The Dilemma for the Indian Patient: Self-management when doctors and patients don’t communicate effectively

Challenge

Without a strong doctor-patient relationship or a reliable healthcare safety net, many Indians with chronic conditions rely on their own research, advice from family, chemists, and social networks to make health decisions. This often leads to delayed interventions, inconsistent medication use, and uncertainty about what’s working—a loop of self-assessment, partial adherence, and intermittent crisis that can have serious long-term health consequences.

Indian patients face numerous challenges in building effective doctor-patient relationships. With average consultations lasting under five minutes, meaningful communication is limited. Paternalism dominates, with shared decision-making still a novel concept. Unsurprisingly, less than half of patients consistently trust their doctors.

Unlike acute illnesses that demand immediate medical attention, chronic diseases like diabetes, hypertension, and asthma unfold over years—yet many people do not regularly consult a doctor about them.

Why? Because the healthcare system puts the burden on patients.

• Outpatient care is largely self-funded, with drugs making up 60% of out-of-pocket costs—creating financial pressure to ration treatment.
• India’s primary care system is evolving, but many patients still face challenges in accessing consistent, long-term medical support. Lack of continuity of care often requires individuals to navigate their health needs across a fragmented landscape.
• Doctors are overburdened, leaving no time for questions or counseling. This breakdown in the doctor-patient relationship erodes trust—patients hesitate to ask questions, and doctors avoid encouraging them.
• Weak regulation allows for exploitation—patients are often marketed unnecessary tests, treatments, or branded medications, reinforcing skepticism about the system.

Medwiki wanted to understand: How can we help people break this loop?

Work

Medwiki is a consumer-first health knowledge platform for trustworthy and accessible information, provided in multilingual and multimedia formats.

Medwiki wants a differentiated value proposition transforming from a health knowledge repository—to a capacity-building tool that enables better, informed health decisions for underserved healthcare consumers.

Catapult Design partnered with Medwiki to conduct inspirational research with Indian patients and caregivers to understand the complex health journeys of chronic patients and carers, and information seeking behaviors therein:

• What triggers people to seek (or avoid) care?
• How do they make sense of chronic conditions with limited provider guidance?
• Why or when do they stop, start, or modify treatments on their own?
• What information gaps are keeping people in the cycle of uncertainty?

Results

Through interviews and fieldwork, we uncovered key patterns in how people navigate chronic illness:

1. People delay formal care. Many only seek medical attention when symptoms become unmanageable, relying instead on self-diagnosis, test results, or social advice to decide their next steps.
2. Diagnosis doesn’t always lead to action. Receiving a diagnosis doesn’t guarantee that someone will change their behavior. Fear, confusion, and misinformation often cause them to delay or modify treatment.
3. Treatment isn’t a straight path. Medication use is often inconsistent—people pause, switch, or adjust dosages based on cost, skepticism, or advice from peers.
4. People don’t always trust the system. Short doctor visits and a lack of counseling leave many feeling unsupported, leading them to turn to alternative providers, YouTube, or family members for reassurance.

Rather than prescribing solutions, our research helped Medwiki refine critical questions that will shape the platform’s future:

• How can Medwiki aid in improving patient-doctor communication at different stages of the health journey?
• What kinds of nudges or tools could encourage people to stick with treatment plans long enough to see results?
• How can Medwiki engage important stakeholders in the healthcare ecosystem to build trust and effectiveness?
• What content or features could make Medwiki feel more personal and relevant to Indian healthcare consumers?

NEXT STEPS

These insights are guiding Medwiki as it redefines its platform strategy and features. The goal is not just to provide health information, but to help people break the cycle of uncertainty and take control of their long-term health.

Medwiki’s journey to support underserved healthcare consumers in India is ongoing, and we’re excited to see how these findings translate into real-world impact.