The year was 2015.I had just completed my MD in Psychiatry from Maulana Azad Medical College, Delhi, and joined as an Assistant Professor at MGM Medical College, Indore. Since private practice was legally permitted here, I opted out of taking NPA (Non-Practicing Allowance) and began looking for a place to start evening consultations. Someone suggested a place near the college. I went to see it – a diagnostic centre downstairs and an old, shut-down chamber upstairs, with cobwebs on the walls and furniture fit for a museum. Once a polyclinic used to run there, but it had long since ceased operations.
The only appealing aspect was the rent – ₹2500 a month – which seemed like a blessing for someone on a tight budget starting out. The owner, fearing I might leave too soon, insisted I pay six months’ rent in advance. After cleaning up the place, putting up a small wall-mounted temple, I began my practice. I hired one support staff member to open and close the clinic and handle patient entries and fees. He was a nursing student working part-time in the evenings, with a particular talent for playing mobile games outside the clinic. One person was assigned for cleaning.
So now we had a setup – doctor and support staff in place. All that was missing were the patients. And the wait was long.
I had imagined that being a doctor trained from Delhi, I’d barely have time to catch my breath due to the crowd of patients. Instead, I was sitting so idle that I was tempted to play PUBG with the boy outside.
I started thinking: how do I get patients, without violating any official regulations – being a government employee and all? First came a Google listing. Then, I posted a photo on my Facebook profile announcing the start of my clinic. I put up a board and printed visiting cards to give out to acquaintances – though to this day, I think I still have most of them lying around.
And just like new towns attract bandits before settlers, doctors barely start practicing when paid portals start calling. Their reps came with offers – pay a certain amount and we’ll show your clinic at the top of listings and guarantee you so many calls. I asked: what about the doctors already listed?
He said: “You’ll be shown above them.”
And what if someone pays more than I do?
He replied, “No sir, your place is fixed.”
I understood – this was all illusion and marketing fluff, neither ethical nor affordable. So, I said goodbye to that idea. Eventually, a few patients trickled in – mostly medicos or referred by acquaintances. Even a single patient brought joy – at least fuel money for commuting was covered.
Some long-time patients also seek second opinions and prefer younger doctors who spend more time with them – but eventually, they return to their old doctor who charges more and talks less, because where there’s a crowd, there’s perceived value.
In the beginning, with so few patients, I’d speak at length with whoever came in, even if it was just a medical representative – just to avoid the chamber looking empty.
At one point, someone suggested holding a “camp” at the clinic. So, I set a nominal registration fee of ₹100 and organized one. That was the first time I saw double-digit patient numbers in a single day. However, almost none of them came back for follow-up, expecting that the same discounted fee would apply forever – a notion I failed to correct. One man even walked out without paying, and when called, said, “Doc sa’ab, that’s my illness – forgetfulness. I forgot the fees.”
I tried visiting peripheral areas on Sundays, but laziness got the better of me, and that plan was dropped. I also met nearby doctors, informing them that I had started practice and could be referred to if needed. But as that legendary dialogue from 3 Idiots goes – “Everyone has patients, but no one gives them away.”
Six months went by, and it became clear that patient inflow would only grow gradually.
A senior professor consoled me, saying, “Happens to everyone. Hang in there.”
It was comforting – like learning that a power cut didn’t affect only your house, but the whole street. So, I kept my focus, and slowly, when I started getting positive feedback from patients, it felt good.
I realized that it’s not just about numbers – patient satisfaction and long-term trust matter too. A happy patient brings along family, neighbours, and friends. During that time, a close acquaintance of a former Madhya Pradesh minister benefitted from treatment and sent a handwritten appreciation letter. That letter, to me, is more valuable than any paid award.
Another important lesson I learned from seniors: Just as a sharp axe is essential to cut wood efficiently, the quality of medicine you prescribe is crucial for patient outcomes. Never compromise on medication quality. Also, never badmouth a fellow doctor in front of a patient – it sends a negative message.
Once, a senior doctor crossed out all the medications I had prescribed and wrote the same ones under different brand names, saying my treatment was wrong. The patient was well-read, Googled the medications, and returned to me, sharing the whole incident.
A year had passed, and slowly a few regular patients had started to come. Encouraged by the positive feedback, I shifted to a better clinic in a modern building – good infrastructure, no parking issues (a major factor in bigger cities). A responsible and polite receptionist was hired, and slowly the practice began to pick up.
Eventually, I understood that prescribing less and spending more time with patients is a new doctor’s unique strength – and it’s vital to preserve that instead of chasing numbers.
A few more important tips for young doctors:
• Always take professional indemnity insurance. The premium is low, and it gives peace of mind.
• Stay away from paid awards and promotions.
• For professional networking, become an active member of organizations like the IMA.
• Use social media to spread awareness but always protect patient privacy.
“Kvachiddharmaḥ kvachinmaitrī kvachidarśaḥ kvachidyaśaḥ
Karmabhyāsaḥ kvachiccheti cikitsā nāsti niṣphalā…”
– Charaka Samhita
Translation:
“Sometimes it brings virtue, sometimes friendship, sometimes wealth, sometimes fame, and always, it hones the practice – the medical profession is never fruitless.”
Dr. Vijay Niranjan
Associate Professor
Department of Psychiatry
MGM Medical College, Indore
