Doctors dispensing medications: contemporary India and 19th century England.

In developing countries the widespread use of medications in ways that are unsafe and inappropriate is a threat to health and a waste of scarce resources. It is possible that doctors contribute to the problem when, as in rural India, the doctor earns a living by selling medications rather than by charging a consultation fee and writing a prescription; the incentive is to medicate irrespective of the diagnosis. In this article, doctor-patient roles and paying for the doctor's services in a South Indian town are described. Similarities between the town and 19th century England in regard to doctor-patient roles are noted and analyzed.