The private-public divide: impact of conflicting perceptions between the private and public health care sectors in India

SETTING: India's private health care sector manages half the nation's tuberculosis (TB) patients, accounting for an estimated sixth of global TB cases. While several studies have demonstrated private physicians' dubious diagnosis and treatment styles and lack of cooperation with public physicians, very little is still known about the private sector. OBJECTIVES: Using a detailed questionnaire to randomly survey private and public practitioners in Ahmedebad, Gujarat, India, we quantified perceptions held by each sector. STUDY DESIGN: Cross-sectional survey of private and public physicians. RESULTS: Significant conflicts in perception were found regarding interpretation of general facts, attitudes towards each sector, and effectiveness and social implications of DOTS. We also found that such differences in perception were likely to result in mistrust, differing views on reform propositions, conflicting mindsets about social agendas, and unwillingness to cooperate. CONCLUSION: Our data suggest that reconciliation is attainable by obtaining and distributing unbiased, evidence-based information and exposing physicians to both private and public health care sectors in a professional setting.