{"id":901941,"date":"2025-09-29T14:19:23","date_gmt":"2025-09-29T14:19:23","guid":{"rendered":"https:\/\/iapsm.org\/blog\/?p=901941"},"modified":"2025-09-29T14:19:23","modified_gmt":"2025-09-29T14:19:23","slug":"why-is-a-doctors-fee-always-a-debate-reflections-on-value-trust-and-change","status":"publish","type":"post","link":"https:\/\/iapsm.org\/blog\/why-is-a-doctors-fee-always-a-debate-reflections-on-value-trust-and-change\/","title":{"rendered":"Why Is a Doctors Fee Always a Debate. Reflections on Value, Trust, and Change"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>It happens so often now that it feels scripted. A friend\u2014or sometimes a friend of a friend\u2014pings me out of nowhere. The chat starts warm: \u201cHey! Long time, how have you been?\u201d For a moment, I think they genuinely want to catch up. And then, the real reason emerges:<br \/>\n\u201cDoc, quick question\u2026 my reports look a little off, should I worry?\u201d<\/p>\n<p>What follows is predictable. I explain, calmly. They nod (or type) in agreement\u2014until Google joins the conversation. Suddenly, my explanation is countered with, \u201cBut I read that\u2026\u201d or \u201cSomeone told me\u2026\u201d After 20 minutes, they circle back: \u201cSo, what do you think I should do?\u201d<\/p>\n<p>&nbsp;<\/p>\n<p>This isn\u2019t a one-time thing. It\u2019s on repeat\u2014festivals, random pings, even \u201curgent\u201d midnight voice notes. The assumption is universal: if you know a doctor, their expertise is yours to claim. No appointment, no fee\u2014just social currency.<\/p>\n<p>&nbsp;<\/p>\n<p>Every doctor I know\u2014seniors, colleagues, juniors, in cities or small towns, private practice or public service\u2014faces the same question:<br \/>\n\u201cWhy is a doctor criticized when they charge a consultation fee?\u201d<\/p>\n<h3><\/h3>\n<h3>The Glorification of Medicine vs. The Reality of Doctor Shopping<\/h3>\n<p>Indian society glorifies doctors. They\u2019re often called second to God, saving lives and healing suffering. Families proudly announce when a child \u201cbecomes a doctor.\u201d<\/p>\n<p>&nbsp;<\/p>\n<p>Yet, the same society often turns transactional. Patients visit multiple doctors for the same ailment\u2014\u201cdoctor shopping\u201d\u2014until reassured or charged less. It\u2019s common to hear, \u201cDoctor ne jyada fees li\u201d (the doctor charged too much), even if the amount is less than a meal at a mid-range restaurant.<\/p>\n<p>&nbsp;<\/p>\n<p>And here lies the paradox: people won\u2019t bargain with their hairstylist or question their mechanic, but hesitate, complain, or criticize a doctor\u2019s fee.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h3>Why the Criticism? Layers of Perception<\/h3>\n<ul>\n<li>Expectation of nobility: Medicine is seen as a noble profession. Patients assume altruism should override economics, asking relatives or neighbours for prescriptions without considering a fee.<\/li>\n<li>Corporate medicine and inequities: Exorbitant charges in corporate hospitals fuel distrust. The actions of a few institutions colour perceptions of the entire profession, even of small-town doctors charging \u20b9300.<\/li>\n<li>Cultural habits: In Indian households, \u201cfree medical advice\u201d from doctor relatives is common. The same people wouldn\u2019t expect an advocate cousin to fight a case for free.<\/li>\n<li>Trust deficit: High-profile cases of malpractice and profiteering make headlines, reinforcing the narrative that doctors are \u201cin it for the money.\u201d<\/li>\n<\/ul>\n<h3><\/h3>\n<h3>The Quackery Paradox<\/h3>\n<p>Ironically, while doctors face criticism for charging, many people pay extravagantly to quacks or self-styled healers. Whether it\u2019s a \u201cmiracle baba\u201d offering herbs for thousands or online supplements pushed with aggressive marketing, money changes hands far more easily than with a qualified doctor.<\/p>\n<p>A study in <em>The Lancet<\/em> noted that reliance on informal providers remains high in India, with over 30% of healthcare in some states provided by unqualified practitioners. The trust is misplaced, but the willingness to pay is striking.<\/p>\n<p>&nbsp;<\/p>\n<h3>The Human Cost of Becoming a Doctor<\/h3>\n<p>Becoming a doctor in India is not just about intelligence but years of sacrifice, financial investment, and emotional toll. The average student spends over a decade in training\u2014MBBS, internship, postgraduate study\u2014often with loans and immense responsibility: mistakes can cost lives.<\/p>\n<p>In any other profession, such investment justifies fair pay. Yet doctors still feel compelled to defend charging fees at all.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h3>Behavioural Economics: Why Free Advice Devalues the Profession<\/h3>\n<p>Behavioural science shows that free services are perceived as less valuable. Free advice is taken casually, ignored, or second-guessed\u2014not because it\u2019s wrong, but because \u201cit didn\u2019t cost me anything.\u201d<\/p>\n<p>Charging a consultation fee respects the doctor\u2019s time and increases the seriousness of advice, improving compliance. Research shows patients in India often perceive consultations as \u201cexpensive,\u201d but this perception stems more from mistrust and lack of transparency than actual cost. When doctors explain both the diagnosis and the value of the consultation, patients are more willing to pay.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h3>A Need for Behavioural Change\u2014Among Doctors Too<\/h3>\n<p>Here\u2019s the paradox: we doctors sometimes enable this culture ourselves. Out of goodwill, social obligation, or discomfort, many of us give away time and expertise freely. While kindness matters, a blanket culture of free consultations devalues the profession.<\/p>\n<p>Other professions charge without hesitation\u2014lawyers, architects, trainers. Why should medicine be different, especially when the stakes are higher?<\/p>\n<p>Of course, some doctors do overcharge or exploit patient vulnerability, and corporate models sometimes push unnecessary tests. These practices must be acknowledged and corrected. But exploitation exists in every profession\u2014law, finance, real estate. It should not define the majority who work sincerely, often in harsh conditions.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h3>The Way Forward<\/h3>\n<p>Perhaps a behavioural shift is needed on both sides.<\/p>\n<ul>\n<li>For patients: Understand that medical advice is not \u201cfree.\u201d It represents years of training and responsibility. Paying a reasonable fee respects the doctor\u2019s work.<\/li>\n<li>For doctors: Charge transparently and fairly, building trust through open communication and empathy.<\/li>\n<li>For policymakers: Strengthen public healthcare to reduce out-of-pocket spending, while allowing private practice to remain a fair and respected option.<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<h4>Conclusion: Leaving the Question Open<\/h4>\n<p>Doctors in India are called nobles but expected to work for free. Their modest fees are questioned, while people pay more to quacks or miracle cures. The reality is complex. Yes, exploitative practices exist, but so does immense dedication, responsibility, and integrity.<\/p>\n<p>Next time you text a doctor friend, remember: advice is easy (India me raste chalte log advice de jayenge), but experience isn\u2019t free.<\/p>\n<p>Perhaps the solution lies not in criticizing the act of charging, but in collectively deciding what is reasonable, transparent, and respectful\u2014for both the healer and the healed.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; It happens so often now that it feels scripted. A friend\u2014or sometimes a friend of a friend\u2014pings me out of nowhere. The chat starts warm: \u201cHey! Long time, how have you been?\u201d For a moment, I think they genuinely<\/p>\n","protected":false},"author":1,"featured_media":901942,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[104],"tags":[340],"class_list":["post-901941","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ethics-and-professionalism","tag-buisnessorservice"],"acf":[],"_links":{"self":[{"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/posts\/901941","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/comments?post=901941"}],"version-history":[{"count":1,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/posts\/901941\/revisions"}],"predecessor-version":[{"id":901943,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/posts\/901941\/revisions\/901943"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/media\/901942"}],"wp:attachment":[{"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/media?parent=901941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/categories?post=901941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/iapsm.org\/blog\/wp-json\/wp\/v2\/tags?post=901941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}