Monday, 19 August 2019

Time to revamp for a new health world

01 July 2019 | Features | By Dr. NK Venkataramana

Healthcare is now a thriving industry in India

image credit- istock.com

image credit- istock.com

The Doctor’s day commemorates the birth anniversary of Dr. Bidhan Chandra Roy, a towering intellect who served the health sector with great distinction in various capacities - doctor, teacher and policy-maker. But, as the saying goes, those were the days.

Though the sanctity of the Hippocrates Oath and the ideals of Dr. Roy remain a gold standard for the medical profession, healthcare itself has gone through a sea change over the decades. Put simply, the change, aided by space age technology, has been transformational, sweeping every aspect of health care across the value chain, from prevention and diagnosis to disease management, treatment, life-saving emergency care and rehabilitation.

The change in most part has been spectacularly beneficial to all stakeholders (patients, caregivers, doctors, hospitals and so on) propelling both proficiency and expectations to a new level. In the gold dust of what has been a knowledge explosion, medicine has crossed most frontiers and conquered all but a few diseases. 

In this new technology united world, even as geographies blur, both people and knowledge are constantly on the move: meeting, mingling and pushing medical science to new level of excellence and sophistication. Alongside, doctors must now treat global citizens, people who have travelled the world either physically or digitally, and are therefore, far more aspirational. In the India of the 60’s it was a struggle to get any kind of medical care and people were grateful for whatever little they got. Now, at least in our cities, they are spoiled for choice and can demand and get what they want. 

The entry of private investment in healthcare aided by favourable policy changes has inspired this tectonic transformation and put India at par with the best in the world. Healthcare is now a thriving industry in India, which attracts top dollars, best global practices, leading-edge technology and the finest of people from around the world.

Every single change is positive and collectively they have put India on the global healthcare map. However, the change has also brought in its wake a regulatory framework that is without doubt unreasonably skewed against doctors because unlike in the developed world from where it has been transplanted, India simply does not as yet have the ecosystem for it to work fairly. Even the basic standards here remain underdeveloped and undefined, the regulations are open for misuse, which often results in controversy and unjustifiable punitive action, which doctors couldn't even have imagined back then in the era of B C Roy.  

On the other side, easy access to a glut of information on the Internet, much of it half-baked, has led to patient being bias and at times difficult to manage and misinterpret, which leads to trust deficit. The fact is that, owing to all these ambient factors that have changed the very paradigm of healthcare, patient and regulatory expectations are often out of whack with reality. So, what is the way ahead for us doctors and the healthcare industry in general?    

To begin with, in order to be in tune with the changing realities, our health system need to go through a comprehensive revamp. This would require doctors to join forces and work in unison. We must respond to the new environment appropriately and evolve policies and guidelines focused on quality, transparency and effective communication with all the stakeholders. We must develop a robust regulatory framework of our own, instead of being told how to conduct our lives and practices by government or some external authority with scant knowledge of our profession.

In the new world doctors can no longer be content with, well, just being doctors. Meaning they must develop the savvy to go beyond the confines of their specialization and devote some of their time to issues that shape their environment, like health planning, education and delivery. They must move from being mere inert participants to active managers of their ecosystem by effectively engaging themselves with all stakeholders: policy makers, regulators, legislators, the judiciary, industry, censor boards and media, which often project them in poor or distorted light. We must work towards ensuring that the right information goes into the public space about who we are, what we do, the challenges that we face every day, the work we do and the commitment we have towards our profession and our patients.

Over the last five decades and more when the world lost Dr. B C Roy almost everything has changed except one cardinal tenet: for a doctor there is scarcely anything more important than his patient and the clinical outcomes.

 

Dr. NK Venkataramana, Founder Chairman & Chief Neurosurgeon, Brains Hospital, Bangalore

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