A fair redress for wronged patients

By Alexander Thomas and Som Mittal

The patient-doctor relationship should be built on trust. When this foundation is strong and communication is effective, it boosts patient satisfaction and improves health outcomes. But doctors are human too, and when something goes wrong, which it sometimes does, patients are entitled to an honest and transparent explanation.

After a medical mishap, patients frequently say, “If only I had been told earlier...” or “If I had known, I would have asked!” when it is too late. Regret often weighs more than grief. When patients feel excluded from decisions, anger replaces trust in the patient-doctor bond. Many turn to litigation not just for compensation but to “teach a lesson.” Others remain silent, convinced that nothing will change, while sharing negative experiences informally, damaging reputations and masking the true scale of harm. For harmed patients, there should be a swift, fair, and compassionate grievance redress process. Unfortunately, in our country, the most common route for grievance redress is consumer forums under the Consumer Protection Act, and these fall short. The system is slow, adversarial, and rarely delivers justice.

The law promises resolution within three to five months. In practice, most cases take two years or more, with appeals dragging on longer. Official data in 2024 shows that 1.73 lakh new complaints were filed nationwide, 1.58 lakh cases were disposed of, and nearly 5.5 lakh cases are pending across all forums – and these are just the ones that have been filed as complaints; the majority of harmed patients do not file complaints at all, resigned to the futility of the process.

Persistent vacancies in consumer forums stall hearings and delay judgements. Many judges lack the medical expertise to evaluate complex evidence, and there is no uniform framework for compensation. Awards for similar cases vary widely, while doctors face years of litigation, even over frivolous claims. From our experience with both medical practice and patient advocacy, we have seen disputes drag on for years, hurting patients, families, and providers alike.

During this time, patients relive trauma, families lose hope, and doctors see their careers overshadowed by unresolved cases. Such delays fuel the rise of “defensive medicine” in our society: unnecessary tests, avoidance of high-risk but necessary interventions, higher costs, and eroded trust.

Patients are also confronted with having to choose one of many forums, each with their own limitations: if they go to a consumer commission, they have to deal with lengthy wait times and lack of medical expertise; civil suits have broader remedies, but are costly; criminal cases require a high burden of proof, and hold the risk of misuse; medical council complaints result in a professional review, but with lengthy delays and no compensation; out-of-court settlements may be fast and private but are rarely transparent; Human Rights Commissions’ orders are not binding.

An alternative, collaborative approach

India does have options other than consumer forums, but awareness of these options is low. State Medical Councils and arbitration panels have expert-led grievance redress mechanisms, but they take time. Patient Advisory Councils (PACs) bring patients’ voices into decision-making and shift grievance handling from adversarial to collaborative. However, there are no dedicated regulators to oversee these alternatives. This is necessary to unify standards, ensure systemic learning, and enforce accountability.

Apart from these, other viable alternatives for grievance redress can also be developed. Hospitals can establish grievance committees to investigate complaints transparently, explain outcomes, and implement corrective measures. Independent ombudspersons – a model already proven effective in insurance and banking – can be introduced within hospitals to ensure impartial
resolution. In addition, digital grievance portals with regional language access, including those linked to government schemes, can make complaint handling faster, more transparent, and more accessible.

If India is to restore trust, grievance redress must be timely, expert-led, and patient-centred. Awareness campaigns should inform patients of their rights and treatment risks, while also promoting faster grievance channels. Professional indemnity for doctors and insurance literacy for patients can reduce financial disputes. A credible system must distinguish genuine negligence, poor skills, or lack of infrastructure from judgement errors, which should be addressed through structured review and learning, not punishment.

New platforms, such as PACs, must be expanded. By bringing patients and healthcare representatives together, PACs provide feedback, resolve issues, improve communication, and build loyalty. Over time, they can shift grievance handling from reactive to collaborative.

Honest, two-way communication and prompt acknowledgment of mistakes can go some way in repairing the patient-doctor bond, provide closure, and prevent escalation. A sincere apology, when appropriate, often rebuilds confidence before disputes harden into medico-legal cases. A positive step in recent years has been the introduction of communication training into India’s medical curriculum. Since 2019, all undergraduate and postgraduate students have been taught these communication skills, and NABH-accredited hospitals must meet clear communication standards.

This is not about reducing accountability. It is about ensuring that only qualified practitioners are allowed to practice, providing patients with closure without years of waiting, and implementing corrective actions where needed. In healthcare, time lost often means health lost. While forums, councils, and courts must reform, the healthcare sector itself must embrace transparent, patient-centred grievance mechanisms. Only then can India protect patients, support providers, and rebuild the trust on which good care depends.

(Alexander is founder and patron, Association of Healthcare Providers India; Som is Chair, Patients for Patient Safety Foundation, and 
former president, Nasscom)