What you need to know about Healthcare in India
Posted: Wed Jan 07, 2015 5:24 pm
The current thread discussing this in detail anecdotal accounts made me feel I had to give my insight for what its worth.
Healthcare in India
Can vary hugely- no consistency. You can get the very best or the worst. How to know the difference?
Factors that create this
[LIST=1]
Lack of a system- most developed countries have a referral system which also packs in relevant measures to be undertaken prior to referral which is lacking in India. Referral is based on the nature of the doc u see who might be feel he /she can treat anything ( fallacious thought) and not borne out of an accountable responsibility towards doing the best for the patient. By luck or fate however if you land up referred to the right doctor, you will get treatment on par with anywhere in the world.
Emergency services are definitely better in developed nations. I would wince to the general default that US is better because I definitely do not think so. The Swedish systems are far superior to anywhere else. But we are improving. In Kerala, ambulances are always given priority on the road. However, many hospitals compromise on maintaining quality ambulances which should be something the government inspects and forces them to improve. Why would anyone do something unless they do they will get penalized if its not right? My advise to all of you is that the good ambulances are called cardiac ambulances- they have good facilities, including oxygen, better paramedics and often will also come with a doctor. The good corporates advertise these and its worth paying for them if you can. I would not recommend small hospitals or nursing homes for attention to significant trauma or any serious problems. Get to the good corporates. Small nursing homes are ok for minor fevers, minor aches and pains, diarrhoea needing short duration iv fluids etc. they are rarely set up for much more though they themselves are not aware of their inadequacies.
Doctors in India tend to see huge numbers of patients- hence don’t give much time. Partly the reason for this is the low consultation fees . Esp in Kerala, no hospital I know charges more than Rs 350 for an OP consult or in private outpatients ,perhaps Rs 500/- . Patients crib even to pay this. In the US , a patient is billed at least $600 to meet a subspecialist .Do your math.
The biggest issue- I think nova2blr touched on this mildly. The bulk of healthcare in India is still paid at point of delivery by patient out of pocket. Insurances cover only a small number of patients. Good healthcare is not cheap and if you want the advantages of modern medicine , they are expensive. Unless there is better provision or people start planning with private investments towards healthcare costs like house mortgage etc, it will keep hurting
Health insurances in india- not very well developed. Still largely only for inpatient admissions and expenses. Chronic disease care which is a very common problem these days and mainly managed through outpatients is not even considered by most insurance agencies. Who needs to be convinced for all this? ESI, CGHS and governmental schemes seem better. IT companies seem to offering more reasonable insurance coverages
Our people do not budget for health. They still live in denial that anybody can get anything and that nasty things only happen to others and not to them
Their kids will not get chronic diseases, their youngsters will not face infertility or premature births or cancer or need prolonged intensive care for a bad accident and in their old age they will not need joint replacements, state of the art cataract surgeries, prostate surgeries, prolapse surgeries etc etc. Heart attack is the only serious illness they will budget for-for that one cardiac surgery. These are all facts, they happen to many and it is really important that we are prepared to face all this. There are good doctors everywhere – if your general physician recommends you travel to another metro to see a rheumatologist- go see them instead of compromising on someone less qualified locally. People are far more willing to spends huge amounts on their kids wedding/capitation fees than pay for health.
Our people have an unsubstantiated faith in alternative therapies which is completely unjustified in todays world. If you go to right allopathic doctor, you can get far better quality treatment that addresses your illness with all the level of modern understanding of the disease. Be it Ayurveda ,homeopathy, Siddha, Unani are all based on ancient knowledge ,unprogressed and totally out of comparison to what allopathy has to offer. My husband (Orthopaedic surgeon) advised my aunt knee replacement surgeries 15 years ago- she continued going to ayurveda doctors getting massage and other stuff and paying huge sums each time. Finally after 15 years with legs totally bent and not able to go out of the house even for her own children’s/ grandkids pleasure, she finally underwent knee replacements and is very very active now, travelling and in a ‘punarjanmam’(new phase of life). Of course if you go to a surgeon who will operate you for Rs 10,000 less and has less experience or proper training you will get a raw deal, but the fault goes to the treatment rather than the cause for bad treatments unfortunately. Everyday in my OPD I see kids disfigured, disabled and sometimes serious illnesses missed by alternative practitioners( at least once a month I see missed leukemia in kids mistaken for arthritis) and also children with psychological aches and pains who have no organic medical disease wrongly treated as arthritis.
I would recommend ayurveda only for wellness and not for illness- I know that this statement will shock and insult many ,but I do have enough knowledge to back what I say. I will not recommend homeopathy or Siddha or Unani for anything. Naturopathy is very good for getting weight down and can thus help with lifestyle diseases( along with allopathic medication) but the patient needs to have the will to continue that naturopathic recommended diet else all will be of no use.
Regarding medical education- more than the education, its evolution of a system of medical practice that is superior in the developed world. Most tertiary centres will practice similar steps or protocols and results will be the same. In Kerala- children’ s cancer can be treated at Govt medical colleges- here medicines are free but tests/ consults/drugs used in complications like infections are not free and can be quite expensive and transfusions are also not free. Moreover, the treating doctors are just general paediatricians who have no additional training in paediatric oncology ,which is terrible. One govt based tertiary cancer centre- facilities are better, doctors are trained- but expenses the same as above plus patients need to rent places and live nearby for several months while treatment goes on, plus so overwhelmed in numbers they’ve not got the infrastructure to deal with it- hence patients are admitted on floor beds for chemotherapy, nurse patient ratios for chemotherapy etc are positively dangerous etc Private corporates- several are well equipped, personnel to treat adults and kids, better facilities overall. But obviously expensive. In a condition like the common leukemia of childhood where cure rates are currently > 85% ,one can achieve these rates only in these recommended private corporates. The govt medical colleges have cure rates of 20-25% and the tertiary govt centre 50-60%, but do people even know to ask such figures before they decide on treatment. As I said before, people will mortgage their land for daughter’s marriage but not to treat her leukemia- we need as a population to change the way we approach health
Education- MBBS is largely fine. Postgrad –is variable. Superspecialties-also depends on institute. Unfortunately while healthcare is largely more progressed and better quality in private corporate hospitals, one cannot say the same of medical education. Paying crores does not guarantee that the student is motivated or that they will actually learn and the govt trained doc is often better.
[/LIST]
The greatest problems facing Indian healthcare are
[LIST=1]
Lack of a system and inconsistency in quality- which I see as detrimental to lay patient
Need to pay at point of delivery which very often causes a doctor to compromise and cut corners which can also impact quality
Don’t even compare costs between India and the developed world- our costs are miniscule in comparison!!!!
It does help in India if you have a good doctor as a friend or relative to guide you through the labyrinth and help you choose who where and what for.
[/LIST]
Healthcare in India
Can vary hugely- no consistency. You can get the very best or the worst. How to know the difference?
Factors that create this
[LIST=1]
Lack of a system- most developed countries have a referral system which also packs in relevant measures to be undertaken prior to referral which is lacking in India. Referral is based on the nature of the doc u see who might be feel he /she can treat anything ( fallacious thought) and not borne out of an accountable responsibility towards doing the best for the patient. By luck or fate however if you land up referred to the right doctor, you will get treatment on par with anywhere in the world.
Emergency services are definitely better in developed nations. I would wince to the general default that US is better because I definitely do not think so. The Swedish systems are far superior to anywhere else. But we are improving. In Kerala, ambulances are always given priority on the road. However, many hospitals compromise on maintaining quality ambulances which should be something the government inspects and forces them to improve. Why would anyone do something unless they do they will get penalized if its not right? My advise to all of you is that the good ambulances are called cardiac ambulances- they have good facilities, including oxygen, better paramedics and often will also come with a doctor. The good corporates advertise these and its worth paying for them if you can. I would not recommend small hospitals or nursing homes for attention to significant trauma or any serious problems. Get to the good corporates. Small nursing homes are ok for minor fevers, minor aches and pains, diarrhoea needing short duration iv fluids etc. they are rarely set up for much more though they themselves are not aware of their inadequacies.
Doctors in India tend to see huge numbers of patients- hence don’t give much time. Partly the reason for this is the low consultation fees . Esp in Kerala, no hospital I know charges more than Rs 350 for an OP consult or in private outpatients ,perhaps Rs 500/- . Patients crib even to pay this. In the US , a patient is billed at least $600 to meet a subspecialist .Do your math.
The biggest issue- I think nova2blr touched on this mildly. The bulk of healthcare in India is still paid at point of delivery by patient out of pocket. Insurances cover only a small number of patients. Good healthcare is not cheap and if you want the advantages of modern medicine , they are expensive. Unless there is better provision or people start planning with private investments towards healthcare costs like house mortgage etc, it will keep hurting
Health insurances in india- not very well developed. Still largely only for inpatient admissions and expenses. Chronic disease care which is a very common problem these days and mainly managed through outpatients is not even considered by most insurance agencies. Who needs to be convinced for all this? ESI, CGHS and governmental schemes seem better. IT companies seem to offering more reasonable insurance coverages
Our people do not budget for health. They still live in denial that anybody can get anything and that nasty things only happen to others and not to them
Their kids will not get chronic diseases, their youngsters will not face infertility or premature births or cancer or need prolonged intensive care for a bad accident and in their old age they will not need joint replacements, state of the art cataract surgeries, prostate surgeries, prolapse surgeries etc etc. Heart attack is the only serious illness they will budget for-for that one cardiac surgery. These are all facts, they happen to many and it is really important that we are prepared to face all this. There are good doctors everywhere – if your general physician recommends you travel to another metro to see a rheumatologist- go see them instead of compromising on someone less qualified locally. People are far more willing to spends huge amounts on their kids wedding/capitation fees than pay for health.
Our people have an unsubstantiated faith in alternative therapies which is completely unjustified in todays world. If you go to right allopathic doctor, you can get far better quality treatment that addresses your illness with all the level of modern understanding of the disease. Be it Ayurveda ,homeopathy, Siddha, Unani are all based on ancient knowledge ,unprogressed and totally out of comparison to what allopathy has to offer. My husband (Orthopaedic surgeon) advised my aunt knee replacement surgeries 15 years ago- she continued going to ayurveda doctors getting massage and other stuff and paying huge sums each time. Finally after 15 years with legs totally bent and not able to go out of the house even for her own children’s/ grandkids pleasure, she finally underwent knee replacements and is very very active now, travelling and in a ‘punarjanmam’(new phase of life). Of course if you go to a surgeon who will operate you for Rs 10,000 less and has less experience or proper training you will get a raw deal, but the fault goes to the treatment rather than the cause for bad treatments unfortunately. Everyday in my OPD I see kids disfigured, disabled and sometimes serious illnesses missed by alternative practitioners( at least once a month I see missed leukemia in kids mistaken for arthritis) and also children with psychological aches and pains who have no organic medical disease wrongly treated as arthritis.
I would recommend ayurveda only for wellness and not for illness- I know that this statement will shock and insult many ,but I do have enough knowledge to back what I say. I will not recommend homeopathy or Siddha or Unani for anything. Naturopathy is very good for getting weight down and can thus help with lifestyle diseases( along with allopathic medication) but the patient needs to have the will to continue that naturopathic recommended diet else all will be of no use.
Regarding medical education- more than the education, its evolution of a system of medical practice that is superior in the developed world. Most tertiary centres will practice similar steps or protocols and results will be the same. In Kerala- children’ s cancer can be treated at Govt medical colleges- here medicines are free but tests/ consults/drugs used in complications like infections are not free and can be quite expensive and transfusions are also not free. Moreover, the treating doctors are just general paediatricians who have no additional training in paediatric oncology ,which is terrible. One govt based tertiary cancer centre- facilities are better, doctors are trained- but expenses the same as above plus patients need to rent places and live nearby for several months while treatment goes on, plus so overwhelmed in numbers they’ve not got the infrastructure to deal with it- hence patients are admitted on floor beds for chemotherapy, nurse patient ratios for chemotherapy etc are positively dangerous etc Private corporates- several are well equipped, personnel to treat adults and kids, better facilities overall. But obviously expensive. In a condition like the common leukemia of childhood where cure rates are currently > 85% ,one can achieve these rates only in these recommended private corporates. The govt medical colleges have cure rates of 20-25% and the tertiary govt centre 50-60%, but do people even know to ask such figures before they decide on treatment. As I said before, people will mortgage their land for daughter’s marriage but not to treat her leukemia- we need as a population to change the way we approach health
Education- MBBS is largely fine. Postgrad –is variable. Superspecialties-also depends on institute. Unfortunately while healthcare is largely more progressed and better quality in private corporate hospitals, one cannot say the same of medical education. Paying crores does not guarantee that the student is motivated or that they will actually learn and the govt trained doc is often better.
[/LIST]
The greatest problems facing Indian healthcare are
[LIST=1]
Lack of a system and inconsistency in quality- which I see as detrimental to lay patient
Need to pay at point of delivery which very often causes a doctor to compromise and cut corners which can also impact quality
Don’t even compare costs between India and the developed world- our costs are miniscule in comparison!!!!
It does help in India if you have a good doctor as a friend or relative to guide you through the labyrinth and help you choose who where and what for.
[/LIST]