According to the latest study in PLoS medicine, in India, private practitioners are delivering inadequate care to the TB patients. The study was conducted in Mumbai and Patna. The study warns that almost 6 out of 10 TB patients visiting private doctors in these two places fail to get medical treatment.
The findings came ahead of the United Nations General Assembly’s first high-level meeting on September 26. It will focus on stepping up efforts to end TB. The lead author of the study Dr Madhukar Pai from McGill University in Quebec says that the Quality of TB care is sub optimal and variable in urban India’s private health sector. Addressing this is critical for India’s plans to end TB by 2025. The study was conducted by Dr Madhukar Pai, director of the McGill International TB Centre, along with Ada Kwan, a PhD student at the University of California at Berkeley, Benjamin Daniels and Dr Jishnu Das from the World Bank, and other colleagues. The study was conducted during 2014-15. As a part of the study, 24 standardised patients (SPs)-dummy patients to portray four different case studies- were sent to 1,203 healthcare providers in Mumbai and Patna to assess management and quality outcomes of private providers. The results disclosed that only one third(37%) of the standardised patients were correctly managed. Also, the qualified doctors did a much better job than informal or alternative providers. Out of a total of 2,652 standardised patient-provider interactions analysed, only 949 interactions were correct. There was no single and widely-adopted “common practice” among providers and SPs encountered a wide range of observed quality and various treatment protocols.

Apart from these, there were several positive findings too. For example, the research has found that the Allopathic providers with MBBS or Bachelor of Surgery or higher were able to correctly manage cases than others. Providers who were presented with more diagnostic information by the patient offered better care, even if it meant referring their patients to the public-sector TB programme.
Dr Yatin Dholakia of the Maharashtra State Anti-Tuberculosis Association said there is indeed a variation of care among private providers. “Some private doctors write out fluoroquinolone as the first-line of treatment when it isn’t,” he added. He also added that the biggest problem in India is the time lag between the appearance of the symptoms and starting of treatment. “Patients don’t seek medical help until they cough blood. Even then they rarely go to the right doctor and waste a couple of weeks to a month in reaching a doctor who can offer them the right treatment,” he says.
However, Mumbai’s TB official Dr Daksha Shah says that the study was conducted before BMC began its private support programme. She also adds that the BMC has conducted medical education programs that year itself. She also points out that the quality of health care has improved over the last three years.

Source: https://timesofindia.indiatimes.com/city/mumbai/private-doctors-fail-to-treat-60-of-tb-cases-in-mumbai-study/articleshow/65957587.cms
Vast variation, significant deficits in TB care in urban India: Study

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