Saturday, March 21, 2015

Corporate Hospitals - A Boon?

By god’s grace, I do not have much experience of the corporate hospitals which are supposed to be the shining (literally) symbols of India’s advancement in health care. I have visited them a few times for consultations, the outcome of which, have been very satisfactory. The fact is that the hospitals had nothing to do with the outcome. What mattered was the doctors whom we consulted. Had we consulted the same doctors in places other than these hospitals, I would have saved a hundred or two on consultation fees but I will not grudge that. The hospital provided comfortable parking space, waiting space and most importantly, clean toilets, and I consider these facilities worth the extra money spent.

Quite a number of my friends and relatives have visited these hospitals for surgeries and other procedures and have expressed satisfaction. At the same time almost all of them have mentioned the fact that they have found the hospitals very expensive. Some of them have complained about unnecessary investigations and procedures but that is part of the ‘health care business’. I have no idea about the economics of these establishments but even as a layman I can see that maintenance of these establishments must be quite expensive. Obviously, to recover their cost plus profit, the hospitals must charge the patients a lot. And since they have to maximize profits they find different ways of charging the patient. Recently I heard about the changes in functioning of the dental clinic in one of the corporate hospitals in Goa and if that is how the other departments are also run, one need not wonder why they are so expensive.

This hospital had a dental clinic and had appointed a dentist on a monthly salary. But for the fact that the clinic is located in a swanky building with a big name, the dental set up is the same as any of the hundreds of dental clinics run by individual dentists in any city. For some of the procedures beyond the capabilities of the ‘in house’ dentist, the hospital called a specialist, who was paid on 'per case' basis.

Let us consider a surgical extraction for which the specialist is called. The procedure done in an ordinary dental clinic, by a visiting specialist, would cost the patient about Rs 1500 - 2000. The same procedure performed by the same specialist in this hospital was being charged Rs 3500. The specialist would get Rs 1500 and the rest went to the hospital.

Now, the hospital decided to outsource dental services. A company which is in the business of running dental clinics in corporate hospitals all over the country has taken the contract. The company sets up its own equipment, maintains it and also appoints a dentist. The hospital gets a fabulous rent - 3 lakh if what I hear is right - for the space provided for the dental clinic. The company has retained the same specialist who used to attend the hospital earlier, but, it now charges Rs 7000 for the procedure which was being charged Rs 3500. The specialist gets the same Rs1500, the company keeps Rs 2500 and the hospital gets its share of Rs 3000! This is apart from the rent.   

The company running the clinic banks on the name of the hospital and the volumes generated by running such clinics all over the country. The hospital provides its name to the clinic but has nothing to do with the quality of service. It just collects a tidy rent as well as a share of the fee. The hospital exploits the company and the company exploits both the dentist and the patient.  

If you ask me what is that I am trying to convey here, I have no answer. I am just placing here a fact that came to my notice. 

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