KIT Health, Royal Tropical Institute, Amsterdam, The Netherlands.
Gokhale Institute of Politics and Economics, Pune, India.
Int J Health Policy Manag. 2017 Jan 1;6(1):5-8. doi: 10.15171/ijhpm.2016.143.
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.
在印度，过去十年中，医疗体系，特别是医疗行业的一系列管理不善事件导致了公众对这些机构的信任度大幅下降。在许多低收入和中等收入国家（LMICs），情况类似，已达到危机程度；这一危机需要引起紧急关注。本文借鉴了印度最近事态发展的观点，认为印度议会和最高法院目前正在考虑的，对医疗行业这场危机采取单纯基于控制的监管措施，可能会破坏医生与患者之间的信任关系。有必要采取一种更加平衡的方法，考虑到系统和人际形式的信任和不信任之间的差异。这种方法一方面应大力监管受托管理和护理质量功能的机构，另一方面应同时采取措施培养医生与患者之间的信任关系。本文最后呼吁医生以及负责管理该行业的人员，个人和集体地对其行业的现状、优先事项和未来方向进行批判性的自我反思。
