Hospital (mis)Management In India 


It’s been a difficult time – my father in law had been in and out of various hospitals for over a year , and couple of days ago he lost his fight . It’s hard to reconcile that we won’t be listening to his soft humming of old Malayalam songs , animated conversations with my daughter , the many trips a day on his scooter to the local grocer and all the little things we took for granted when he was alive . It’s not going to be easy – but knowing he is not suffering any more  is indeed a big relief . My family can’t thank enough the kind words and gestures of love and support from countless folks around the globe . 

Couple of years ago, while I was on vacation in India – I lost an aunt to cancer . We knew it was a losing battle but we spent a significant time at the hospital trying to do everything we can to make it a little less painful for her . To say it was extremely frustrating is putting it lightly . 

There were a few more incidents where loved ones had to spend time at hospitals in recent times . The common thread amongst all these episodes is the fact that hospitals in India have some serious and significant rethinking to do on how they care for patients .

I have the utmost respect for medical professionals. I am proud to have several friends and relatives who are members of that profession  . They are normal humans expected to do superhuman tasks on a routine basis . We generally don’t go visit them under pleasant circumstances – so they need to perform at superhuman levels in front of totally unreasonable clients every single day . In my day job , I am a professional Servcies provider – and I know how hard that job can get even when my clients are not stressed out . So it’s not just respect that I have for doctors and nurses and others in that field – I hold them in absolute awe ! 

I do think from the perspective of sheer skills and competence levels – the medical professionals in India are on par with their colleagues anywhere else in the world , and in some cases a little better too given they get exposure to hands on work a lot sooner in college . Where they have some catching up to do is on their “client facing skills”. 

In the field of medicine – How you do it is just as important , and maybe even more important – as what the outcome is for the patients and their families . Unfortunately the prevailing practice here seems to be that doctors and nurses dissuade patients and their family from asking questions . “Because I told you so” – is a terrible answer . I have experienced this first hand and I know my family has often feared that asking questions will piss off the medical staff to the extent that the quality of care may come down . So out of sheet fear – they stopped asking . 

I have a theory – I think medical professionals here are not trained sufficiently in how to handle the patients on the non medical issues like answering questions from family members , giving them options in plain speak and so on . So the younger professionals just do what their older colleagues do and being rude just becomes the norm . I am sure there are great exceptions to this norm – but the status quo needs to change and it needs to change quickly .
Then there is the actual hospital management . The big hospitals own a blood bank, some labs, a pharmacy and a canteen . You would think that , the hospital would figure out how to make it easy for the patients to get tests done , get food/Meds delivered on time and so on . But that is not how it works . 

There is a sign out side the critical care unit that reminds families that someone should stay there 24X7 to take instructions . A nurse would pop out from time to time and say “here is a list of Meds we need – go to the pharma and get them right now. If our pharma doesn’t have it – go find it from elsewhere. We need it next hour”.  And you have to do it while keeping some one else in front of the critical care because the nurse could come back in few minutes and say “go buy tea and biscuits for the patient and deliver it”. It’s totally common place to also ask for “6 bottles of O negative blood” without any instructions on how to do it or what options exist .

How is this acceptable behavior in a professional setting ? This is not hospital management – it is hospital mismanagement. Within hospitals and across hospitals – the administrators and medical professionals have more ability and skills to provide seamless care than putting the onus on patients and their families . How do you expect the patient’s family to figure out where in the state a rare drug can be found ? I shudder to think that someone will bleed to death if there is no one outside the CCU to go find enough people to deliver 6 bottles of blood . There is no excuse to keep doing this – hospitals should absolutely get their act together . 

Hospitals are not inexpensive . Insurance is not widely used yet . Many patients and their families are ignorant of their rights . And there are possibly a million more excuses why things are the way they are . It’s also possible that grief makes me look at things more harshly than usual . But in the end – the noblest of all professions need to live up to its billing , both literally and figuratively !

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3 thoughts on “Hospital (mis)Management In India 

  1. Doctors do 2-3 times work load in India than in Western countries. Most of them are not trained / well versed in counselling patients, it also mostly goes with blind trust on Doctors.
    It is always hard for an attendant to run around 20 times a day to handle procurement of medicines, meal, taking to test, paying fees separately to each entity. It has become a culture except when treatment is offered on package basis. Also the trust level is low as patients think that they are over charged for medicines not used, etc.
    Also the varieties of food / taste expectations is mind boggling in India and half of them prefer/get home made food.
    Nursing staff are less trained and less paid and no effort is made to fix this. Other lower staff look for someone who would pay a small tip to provide better service.
    Hospital are run as landlord + service provider model and everyone tries to optimise their revenue individually and this impacts professionalism.
    I found smaller hospitals are more efficient than large hospitals.
    But for these irritants, I found Indian Healthcare is far more efficient and economical than British (NHS) based healthcare.

    • Just like the five fingers on one’s hand, I beg to differ on your last sentence, Sundar.
      But, I must admit, I am very biased, being the non-medical spouse of an NHS doctor.

  2. The medical profession, at least in the USA, is radically changing. I’d encourage you to speak with my sister-in-law’s daughter who is medical school. Gone is the hazing and fear factors. Replacing is a much better way of working with patients and their family of choice (may be spouse, lover, sib, friend, partner, child, or many of these in terms of race, creed, color, and gender). Focus is mental and physical health with an emphasis on dignity of the individual and inclusion of the family of choice. Med school is still extremely tough, but at least it does not turn out in-human doctors. It is slowly filtering downward and outward, but it is a slow transformation inhibited by a lack of training, sensitivity, funding, time, and a bunch of old geezers hanging on for old times. I’ll always take a Dr. 2 years out of school. Their knowledge and approach is fresh.

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