every year.?
• India’s population has been projected as 144 Cr by 2024. So, by 2024, the doctor–population ratio is expected to be around 1.03 per 1000 population.?

Ways To Improve Patient-Doctor Ratio in a Hospital.

Assess the patient volume.

The patient volume is the key indicator of the patient-doctor ratio and also determines the quality of the patient-doctor relationship in a hospital. The number of patients admitted decides on the number of physicians needed for the hospital.?But the number of patients discharged help to keep this number within limits.

Employ experienced physicians.

?Several hospitals employ a large number of medical students, trainees and interns hoping to meet their staffing needs for physicians. But they fail to realize that inexperienced medical personnel take a longer time to diagnose or treat patient than an experienced one. Experienced doctors can handle several patients within a day, quickly and efficiently.?

Implement pre-screening of patients by non-medical staff or by medical interns.

Pre-screening of patients with checking their vital signs and recording their health complaints can be done by non-medical but clinically trained staff or medical interns, a lot of time can be saved for experienced doctors.?

Enlisting physicians on seasonal or need basis.

To meet the seasonal demand for physicians, hospitals can consider enlisting physicians on a makeshift or requirement basis. Senior surgeons and specialists can be called for, during emergencies or severe cases while intern can be used to meet the normal influx of patients.?

Use technology to augment patient-doctor relationship and ratio.

Technology can act as a powerful tool in maintaining an ideal patient-doctor ratio. The use of EMR reduces the time for patient screening while the use of telemedicine helps in attending to the patients even at remote locations.???

References

1. https://www.frontenders.in/blog/patient-doctor-ratio-in-india.html
2. https://theprint.in
3. https://www.livemint.com/news/india/govt-aims-to-achieve-who-doctor-patient-ratio-of-1-1000-by-2024-11635432454203.html
4. https://www.medindia.net/news/view_news_main.asp?x=20690
5. https://timesofindia.indiatimes.com/blogs/voices/we-dont-even-know-how-many-doctors-currently-practice-in-india/
6. https://financialtribune.com/articles/people/59036/doctor-people-ratio-improving-shortage-of-specialists-persists
7. https://www.ijph.in/article.asp?issn=0019-557X;year=2017;volume=61;issue=3;spage=182;epage=187;aulast=Potnuru