Article : PHC doctors — a case where the caregivers need care
Published: The Hindu-23 Sep , 2025
Very Important Topic for UPSC/PCS Mains : GS 1/GS 2/ Health Sector /Issues/Reform
The article talks about the role of Primary Health Centre (PHC) & issues related to it.
Key Points / Issues:
Role & Responsibilities
- Serve as clinicians, planners, coordinators, and community leaders.
- Bridge gap between health policy and community needs.
Key functions include:
- Clinical care across all age groups and specialties.
- Immunisation, maternal & child health, vector control, school health, outbreak response.
- Mentoring ASHA workers, ANMs, village health workers.
- Community engagement via gram sabhas and health education.
Workload & Challenges:
- Serve 30,000–50,000 population per PHC (varies by region).
- Daily outpatient load: ~100 patients, including antenatal care.
- Must handle emergencies across all specialties.
- Need to stay updated on national guidelines, protocols, and evolving medical knowledge.
Administrative Burden:
- Maintain 100+ physical registers (OP records, MCH, NCDs, drug inventory, sanitation, etc.).
- Parallel digital systems: IHIP, PHR, Ayushman Bharat Portal, IDSP, HMIS, UWIN.
- Duplication of data entry (paper + digital).
- Administrative tasks often spill into personal time, reducing focus on clinical care.
Burnout & Systemic Stress:
- Emotional exhaustion, detachment, sense of futility (WHO ICD-11 recognized).
- WHO meta-analysis: 1/3 primary care doctors in LMICs report burnout.
- Burnout caused by mismatch between expectations and systemic support.
- Consequences: reduced quality of care, delayed data reporting, decreased motivation.
Impact on Public Health:
- PHCs are gateways to UHC (SDG Target 3.8).
- Weak PHC support threatens SDG goals of health and well-being for all.
- Programmes like NQAS emphasize checklists, but true quality is humane, enabling, sustainable care.
Challenges:
| Category | Details |
| Clinical | High patient load, diverse medical cases, emergency care without specialist support |
| Administrative | Excessive registers, duplication in paper and digital records |
| Systemic | Lack of support staff, inadequate resources, misalignment between policies and field realities |
| Personal | Burnout, emotional stress, lack of time for learning, reflection, research |
Way Forward / Solutions:
System Redesign:
- Reduce redundant documentation; meaningful digitisation.
- Automate routine data entry; delegate non-clinical tasks.
Support & Recognition
- Adequate staffing, infrastructure, incentives, and mental health support.
- Valuing physicians’ work beyond metrics.
Training & Capacity Building:
- Regular updates on treatment protocols, disease surveillance, and public health programmes.
- Opportunities for research, learning, and professional growth.
Global Best Practices:
- Example: 25 by 5 campaign (U.S.) – reduce clinician documentation by 75%.
- Adopt implementable targets to free doctors’ time for patient care.
Community Engagement
- Strengthen community involvement, preventive care, and health literacy.
- PHC doctors as enablers, not just service providers.
Conclusion:
- PHC doctors are the linchpin of India’s primary healthcare and the foundation of UHC.
- Their physical, emotional, and professional well-being is critical for sustainable, high-quality healthcare.
- Reimagining PHC as an investment, not a cost, requires systemic reforms, empathy-driven policies, and adequate support.
- Strengthening PHCs ensures India can achieve SDG 3 – Health and Well-being for all, making care truly Ayushman.
Article Based Mains Questions : UPSC/PCS/250/200 words
“Primary Health Centre (PHC) doctors are the backbone of India’s public health system, yet they face overwhelming clinical, administrative, and programme-related burdens. Discuss