'We're the best crisis managers'

The city's top medicos feel doctors here are well-equipped to handle crisis situations

The city's top medicos feel doctors here are well-equipped to handle crisis situationsu00a0
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In the fourth instalment of In Theu00a0 Hot Seat, MiD DAY called prominent doctors heading institutions that are iconic to the city to discuss the problems that the common man faces in accessing healthcare services. The doctors engaged in an open conversation and spoke about variety of issues ufffd lack of dedication by the government towards healthcare,u00a0 overcharging of services in private sector, unethical practices of medical doctors ufffd and strongly emphasised their demand for healthcare to be taken seriously.
We bring you excerpts of our conversation with Dr Renu Bharadwaj, dean of Sassoon general hospital; Dr Prasad Muglikar, director of medical services at Jehangir hospital and Dr Sharad Agarkhedkar, president of Indian Medical Association...
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In conversation: (From left) Dr Sharad Agarkhedkar, president of IMA, Dr Prasad Muglikar, director (medical services) of Jehangir Hospital, and Dr Renu Bharadwaj, dean of Sassoon General Hospital, at the MiD DAY office. Pic/Jignesh Mistry

There have been several instances where patients in critical conditions have been refused by hospitals owing to shortage of beds.
Dr Muglikar: That is the most crucial problem that Pune hospitals are facing right now. There is an acute shortage of beds especially in critical care units in the city. On an average, our hospital refuses 2-3 patients, who require ventilator services, everyday. Pune has a crying need for extra beds and one of the solutions we are trying is to set up more hospitals in the peripheral areas.
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What do you mean by peripheral areas and why set up hospitals there?
Dr Bharadwaj: Our hospitals are concentrated in one area. For instance, Bund garden and its neighbouring areas have Ruby Hall Clinic, Jehangir hospital and Sassoon general hospital. So, a person living here has access to all these hospitals, but what about people living in Aundh Annexe? There is not a single tertiary care hospital with advance technology up to a radius of 10 km. We refer to such areas as periphery. If we are able to start hospitals there, the burden on existing structure would reduce and the beds would be available.

Do you think public hospitals adequately support the private sector?
Dr Agarkhedkar: Besides Sassoon hospital, which other public hospital can you think of? On a scale of ten, I'd not rate the services of PMC hospitals more than four and I'm being quite lenient about it. I think that the civic hospitals need serious upgradation and more importantly they need to hire competent and trained doctors to manage their hospitals.
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Do you think the government is serious about healthcare services?
Dr Agarkhedkar: No. Every year the spending on healthcare is reducing.u00a0 As per our current budget, we have about Rs 194 to look after a person's health needs for an entire year. Every time there is a crisis, the government gets into action and promises things. But once the crisis is over, the project goes on back burner.
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What was your experience of swine flu pandemic? Is it over?
Dr Bharadwaj: The pandemic proved one thing- Pune's doctors are the best crisis managers. We may not have adequate infrastructure, not have enough doctors and drugs; but we are the best workers in a crisis. And yes the H1N1 pandemic is now almost gone. We haven't had a positive swab throat result in weeks.
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There is talk of another virus from Ahmedabad, CCHF, which is said to be more lethal than H1N1?
Dr Muglikar: There is no cause for worry. Firstly this virus cannot spread as quickly as H1N1. So there is no question of pandemic proportions. Also, so far, we have not had even a suspected case, forget positive case in Pune. And even if there are cases, we are equipped to handle them and treat them so no cause to panic at all.
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If there is a pandemic like H1N1 again, are hospitals equipped to handle it? What are lessons learnt from last time's experience?
Dr Agarkhedkar: Firstly, we need an emergency medical services or EMS. This service should link all private and public hospitals. We should be able to know in seconds where a patient needs to be taken to, which hospitals have beds available in cases of burns, amputations etc, information about availability of certain blood groups etc. Secondly we need more trained doctors and nurses and that is why Pune needs at least one more medical college. We have suggested to PMC that rather than privatising their hospitals, they should start a medical college and also start offering EMS services. Pune also needs a dedicated infectious diseases hospital and superior laboratory facilities. Just one NIV cannot handle an entire burden of a pandemic.
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Charges of hospitals have gone up across the city, in both public and private sector
Dr Muglikar: This rise that you see is in proportion to inflation. As costs of
deliverables, electricity, drugs etc goes up, hospitals ufffdwhich have to maintain the same standard of services ufffdalso have to hike their rates in order to keep up with the competition. After all, corporate hospitals are here to make profits and though not to a large extent, it has to keep up with costs.
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Isn't it true that doctors have set targets like a certain number of X-rays and CT scans for them to maintain consultancy because of which they do random tests on people?
Dr Agarkhedkar: I'm not denying that some corporate hospitals might have set targets though I haven't come across it in the paediatric section as of now. Maybe it is because they make huge investments in getting
a technology etc. So they need to recover costs. But I doubt that doctors conduct un-indicated tests just to
earn money. At least, not the majority.
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Are doctors always doing ethical practice? What about IMA endorsing brands and doctors appointing PR agents to market themselves?
Dr Agarkhedkar: Being a central council member of IMA, I agree that what our central organisation
members did was completely unethical. They had no means of testing the brands they endorsed and should not have done any ads to commercially benefit themselves or any agency. Also there is a trend of doctors appointing PR agents , which I agree is also unethical. Though, it is fast becoming a reality.
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What are the relations of private hospitals with state health ministry?
Dr Muglikar: We share cordial relations and carry out a lot of projects on behalf of the state health department such as Jeevan Dayi Yogana, Central Government Health Services. Also we treat emergency services without asking for payments. In cases such as German Bakery, where government told us to spend on patients,u00a0 we went all out. But we'd like the government to reciprocate too. Our bills for German Bakery are still pending. In case of a recent accident victim too, we don't know who will pay the bill though we were assured of payment.

I wish that they show reciprocation too or else it puts the private players off.