Cultural Barriers to Modern Medicine in India are Stronger Than Financial Barriers

India’s low investment in the modern medical system is well known but its underlying reasons are not well understood. While various reasons have been proposed such as lack of resources because of its low-middle income status, health being a state subject, poor spending capability of the states, etc., one of the reasons has been overlooked, which is that India and Indians do not like the modern (western) medical system. Indians have been treated by the Indian system of medicines for over two millennia. However, they were ruled by Englishmen for over two centuries and it was only during that time that modern medicine was introduced to Indians and the department of health and the medical colleges were created by the Britishers (foreigners). Emanating from this fact and based on my limited experiences, I speculate that the major barriers to affordable accessible modern healthcare to Indians are not financial but cultural.

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I believe that even today; the modern medicine is not culturally acceptable to most of the Indians. Except for the few middle-class people who send their children to English medium schools, the majority of the people do not trust the doctor who writes a prescription in English, orders investigations that are reported in English and the medicines whose labels are printed in English. They would instead prefer to trust a traditional-system-doctor or even an informal practitioner or a faith healer who speaks to them in the regional language, and prescribes them herbs and shrubs (naturals) but not modern medicines (chemicals).

In my experiences, one of the biggest cultural resistance of the Indians emerges from the side effects of modern medicines. The people cannot culturally accept the concept of adverse reaction of a medicine. To them, what use is medicine, if it has side effects. The people and its leaders are in love with traditional healers, be it faith healers, or practitioners of other traditional systems of medicine who promise side-effect-free medicine. This is even leading to some of the modern-medicine-trained doctors also claiming side-effect-free medicine to the patients, and to an extent that the pharmaceutical companies might also prefer to restrict the information on the side effects.

Another biggest resistance which is obvious to me is towards testing. Any investigation ordered is doubted since a good doctor should be able to diagnose only by clinical examination. The majority of Indians seem to have an obsession with the diagnosis of any disease just by the examination of the pulse. A big concern of most patients is that If the testing results are negative, then why were they ordered in the first place. If they turn out to be positive, then the patients may find the happiness that their money was well spent. However, the screening of diseases in the asymptomatic stage usually meets resistance from most patients with the intentions of the doctor being questioned.

Similarly, although most Indians agree that the population explosion is the biggest problem for India, the concept of modern methods of family planning is still not acceptable to most Indians for the same reasons. Most people are culturally offended by any discussion on family planning, which continues to remain a private matter.

In conclusion, I suggest that the day the Indian population embraces the modern system of medicine and its principles like diagnosis based on evidence and the potential of the side effects, the policymakers would be forced to increase the provision of effective health services and the allocated resources. However, the main concerns are when and how will that day arrive, or will that day ever arrive.

References and suggested reading:

1. Addressing language barriers to healthcare in India

2. Medication concordance in modern medicine – A critical appraisal from an Indian perspective

3. Decentralization of health services in India: barriers and facilitating factors

4. Health care and equity in India

5. Investigating Barriers to Early Cancer Detection for Rural Indian Women

About the author: Dr. Naval Asija is a licensed MBBS Physician from India. MBBS is the equivalent of the MD degree offered by international medical schools. He is based in Delhi, India, and works as a medical writer, editor, and consultant. He supports medical researches as an author's editor, medical communication companies involved in medico-marketing activities, and medical technology companies in improving their products. He can be contacted via his LinkedIn Profile: https://www.linkedin.com/in/navalasija/