Patients benefit from human, responsive grievance systems focused on resolution-Not prolonged litigation: Dr Alexander Thomas

The matter was brought before the Court through a writ petition filed by the Association of Healthcare Providers (India). The petition seeks directions to the Centre and the NMC to clarify that services rendered by healthcare professionals and medical institutions do not fall within the scope of the Consumer Protection Act, (CPA) 2019.

The Association has further requested the Court to direct all consumer forums across the country not to entertain complaints filed under the Consumer Protection Act against healthcare service providers.

Also Read:Doctors exclusion from Consumer Protection Act- Supreme Court issues notice to Centre, NMC

In an exclusive interview with Medical Dialogues, Dr Alexander Thomas, Founder and Patron of the Association of Healthcare Providers India (AHPI), also the second petitioner in the case, shared the rationale behind the CPA petition and addressed concerns surrounding accountability, patient welfare, and the future framework for adjudicating medical negligence in India.

Medical Dialogues: What is the core issue raised in this petition, and what legal change are you seeking?

Dr Thomas: The core issue raised in this petition is not about reducing accountability, but about ensuring that grievance redressal in healthcare remains fair, humane, and centred on the patient.

Having spent a lifetime in mission healthcare, my experience has consistently shown that patients primarily seek understanding, explanation, and timely resolution rather than prolonged adversarial processes. Medical care is inherently complex and cannot always be appropriately evaluated within a framework designed for commercial services. The appropriateness of treating medical care purely under consumer law therefore requires reconsideration.

Equally important is the need to restore trust in the doctor–patient relationship. Increasingly adversarial processes risk eroding this trust. Defensive medicine rises dramatically when medical decisions are driven by fear of litigation rather than clinical judgment, leading to increased costs and sometimes unnecessary interventions that do not benefit patients.

There is also growing concern that the stress associated with frequent consumer litigation may discourage young students from choosing medicine as a profession, at a time when the country needs committed and compassionate healthcare professionals.

The petition therefore seeks the creation of healthcare-specific grievance mechanisms that combine clinical understanding, communication, and patient safety principles, so that disputes are resolved in a manner that heals rather than divides.

Medical Dialogues: You say exclusion of doctors from the CPA would benefit patients. How would limiting access to consumer forums concretely improve patient welfare?

Dr Thomas: The intention is not to deny patients access to justice, but to improve the quality and timeliness of redressal for patients.

Consumer forums have often not been able to fully meet expectations in terms of speed of resolution, and medical disputes frequently require expert clinical evaluation rather than a purely transactional assessment. When disputes become adversarial, both patients and healthcare providers experience prolonged emotional and financial stress without necessarily improving outcomes.

A patient-centred system would encourage:

a. Early communication and explanation

b. Mediation and resolution rather than confrontation

c. Faster, expert-informed decisions

d. Greater transparency and learning from adverse events

Patients ultimately benefit when grievance systems are human, responsive, and focused on resolution rather than prolonged litigation.

Medical Dialogues: If doctors are removed from the CPA, what alternative accountability mechanism do you support, and how would it ensure timely remedies?

Dr Thomas: Faster, fairer, and more patient-friendly alternatives already exist and can be strengthened.

These include:

a. Hospital grievance committees and ombudsman systems

b. Mediation and arbitration panels

c. Patient advisory councils that enable expert and transparent resolution of complaints

d. State medical councils providing ethical oversight

e. Digital grievance platforms that allow time-bound disclosure and response

Importantly, the experience of patient advisory councils in hospitals spearheaded by the PPSF (Patients for Patient safety, Foundation) — often driven by patients themselves and focused on improving patient safety — has been very encouraging. These forums allow patients and families to participate constructively in improving systems of care, ensuring that grievances lead to learning and safer practices rather than confrontation.

The introduction and empowerment of such mechanisms would protect both patient and practitioner while encouraging learning, correction, and system improvement rather than prolonged litigation.

Both organisationally through AHPI and individually through decades of work in healthcare quality, our emphasis has been on capacity building — helping doctors and healthcare institutions develop competencies in areas where they were traditionally not trained, particularly communication, patient engagement, and safety systems.

I am also one of the founders of CAHO (Consortium of Accredited Healthcare Organisations), established specifically to promote patient safety and quality improvement. In parallel, my work with NABH and the Quality Council of India (QCI) has focused on building national standards and accreditation systems aimed at improving the quality and safety of healthcare services for patients. These initiatives were designed to prevent harm and improve outcomes, thereby reducing disputes at their source.

Medical Dialogues: How should the profession address concerns about frivolous litigation while upholding transparency and accountability?

Dr Thomas: Transparency and accountability must remain non-negotiable. However, experience shows that many disputes arise from communication failures rather than negligence.

Nearly 70–80% of medical errors have a communication component, which is why introducing communication skills into the medical curriculum became an important reform. Following the publication of our book on healthcare communication, a broader communication movement emerged, leading to the integration of communication training into medical education. This has made a meaningful difference to patient satisfaction, safety, and trust.

Violence against healthcare professionals is another serious concern, and one of the contributory reasons is the erosion of trust. Through publications and initiatives addressing challenges in medical practice, efforts have been made to highlight how better communication, transparency, and empathy can reduce conflict and improve outcomes for both patients and providers.

The solution lies not in reducing scrutiny, but in strengthening communication, improving systems, and rebuilding trust.

Medical Dialogues: Should the doctor–patient relationship be treated in law as a commercial service or a fiduciary relationship, and what would that mean for liability?

Dr Thomas: The doctor–patient relationship is fundamentally a fiduciary relationship built on trust, not a commercial transaction. Patients seek care at moments of vulnerability, and doctors are ethically bound to act in the patient’s best interest.

Recognising this fiduciary nature does not reduce liability. Negligence must continue to be addressed firmly. However, it ensures that medical care is evaluated within the realities of clinical uncertainty rather than as a guaranteed commercial outcome.

Ultimately, whether through AHPI, CAHO, NABH, QCI, or individual professional efforts, the objective has always been the same — improving the quality and safety of care for patients. All of us in healthcare are here for the patient, and that central purpose should never be forgotten.

Also Read:Supreme Court rejects review plea, says no exemption for doctors under CPA