Medical Facilities - Essential Services or Business Opportunities?

दानधर्मतपस्तीर्थस्नानादिक्लेशवर्जितम् |
प्रदर्शयन्ति लोकेभ्यः स्वर्गमार्गं चिकित्सकाः ||

Yesterday, I thought to go to a hospital to get my eyes checked. Searching for the route, first, I went to Sankara Netralaya. Well, as usual, you can’t go there without an appointment. Then I checked if there are any other good ones. I found another eminent chain, with multiple branches. First I tried Kilpauk. Though the address is given on the main road, it was no where to be seen. Then, directly, I went to Vadapalani thinking it to be either the Chennai main branch or one of the primary branches of Chennai. After all, the number of search results I was getting for this branch made me think so. Now, enter the hospital. Not so big, I immediately got a doubt but took the plunge. Next doubt when told that they take only cash - not debit cards. An eminent hospital chain in India, even though, an acquired branch, you take only cash? Is there no standardisation? No one was ready to listen to my problem. They got a sight check, which I know, is slightly less than .25 - this was done three times, as if that’s the only things the doctors and the attendants know in the hospital. Then, they gave some eye drops. It took almost five hours after that for my vision to be normal. My situation was that bad that I had to ask my friend who accompanied me to dictate the menu in the hotel. Then, I go to the doctor. The problem was eye spasms - is it blepharospasm, is it due to worklife stress, is it vertigo, is it something else, he doesn’t bother. The answer, it’s a habit, you should control it. What the hell? If it is a habit, why would I go to an opthamologist? I would rather go to a neural. I came here because this is a neuro-opthalmic problem, not because I am bored or I have got money to waste. Every chain going on an acquisition spree should note this fundamental thing - it’s quality for which people come to you. Be ready to boot out the doctors who don’t confirm to your standards and maintain similar standards all across your hospitals.

Now, add two more news articles which came today - a person by name Archana Ramachandran who flunked twelfth but by impersonating someone long dead, became a doctor. She was finally caught and was debarred. Now, the question is, a person, who is not able to pass twelfth, how did she pass MBBS and may be advanced medicine? What went wrong in our checks?

Next one, over the demand that medicines should be bought only in the associated medical shops. What is the modus operandi? There is a medicine A for 10,000 rupees and a generic B for 2000 rupees. There can be another medicine C given by the same company which provided A for 3000 rupees. Because it’s on a bulk procurement, I get A for 6000 rupees - 4000 margin on a single shot of the medicine. I will not get this margin on B or C. Also, there is a possibility, if I go to open market, I can get the same medicine for 9000 - I know of cases where people go to known pharmacists to get it slightly cheaper than the hospitals. By forcing the patients to buy medicines from the associated medical shops, you are forcing the customer shell may be 8200 rupees - you haven’t told them about B or C, you haven’t given them an option of buying outside. And, generally, how does this operate? The medicine is too costly and too slow moving for a small time pharmacisit to stock ensuirng that the hospital has a monopoly. These sort of things come out when you are forced to go for B or C or some D because you are away from your hospital and had to get an alternate, which generally is city dependant. One of my friend’s brother rejected an offer in a premier hospital chain because of the condition that he should make a monthly prescription bill of 2 lakhs(this was some 10 years ago). No wonder, pharmacies are contributing to almost 15-20% of overall revenue. And this mode, does it not reek of cartelization?

All this forces us to think about the lack of an effective monitor over medical facilities in India - cost monitoring, procurement, options, facilities, centralized medical history and standardisation. These are some of the main things which are mandatory for India to be called a developed nation. It’s a different thing altogether that, medicine, education and public transport should always have government monopoly and we failed there miserably due to complacency and non-accountability.