Wednesday, 2 October 2013

Panzorconi on the Healthcare Map.



            Goa throws up surprised. Within 3 lakh kilometres, the only National Accreditation Board for Hospital certified medical care centre is in a picturesque place in south Goa: the NUSI Wockhardt.
Until Monday, 15 July, I hadn’t even given much thought to the place. Then, it got the above certification and I looked up what that meant. This is the first hospital in Goa, South Maharashtra and North Karnataka to get the certification. What it means is that it has a definite standard of care. It will have qualified nurses, and technicians, the laboratories will be dependable, patients will be assured that they aren’t taken for a ride.
In Goa, by word of mouth one knows which doctor to trust and which ‘nursing home’ will not take you for a ride. Most often, the nurses aren’t well trained: in fact, they aren’t nurses at all, just women wearing white clothes. The consultant doctors have to monitor everything from bandaging to dispensing medicines. It means a lot of work for them, ‘but what to do we are like that only’. House-doctors not adequately qualified to handle things gone wrong. There are doctors from other branches of medicine handling patients in allopathic institutions. Just as allopathic practitioners must not handle homeopathic or Ayurveda medicines, the reverse must also true. The newer, slightly bigger than usual hospitals like Vintage, Vision, Vrindavan, Galaxy have taken the trouble to professionalize patient care, but costs and treatments need to be uniform and transparent.
With this sort of certification, quality control will be accessible to patients: for eg, tests will be reported within a specified time. Also, the patient will know within how much time after admission a consultant see him/her.   
As a relative, one can know whether all the registrars qualified in the subject of the patient’s ailment, whether all the nurses skilled enough, etc. Bills will be itemized and clear to understand. Clearly printed, too.
            In NABH certified hospitals, patients’ rights and responsibilities must be available to the patients. The names of the doctors, their qualifications, the names of all staff on duty, timings, facilities available and their locations, must be readily available, too. Bills must be presented at reasonable intervals and the approximate cost of treatment told in advance, from time to time. With accreditation, transparency comes in and the patient (as consumer) can handle hospitalisation (the service) responsibly.
            The hospital is run by the Wockhardt group, but owned by NUSI, the sea-farers union. I’m told the Wockhardt Institute of Aesthetics is the first of its kind in Goa. The looks-conscious can have their tummies tucked in, their hips, outer thighs, flanks and buttocks reshaped, their noses/chins/eyelids shapelier, their jowls got rid of, their breasts made to suit the rest of their body… will Wockhardt use these facilities to help burns cases? Surely plastic surgeons and dermatologists are adept at handling far more serious problems (like psoriasis and fungal infections) than hair transplantation?
            I visited the place. The lobby had colourful brochures that educated patients on various conditions: hernia surgeries, high blood pressure and heart care, hip resurfacing (must find out if anyone else in Goa is doing this already) and joint replacements.
            The hospital also has a urology centre with separate clinics for prostate problems, stones, cancer, andrology (antonym: gynaecology), blood in the urine, and pediatric urology. Goa’s private sector has a long way to go as far as organ transplants are concerned. GMC still leads.
As expected from a hospital that’s into aesthetics, reconstructive urology is also done; this, of course, is to help patients who have medical difficulties due to dreaded diseases or conditions, not for cosmetic reasons. The Casualty and ICU are well-equipped and yet to be used to the optimum.
            I’m a great fan of public hospitals, and GMC would be my hospital of choice for tertiary care. But there are many people in the state (and yes, tourists who would like to be here to get a new look, some teeth-work done or even an abortion conducted) who are willing to pay for treatment if they get the quality. It’s a ‘market’ (I hate this word to describe healthcare, but there, I’ve said it) to be tapped. Potential ‘customers’ looking for cataract operations are shopping around for more than a doctor with a good ‘hand’ (an Indianism that means skill and success rate): they want a comfortable and modern ambience, good air-conditioning and blankets to combat the resultant temperatures. Customer service staff to carry their documents and stand in the queue to pay the bills. A menu for snacks and meals that will meet with the patients’ approval and the accompanying relatives’ also. Valet parking, follow up visit reminders… these are given weightage, too.
            But behind the scenes, keeping medical records, generating error free reports, doing work within a specified, reasonable amount of time, charging correctly and evenly, not based on place of origin of passport or income, are things being considered and questioned. Accreditation involves documentation. Following a fine-tuned system leads to reduction of errors. No patient wants to suffer because of a hospital staff’s mistake. Accreditation ensures (or at least drastically reduces) chances of human or systemic errors. That’s why this NABH certification of a private hospital in Goa is welcome.
            Will it mean that the bills will increase? Market forces govern that. Time will tell. Until then, just happy to note that Goa’s finally arrived in the Big League in medical care. 

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