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Paper short abstract

This paper examines the changing professional identity of medical doctors in India amid growing polarisation and rising violence in the healthcare sector. It interrogates the erosion of the historic social/moral contract between the professional and the society.

Paper long abstract

The medical doctor has long embodied the moral ideal of professional modernity in India, commanding social respect and reverence. In recent decades, however, hospital spaces have increasingly become sites of tension, marked by rising instances of verbal and physical violence against practitioners. According to the Indian Medical Association (IMA), nearly 75% of doctors have experienced some form of violence during their professional lives. Younger practitioners now recognise that medicine no longer guarantees a “quality life,” and themselves caution others against entering a vocation they once idealised. India’s doctor–patient ratio stands at approximately 1:811, surpassing the WHO’s recommended standard. Yet this apparent numerical adequacy coexists with stark rural–urban disparities and the absence of institutional guarantees of safety, dignity, or stability in everyday medical work. Against this backdrop, this paper asks what it means—socially, affectively, and materially—to be a doctor in contemporary India amid changing political regimes and precarious healthcare environments. This dissonance between symbolic reverence and lived precarity signals a significant transformation in the profession.

Drawing on ethnographic fieldwork in a government teaching hospital in South India, supplemented by archival and discourse analysis, the paper argues that the historic social/moral contract between doctors and society has become strained. It examines the rise of “defensive medicine,” wherein clinical practices and pedagogies are shaped by fear of violence, litigation, and mistrust. By tracing shifts in how doctors perceive their work, the paper situates these changes within broader transformations in state imaginaries of development, public expectations of care, and everyday experiences of medical practice.