the current status of doctor-patient relations in your country and the government's efforts to alleviate doctor-patient disputes.

 In this world doctor’s profession consider as one of the noblest professions due to their service toward mankind. Doctors were highly respected in society. The medical profession is more based on public-oriented.

DOCTOR-PATIENT RELATIONSHIP [DPR] is considered to be the core element in the ethical principle of medicine. DPR is developed when patients come to physicians for medical treatment. 

DOCTOR-PATIENT relationship is assumed to be very straightforward between an expert in medicine and a person who needs medicine via checkup, diagnosis, and treatment but it is a very complex relationship. Medicine is not a trade to be learned, but a profession to enter with high responsibility on the shoulder to save a life. 

 Relationship between healer and patient based on trust, communication, doctor empathy, informed consents, professional boundaries, understanding between both physician and patient, maintain confidentiality and provide the highest standard of care. Patients trust physicians and reveal secrets, worries, and fear to the doctor that they have not yet disclosed to family members and friends. The success of any kind of relationship is based on the utmost element that is trusted on each other. According to EMANUEL and DUBLER, the ideal doctor-patient relationship consist of six C’s that is CHOICE, COMPLETENCE, COMMUNICATION, COMPASSION, CONTINUITY, AND [NO] CONFLICT OF INTEREST.

  In ancient Indian system of medicine is considered to be the most methodical and most holistic system. Doctor’s given as highest respect next to the god in the society because the doctor has been considering as gods child or divine healer. They are recognized by their healing power, not by a degree or formal course. During that era, the doctor treats a patient for free of cost rather than making money. Medical practice was seen from a social and humanitarian point of view. In the early and middle part of the twentieth-century maximum doctors were practice in rural areas only a few specialists were available only in rural areas. These physicians practice medicine usually in their village or nearby area. Because physicians known people already so this helps the physician to develop a good relationship with the community and they usually disused with patients about their personal life regarding family matters rather than the usual questions that doctors asked patients. As a result, the doctor explains to the patient nicely about the problem, diagnose properly and the patient also feels free to express their views as much as possible because there was no time-bound they discussed everything properly. From this patients develop trust in doctors. Patients believe in doctors blindly so they hardly think doctors harm them or sometimes if a misfortune happens then patients accept it as God's will. They do not blame doctors for anything. Over time dynamics of society changed toward doctors. There have been some positive as well as negative changes in medical science.

Age of industrialization revolution as improved transportation, technology, everything improvising so this lead to opening new business opportunities and division of labor in the medical sector. The first of these divisions was the founding of the pharmacological industry has emerged as a strong player. In India, each drug is marketed by hundreds of pharmaceutical companies and each company needs to sell its brand generic to make money. Just to make money companies convince the doctor to prescribe their specific brand and for this, they also pay huge cash to doctors. The second development of nursing, which public imagine nurse like the other important pillar of the health sector by replacing the doctors. Technological advanced, medical science accept laboratory service, MRI, CT Scan.

Violence against doctors rises not just only in India but all over the world. According to the Indian Medical Association reports that over 75% of doctors in India face some verbal or physical violence from the patient and their families. A study concludes that the 50percentage violent incident took place in the Intensive Care Unit of hospitals and in 70 percent of cases the relatives of the patient were actively involved. This result of the growing negativity, increase distrust toward the healthcare sector and result in increases cases of violence against doctors and hospital. Doctors are considered corrupt, fraud, and money maker. Due to this many famous doctors have hired personal security and hospital hired bodyguards for protection. Even many doctors' practice has been ruined by fake cases on doctors and hospitals. This happens because of -

Nowadays medicine becomes more commercial and a good source of income for some people while some patients also think they can purchase life easily by paying hospital bills and save their life. Development of corporate culture in the health sector. The concept of privatization gives rise to added fuel to the fire. 

 Good communication skills play a very important role to develop a good relationship between doctor and patient but unfortunately communication skills almost forgettable. Doctors give more importance to the technical part of their profession. Some mistake done by doctors while communicating:

1] Do not listen to the chatter carefully

2] Dependent language

3] Talking to many persons while attending the patient

Ignoring patient questions

On the other hand, while scrolling on Instagram I come across a picture were a doctor write a notice for the people about irresponsible behavior of their toward health. people usually eat samosa, chat and other fried in recycled oil made from dirty water, served by dirty hand and drink a poisonous liquid that name as cold-drink, smoke, eat tobacco take this without thinking twice even knowing the caution people did not stop it but after the doctor has written a prescription they ask “are you sure there will be no side effect?”

Till now India does not have any health for all policy, government lack of resources to provide adequate healthcare and health care in the private sector which is very costly and business based. Private sector are better, faster and more efficient than the government sector. Poor people did not get free or cheap medical care lead to anger and dissatisfied. Due this when any disease attack to patient it brings a major financial burden on the family especially to those family lives in rural area and low economic strata. For any disease patient take to the nearby city for the treatment leading selling of property. From patient eye- they thought that the frontline workers or physician. It’s not unusual for a patient to pay a hospital bill of [in millions] which may include only 10,000 RUPPES. But in the patient mind, doctors charged [million]. Greedy doctor it turns god to devil [on being asked to pay the bill] patient perception change about doctors. But not all doctors were same some doctors work for humanity and loyal to their profession like DR.MANOJ KUMAR left his psychiatric practice in the United Kingdom and flew back to India. His aim to aware people about the mental health condition of the rural population here. He treat homeless and does not take a single penny for his service. Dr. ABHIJIT SANAWANE doctor from Pune who treat beggars without thinking of his pocket. He resigning from his job on Independence Day 2015, decided to dedicate his life to cure the poor people of their illness and also help people to move on from begging and start small businesses. Like them many more doctors in India doing this kind of selfless treatment. These people shows humanity exist in the world due to some greedy people we cannot judge every doctor as moneymaker.

As literacy rate is very less and whatever doctor told or asked by the patient are the final word for them. They believe doctor blindly. But as literacy rate increase patient and their relatives are more aware regarding to their rights. Patient and their relatives now ask doctors different question and deal with doctor more accurately.

The current revolution in information technology, mostly people spend long hours on computer they develop the symptom of lifestyle disease. They look upon dr. Google on their desktop and try to find nutritional supplements and other common remedies suggested online. Then they finally decided to visit the doctor and think they know much and challenge the physician's advice if it does not match with their internet result. this lead to dispute has heated arguments as the internet and doctor words did not match. this makes doctor impatient, burnout, increase stress level, and doctors get easily frustrated. Blindly trust is being replaced by an informed trust but doctor patient and google is not a healthy love triangle, it only develops misunderstanding and issues. Everyday media shows that every man and women are happy and immortal – until doctors decided to loot or kill them. As case of medical failure is most often sensationalized through media. Media play another important role in making doctor patient relationship more doubtful. But sometimes media also play a very helpful role they educate people from fraud and not only that the build a bridge between doctor and patient.

migration of patient –as patient move from one city to other or one place to other and difficulty to find suitable doctor who negotiate correctly and treat well. This kind of situation make patient usually when patient goes to another doctor, patient already makeup the mind and if doctor did not match to the previous doctor they meet. Patient rise question on their treatment method.

Disproportionate doctor population ratio doctors is not able to spend much time with patient which is required for consultation process especially in government sector. Due to lots of patient they did not give proper time so most of the time patient dissatisfied as well as doctor’s work under pressure because of d working in the situation of life and death with in a really short period is not easy to deal with as result deterioration of relationship day by day. To tackle with this problem doctors even work for 12-16 hour .As now in the pandemic they are doing brilliant work. They work day and night facing all kind of problem. They are the real heroes and sometimes they are not having proper medical equipment still they are working. Facing lots of problem still having a smile on face, making other happy, dancing in the ward, singing, giving hopes to the patient. In this kind of stressful situation still they are rising a hope of light.

Corruption is the most important factor that lead to deterioration of doctor patient relationship in INDIA. For making more money doctors prescribed costly and unnecessary medicines and laboratory test. Private hospital keep patient unnecessary in I.C.U for the extra charge. Doctors makes deal with medical shops and laboratory for the commission. This destroying the reputation of doctors or status of doctor’s profession comes down

Inequality in healthcare delivery this lead to anger and frustration in patient. Those who pay highly fee of hospitals can enjoy the highest level of health care while poor and middle class people depend on poorly developed government healthcare sectors. During illness that time patient understand the value of money. Even more and more clinic are now resorting to defensive practice.

Medical laws is the branch of law which concern the prerogatives and responsibilities of medical profession and the rights of patients. Laws are created to regulate human behavior for the benefit of society. The government has pass some laws for medical safety of doctors as well as for the patient.

Medicolegal is the term which means something that involves both medical and legal aspect. These are the laws governing the doctor-patient relationship, legal consequences of breach of contract and medicolegal aspects of negligence of duty.

1. Consumer Protection Act 1986 [COPRA]: this Act was enacted in 1986, gives easy and fast compensation to consumer grievance. It provide a forum to safeguard the right of costumers and checking unfair trade practices , defect in goods, defeciences in services except those exempted by central government. This act covers all goods and services of all public, private, cooperative sectors.

The right of consumer-

• Right to safety: This law is to be protected against product, production processes and services which are hazardous to health or life.
• Right to choose: according to this law patient has right to choose what type of product and service patient want and doctor did not force patient to take treatment or product if patient is not agreed.
• Right to be informed: PATIENT HAS RIGHT TO BE INFORMED about the illness and the given facts needed to make a choice and to not be misguided.
• The right to redress: this law is to receive a fair settlement of claim, including compensation for poor service, misrepresentation or misbehavior.
• The right to a healthy environment: to live and work in a healthy environment that not threatening

The responsibility of consumer

• Responsibility to be aware
• Responsibility to speak
• Responsibility to think independent
• Responsibility to speak out
• Responsibility to complain

 Law of privileged communication: A doctor is under moral and legal obligation not to divulge the information or knowledge which he learns to come’s to learn in confidence from his patient and such a communication is called privileged communication. This help to build a trust between doctor and patient.

1. Law of torts: Medical malpractice or negligence law, a tort is an act of civil wrong done to an individual resulting in injury, harm , money damage or loss or civil liability applies to doctors on the ground of professional misconduct.
2. Criminal law: Under section 304-A of Indian Panel Code [IPC], the doctor who commit criminal liability such as assault, fraud and abuse, is punishable with imprisonment for a term which may extent into two, year or with a fine or both. Medical crime includes abortion and violence of professional secrecy. The criminal law operates on a doctor in somewhat a different manner than an ordinary persons. This is because it allows a doctor to cause injury to the patient for preventing a greater harm.

IPC Section 52 (good faith) it donates that nothing is said to be done or believed in this, which is done or believed without due to care and attention he criminal law arms a doctor with three formidable defence namely: (1) informed consent, (2) necessity and (3) good faith.

Sec 80 (accident in doing lawful act), Sec 89 (for insane & children), Sec 90 (consent under fear), Sec 92 (good faith/consent), Sec 93 (communication in good faith)

Indian Evidence Act, 1872: this law is all about facts not related to emotion and any other kind of thing. This act introduced a strandard set of law applicable to all Indians.

1. The ethics of medical practice: there are several principal of ethics embraced by medical profession. These includes beneficence, utility, justice, and autonomy.

• Beneficence: means doing good to patient or doing for beneficial to patient
• Utility: Means that doctor’s action should yield good result and benefits of patient without wasting resources.
• Justice: MEANS THAT DOCTORS DECISION on patient treatment is made fairly not partially.
• Autonomy: Means that respect for persons self- decision regarding to the patient choice to treatment.