Towards a Critical Medical Practice: Reflections on the Dilemmas of Medical Culture Today

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High medical costs, the impersonality of technology-intensive speciality medicine and the difficulty in accessing curative primary care constitute a crisis for medicine in India. Towards a Critical Medical Practice is the outcome of a dialogue between a self-critical medicine and the new social sciences that offers original perspectives on the crisis. A set of historical studies provides fresh insights into the dilemmas that surround cholera, kalaazar, post-traumatic stress disorder, ischemic heart disease, and undernutrition in contemporary India. Another group of papers argue that the public health focus on large-scale preventive programmes has resulted in the underdevelopment of primary care in the curative mode. This deficit in curative care is targeted by the new corporate hospitals that adopt as standard an expensive and inappropriate form of tertiary care that is marketed globally. Doctors trained in a tertiary setting are ill-equipped to provide appropriate medical care in any other context. This book is a path-breaking study which captures the drama of the crisis as mirrored in the lives of the poor battling illness on an everyday basis. Doctors practice against this formidable backdrop of knowledge, orientation and elitism of modern medicine. The constant everyday work of translating knowledge and experience to address a local situation and do justice to the individual patient remains largely invisible and undervalued in modern medicine. We argue that theorising this practice, be it in teaching or in research, will open up new directions in health care and medical education.

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Anand Zachariah is Professor of Medicine at Christian Medical College, Vellore. R. Srivatsan is Senior Fellow at the Anveshi Research Centre for Women s Studies, Hyderabad. Susie Tharu was formerly Professor and Coordinator, School of Critical Humanities at the English and Foreign Languages University, Hyderabad.