Ailing in the Queue

In the hospitals and clinics, one thing remains constant: patients waiting. They wait in long, unregulated queues, even some in the scorching heat of summers or the bone-chilling winds of winters. And far too often, they wait in pain, without information, shelter, or hope. Across the length and breadth of the region, patients suffer long before they even reach doctor’s consultation room. The agony is felt in many private clinics, government hospitals, health centres, as well as diagnostic labs, where queues stretch endlessly and appointments are a matter of chance, influence, or erratic schedule. Many are forced to arrive early, crowd entrances, and compete for attention. In many places, those who come later are seen sooner, while others wait for hours. It is a patient’s quagmire.

Waiting in long queues at doctors’ clinics and hospitals is often a distressing and exhausting experience. Patients—many of whom are already in pain or discomfort—are forced to endure prolonged periods of waiting without knowing how long it will take to be seen. This uncertainty creates anxiety, particularly for the elderly, chronically ill, or those who have travelled long distances. Moreover, when no proper queuing system or waiting line discipline is in place, the experience can become even more chaotic. People try to jump ahead, attendants negotiate for priority, and genuine patients are many times left feeling helpless and ignored. This agony of waiting, coupled with disorganization, erodes the trust and dignity patients expect from healthcare environments.

We arrived at 6 a.m. for a 10-minute check-up and returned home by 3 p.m.,” says Saadat Ahmad (name withheld), who brought her diabetic mother to a private clinic in Srinagar. “There was no line. People just walked in. We were told to wait.” This is the agony people go through every day. “There’s no dignity in this system,” says Irfan Ahmad, who travelled from a remote village of Handwara to Srinagar for a neurology appointment. “My mother waited four hours in the hot summer month of July for her turn. People push ahead, there’s no line, no token—nothing, but chaos. After waiting for four long hours, our turn came, and the doctor recommended a few tests and asked us to return again, along with the patient, after 15 days. How could I again face this agony and trauma? I am a poor man and I feel depressed and traumatised.” This situation is not limited to government hospitals or primary health centres. Private clinics and pathology labs also lack standardized systems. Most work on a walk-in basis, leading to overcrowding, favouritism, and rising frustration for both patients and doctors.

Looking at the current healthcare snapshot of Jammu and Kashmir (J&K), the region faces significant challenges in providing adequate medical services to its population. With a population exceeding 13 million, the doctor-to-patient ratio stands at an alarming 1:1700. This is well below the World Health Organization’s recommended standard of 1:1000, highlighting a serious shortfall in medical personnel available to meet the healthcare needs of the public. This gap becomes even more evident in the outpatient departments (OPDs) of major hospitals across the region, where the average daily footfall ranges from 800 to 1200 patients. Such high patient loads place immense pressure on the already overburdened healthcare system, leading to long waiting times, reduced consultation periods, and overall dissatisfaction among patients.

Moreover, the integration of technology in patient management remains minimal. Fewer than 8% of clinics currently use structured digital appointment systems, which could otherwise help streamline patient flow, reduce overcrowding, and optimize doctors’ schedules. The lack of digitization further contributes to inefficiencies in service delivery, making the experience of seeking healthcare more tedious and frustrating for the common person.

For doctors, the challenge is equally real. The “doctor’s dilemma” — balancing care with crowd control — often compromises treatment quality and patient satisfaction. “I see over 80 patients a day in my hospital OPD,” says a senior physician in Srinagar. “There’s no regulation of time, no order. Sometimes genuine emergencies are missed because the waiting area is chaotic.” “We’re doing our best,” says another doctor, “But with no digital system and overcrowded OPDs, we’re stretched thin. Sometimes we have 120 patients in a day and no way to prioritize.”

Unlike a few other metropolitan cities of India and in the developed economies of the world, where scientifically determined appointment methods based on queuing optimization algorithms, online bookings, SMS alerts, or token systems are now standard, J&K still relies on paper slips, first-come-first-served logic, and overburdened front-desk staff. There’s no digital dashboard, no tracking of patient load, and little coordination between labs, clinics, and consultative appointments. Digital healthcare presents vast potential to enhance patient care and clinical outcomes. Traditional methods—centered on history-taking, physical examination, diagnosis, and treatment—are now being complemented by emerging technologies such as machine learning, mobile apps, wearable sensors, and telehealth platforms. The COVID-19 pandemic significantly accelerated this shift toward digital solutions. However, critical challenges remain. These include the need for rigorous evaluation of new technologies, careful and responsible implementation, integration of digital data into unified health records, and ensuring that all tools are backed by strong clinical governance.

It is essential that these innovations benefit patients without increasing the burden on healthcare professionals. While digital advancements may help overcome long-standing limitations in healthcare delivery, they also introduce new obstacles, particularly the risk of excluding those without access to smartphones or reliable internet connectivity.

As we transition into this digital era, clinicians must play a central role in guiding its adoption, advocating both for patients and for their colleagues, to ensure that technology enhances—not complicates—the delivery of safe, equitable, and effective care. Despite the growth of digital services in many sectors, Jammu and Kashmir’s healthcare system remains disconnected from technological convenience. There is no unified online appointment system for public hospitals. Private clinics lack digital tools. Even basic SMS alerts or token displays are rare.

Startups offer a ray of hope

Now, innovation is knocking at the door of this fractured system. Several local startups, supported by the Greenovator Incubation Foundation at NIT Srinagar, and other incubation centres of the valley are working to develop AI-powered digital solutions for streamlining appointments, consultations, and queue management. These systems aim to digitize the entire appointment experience—from remote booking to real-time tracking of delays, factoring in variables such as:

• Patient priority (emergency vs. routine),
• Estimated consultation time,
• Doctor availability,
• Weather conditions, and
• Network/server delays.

and so forth

“Our goal is to bring structure to a system that’s deeply broken,” says Dr Nawab Ahamd Dar, a founder of one such US-based Kashmiri health-tech startup. “Through AI, we can reduce wait times, maintain fairness, and improve the doctor-patient relationship. Our AI engine looks at how long a doctor takes per patient, whether it’s a follow-up or first visit, and even accounts for weather-related disruptions. “We aim to bring predictability, so people don’t have to wait for hours with no clarity.” The aim is to cut average wait times by 30–40%. But these solutions need integration with public health systems and support from policymakers.

Initial trials of these systems in select clinics in Srinagar and Jammu have shown promise. With the right support from medical institutions and the government, these digital tools could transform healthcare accessibility across the region, especially in remote districts where travel and wait times are even more burdensome.

However, challenges remain. Awareness, training, infrastructure, and public trust must be built. Doctors must adapt to digital practices, and patients must be guided through new systems.

For a region already coping with healthcare disparities, this is a crucial moment. The system must evolve—from manual registers to intelligent platforms, from chaotic lines to structured queues, from discomfort to dignity.

Until that change comes, the people of Jammu and Kashmir will continue to suffer silently in the waiting rooms of both cities and villages, caught in a system that heals slowly and listens.

This dysfunction is not just an inconvenience—it’s dangerous. Delayed diagnostics, missed follow-ups, and avoidable suffering are now regular outcomes.

It’s time for a healthcare revolution—one that starts with something as simple as a queue, and as powerful as a timely appointment, diagnosis, and treatment. A win-win situation for all.

Dr Saad Parvez, Director, Greenovator Incubation Foundation, Pi Itbi-Dst Project, National Institute Of Technology Srinagar