Thursday, February 17, 2005

The price of affordability- A Link To Be Bridged- ABout hospitals(Health Care)

Hospitals
The price of affordability- A Link To Be Bridged

AS A DEVELOPING COUNTRY WITH MULTIPLE HEALTH CARE PROBLEMS, INDIA NEEDS PRIVATE HOSPITALS THAT CAN MEET THE HISTORICAL BURDEN OF FILLING THE SPACE LEFT BEHIND BY THE GOVT. HOSPITALS. IN KERALA, THERE ARE INSPIRING EXAMPLES THAT BY THEIR PERFORMANCE PROVED THAT THEY ARE UP TO THE TASK.

VINOD CV

Health care at affordable rates is a challenge to any society. Even the affluent countries do face insurmountable difficulties while addressing this issue. As for the developing countries with a third world tag, health care facilities at acceptable and reasonable cost are of paramount importance. In a country like India, this assumes serious dimensions, which affects the overall well-being and quality of life of the population as majority doesn’t have the wherewithal or financial sinews to access the quality medical service.

After India attained Independence, as we envisaged a mixed economy for the social reorganisation, the history of Indian health care system map was equally dotted with the contributions from private and public sector participation. Since the required efforts and inputs were massive and on an astounding scale, a synchronised style of working was required to address the grave necessities in the healthcare sector. In this connection, many private hospitals with a philanthropic bent of mind came into existence even in rural areas to cater to the needs of the deprived. But with the introduction of the liberalised economic agenda in 1990s, Govt is withdrawing from the health sector. This puts additional burden to private hospitals, both in terms of quantum of work they do and the type and profile of patients they handle.

Of late, the pace with which high priced diagnostic equipments and costly curative techniques are introduced, has become very fast. Now the situation is that the cost involved with the latest diagnostic and curative practises are getting high by everyday. As health care industry is capital intensive, the business proposition of a hospital won’t work, if one fails to charge proportionately. The failure to acquire the state-of-the -art gadgets of treatment and analysis will leave the hospital in a loop of failure as patients won’t turn up in enough numbers to sustain the economics of a hospital, as patients prefer hospitals with all modern facilities.

The paradox is that the charge the hospital can place on a service, is many times beyond the reach of middle class and lower middle class. A purely business hospital can turn a blind eye to that reality and safely sleep in the socially sanitised environment. But hospitals that are built and designed to help ordinary people are feeling the pain and pinch of difficulties associated with the financial management of bridging the gap between the legitimate charges for the investment and the charges that can be levied from the already hassled poor patient.

There are hospitals, which successfully filled this gap. They strive to fill this difference by prudent financial and administrative management, service mindedness of doctors and supporting staff, diversion of money from other businesses and free and nominally charged service of staff, as seen in the case of mission hospitals. These hospitals are pure examples of true spirit and public service. They are trying to address and mitigate the gigantic health care deficit we face as a nation, in their own way.

Tuesday, February 15, 2005

Small Steps, Giant Leaps-A brief sketch of medical education in kerala(Medical Education)

Private Medical Colleges
SMALL STEPS, BUT GIANT LEAPS

Though the introduction of self-financing medical colleges courted many controversies, the smartest of the lot started showing the ability to excel by rigorously adhering to the fundamentals of medical education.

Vinod C.V

In Kerala, educational sector is always a battleground of ideas and ideologies. There are student leaders who made a career out of the confusions and controversies in the field. Given that such a societal spotlight is there, it was natural then that the introduction of self-financing colleges had a tectonic impact in Kerala’s political and social life. Govt went for the self-financing colleges to stem the outflow of money to outside states, as most of the students in the neighbouring states were from Kerala. Govt. also wanted to diversify and broaden the scope of professional education in Kerala.

The readiness of many managements to contribute to the educational endeavours also helped the govt in its attempts to widen the scope and magnitude of professional education. It is true that many of the actions of govt and managements were confusing and baffling to the common man on account of the inconsistent stands, contradictory nature of court verdicts, and misleading arguments by all involved.

The puzzle of self-financing education including the medical sector is not fully resolved. Even during this period of uncertainty, though not noticed by many, some of the institutions started in the self-financing sector are in the process of becoming centres of extra ordinary excellence. In the near future, many of them will be noted for their research facilities and teaching paradigms.

But at times, their appetite for maintaining standards calls for mobilising resources in an active manner. At times, these attempts are in collision with the long held norms and visions of free education. However, their commitment to enhance value by offering the cutting edge facilities and skill rich methodologies cannot be questioned by any. Running an institution like a medical college is itself, a stupendous task.

Constant and continuous value addition at all levels of learning is very important as far as medical education is concerned. Inputs and resources ranging from financial to intellectual are to be made available to maintain the quality. Latest techniques of diagnosis and state-of-the-art equipments are necessary to raise the awareness level of students.

The medical college hospital is the nerve centre of medical education. The facilities and advanced features available make a qualitative difference with regard to the exposure students get. This starts right from the bed strength of the hospital. The expertise and experience of the faculty in the modern systems and approaches make the learning enriching and inspiring.

The atmosphere for studies is very crucial. Unlike many other courses, medical education, from a student point of view, needs a sustained perseverance and unfailing ability to slog. Any slackness in any of these counts affects the over all performance. That is why highly structured monitoring is required to ensure that students are in the right track. It is equally significant to provide all possible helps to facilitate an ambience conducive for studies. Like any institution the strength, experience and teaching skills of faculty are of paramount importance. The wisdom born out of practical experience and exposure is much needed to impart a sense of knowledge to students.

Saturday, February 12, 2005

The Neighbourhood Health Centres- ABout Clinics( Health care)

Clinics
The Neighbourhood Health Centres


Clinics are always close and convenient to access. While comparing to the highly hierarchical hospitals with multiple layers of administration, this neighbourhood health centres are a welcome relief.

Vinod cv

The word ‘clinic’, as it is understood, doesn’t bring a big massive institution into the mind. But that doesn’t mean that clinics are really small. Some of the clinics in Kerala are rich in facilities and strong in attendant hi-tech backing up service.

The advantages of clinics are numerous. Looking from a patient’s perspective, it is single layered service option as against the hassling and irritating hierarchical arrangement in a traditional hospital. And for treatments like eye care and dental care, clinics are the best choices. A clinic doesn’t need huge space. Most of the time, clinics come close to where one resides. The personalised attention is the part and parcel of a treatment in clinic and it comes without asking.

Generally, it is a practising doctor or a group of practising doctors who own clinics. Since they practise in their own institution, doctors enjoy a level of openness and autonomy that is not associated with a hospital. Here in clinics, a doctor is fully in command. He or she can take decisions independently. Moreover clinics are free from professional turf rivalry that is seen in hospitals between doctors and departments.
In a clinic, individualised attention and care is given to the patient. A patient need not deal or negotiate with multiple layers of the administration as in a hospital. It is a simple entry into the doctor’s room. At times doctor recalls and remember the last visit. Since clinics are neighbourhood facilities, the visitor and doctor often falls in the same community or locality. That lends confidence to the patient.

It is widely noticed that for eye & dental care, clinics are very popular. In these departments of medicine, individual skill and expertise are very important. Doctors can develop infrastructure for these departments comparatively easy. That may be a reason for the proliferation of clinics in these segments.

Specialist care and systems can be developed in a clinic. The scope for experimentation for a creative doctor is high. In a clinic, doctors can easily enter into collaboration with outside agencies and suppliers of solutions, equipments and services. Thus clinics offer wonderful opportunities for doctor.

In a clinic, doctor himself fixes the charges for treatment. The rent and physical infrastructure cost component, comes less for a clinic. This enables clinics to frame a more reasonable structure of service charges. The increasing cost of equipments that needs updating throws a challenging situation to many clinics. But many conscientious doctors do the balancing act in fiscal management by strenuously adopting new and novel means to make sure that their valuable clients are not charged beyond the means.