Sunday, 7 September 2014

Medical Tourism in Goa?




(6 May '12)
            I read a few days ago in a newspaper that hospital owners wanted the Goa government to do more for medical tourism.
            The Candolim-Calangute-Baga belt as many dentists' boards as of specialty food restaurants. They are obviously not for making Goans smile prettier. Do Indian tourists go to them? What would these dentists want from the government? Cleaner roads and potable water? Better transport to carry tourists from hotels to clinics? I don't know about the marketing of such 'facilities' for medical tourism, but I do know that whatever is good for the tourist, will be good for the local as far as infrastructure goes.
     The article I’d read said it was the owners of hospitals who were asking the government to help, so maybe the dentists weren't involved.
            My experience with medical services in Goa have ranged from unethical and greedy doctors to those whom I would place amongst the best in the country both in skill and goodness.
            I phoned a couple of hospitals which did complicated surgeries like joint replacements and procedures like cardiac-angioplasty. None gave me an estimate of the cost. In one case, I was put on to a marketing person of the hospital who told me about complications in case the patient was a diabetic, etc. I asked about the cost without a single complication, exclusive of cost of implant. Bed charges, nursing charges, doctors' fees (aha, that's where the secrecy lay), expected consumables that would be used, anaesthetist''s fees, operation room charges... the person told me nothing. S/he said: “Come and meet the doctor, he will tell you.” Would a tourist come to Goa for a major treatment without knowing an approximate cost of the treatment s/he may be looking at? If the charges are not standardized and transparent, a trickle of tourists is all that Goa can expect. No need for the Government to hold the hospitals' hand for that; hospitals can be straightforward and go forth on their own merit.
            In another hospital, where I was invited to help form a clinical research ethics committee, one doctor present wanted to know whether he could be a 'lay' member. A doctor can't be a lay member, obviously. Well, he remarked, I'll just say I’m a B. Sc. then. He was a senior, retired doctor and I found it embarrassing to tell him how unethical hiding facts was. I spoke to a foreigner who had an abscess removed there. She said she'd paid Rs 35000/- for it. Even in the corporate-chain hospitals in Goa, which are said to be expensive, the cost would be (again, I checked over the phone and I must say the staff was helpful and courteous in both hospitals) a third of that. Standardization of rates doesn't need government intervention. Most multi-specailty private hospitals in Goa, barring three or four, are run by medical professionals who can themselves calculate what is a reasonable profit for what level of skill.
            Years ago I had done an article on how many nursing homes and private hospitals had graduate nurses employed on their staff. The conclusion was dismal: almost none. Have things changed today? I hope so.... but doubt it.
            The quality of the laboratories and other diagnostic facilities needs to be documented and the public must know about them. A word about documentation. Doctors' degrees are displayed. A patient has every right to know about the qualifications and experience of the nurses, technicians and therapists attending to them, too.  Meticulously maintained personal medical records don't need government guidance. Common sense and guidelines of quality control Boards and institutions will help improve standards. Accreditation will be necessary if insurance companies from abroad are to be roped in. Alternative medical streams and their practitioners will also have to be monitored. Stringent rules regarding their establishments, claims and practice would have to be put in place. There, perhaps, the government needs to play a role.
            Giving good medical treatment, whether to niz goemkars, Indian brethren or those paying in foreign currency doesn't depend on size of plots on which the hospitals stand. We have a history of family owned hospitals, some of whom are brilliantly run without stamps of ISO or other such approvals. Many of our doctors and healthcare staff are invisibly doing a job that Goa can be proud of. Friend Sonali told me she gets her father to Goa all the way from Belgium because 'her' dentist here is so good. Friend Veena's mother-in-law got her hip replaced here at a fraction of what it would have cost her in Mumbai. “And,” she tells me, “The treatment was outstanding. The staff was caring and efficient.”
            If the government spruces up GMC (physically and in operations) gives the professionals working in it some autonomy, and allows them to monitor what's happening in the State (in healthcare), medical tourism will pick up.
            Then one can demand that the government should market the healthcare 'product'.
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