Dr Sathis Devdoss
Managing Director
Devdoss Multispeciality Hospital

Challenges from the epicenter of the pandemic

Healthcare in India is a complex market where government hospitals and private hospitals provide healthcare to the people of the country. Preventive healthcare, vaccinations, and rural health is taken care of by the government mostly through a good system of primary healthcare centers and rural healthcare workers.

The other end of the spectrum of secondary and tertiary care is given by medical college hospitals, government, and private and mostly by private hospitals of varying sizes.

Though the government driven hospitals are free for the public the government spends large amount of money in running these centers.

Many states like Kerala, Tamil Nadu, and Maharashtra have a robust public healthcare system, where even tertiary healthcare is available to the common man free of cost. There is a lot of government spending in these states on healthcare.

But it is not true in many parts of the country. Hence, private hospitals, nursing homes, and clinics fill up the gaps, providing all kinds of health services.

Here the common man must pay for services, as they must reimburse the cost to the provider. The provider is under pressure to maintain quality, and comfort for the patient, so they need to invest a lot in latest and quality equipment, not to mention highly skilled doctors and nurses.

On budgetary allocation in healthcare
Budgetary allocation is extremely important to plan for at the beginning of the year. Major part of the allocation goes into CapEx and equipment. In today’s competitive markets, to sustain in the race we need to grow, and growth is directly proportionate to the spending of quality equipment and expansion.

This year, what was planned has changed completely due COVID-19 pandemic and the lockdown. The first phase to lockdown saw hospitals running only to 20 percent of capacity due to closure of out-patients departments and avoiding elective procedures.

Also, the employees of hospital had difficulty in traveling to the hospitals. Eventually many hospitals were converted to COVID care hospitals, where costs where skyrocketing and still regular incomes came down. So, this year planning is difficult, and we must plan on a monthly basis as and how the pandemic pans out.

On Health and Family Welfare
My vision is to deliver quality healthcare, affordable to all and no one should suffer for want of money. Sitting in a tier II city like Madurai, we realized getting qualified doctors and nurses was one of the biggest challenges.

However, since we have two medical colleges in Madurai, we do have a good supply of specialists and super specialists.

The skillsets of nursing and paramedical staff were a bit disappointing, so it pushed us to start training for them and we are tied up with many nursing and paramedical institutes, whose students undergo training at our hospitals and some of them eventually come to work for us.

Though affordable healthcare is necessary for the public, the government sponsored insurance schemes for people of below poverty line, pays very poorly for the procedures done at the private hospitals.

In many instances even the cost of medicines and implants are not covered by the insurance payouts. To tackle this we have started, a charitable trust (Annamalai-Padmavathy trust), which attracts donations and poor people are treated by this trust.

Of course, the COVID-19 pandemic is a totally new challenge and every day we had to fight for patients’ lives and our doctors and staffs. With no proven treatment and, vaccine not coming in the near future we are grappling with the pandemic on a day to day basis.

On monitoring the quality of private healthcare
Private healthcare plays a major role in the health of the nation and I am sure they are hugely responsible group and, ethical, quality healthcare is provided by them.

However, there may be some who do not update in the latest treatments or quality parameters.

Also, like in any walk of life, a miniscule group of bad apples may spoil the name of the medical fraternity. So, to standardize the care given, many states have emphasized NABH accreditation for the hospitals and clinical establishment act has also been implemented in many states.

Both NABH and clinical establishment act provide for delivery of quality healthcare. Hence, if these certifications are obtained, we will be fairly sure of quality healthcare.

On policies interventions that the healthcare sector in the state needs to align with the healthcare objectives at large at the national level
With the COVID-19 pandemic, all the healthcare establishments are relying on the central government for policy decisions according to the ICMR guidelines.

We need to extrapolate these policies to the grass root level and states need to ensure this. Like I said earlier, many states have a robust healthcare delivery system and those states lagging behind have to catch up soon. Also, the PMJY health insurance scheme is an excellent scheme to ensure quality healthcare delivery to the people below poverty line.

Anything else you would like to tell us
The healthcare industry is at the epicenter of the pandemic, and the frontline warriors viz doctors, nurses, and paramedical staff have to be recognized by the government and the public as these trained personnel cannot be made in a few days like buildings.

Government insurance schemes and private insurance players must recognize the fact that costing for treating COVID-19 is much more than the regular treatments and they should reimburse accordingly. 

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