Dr (Prof.) Siddharth P. Dubhashi,
Professor of Surgery
AIIMS, Nagpur

Healthcare industry or industry-driven healthcare – A dilemma

The modern system of medicine has steadily evolved during the 17th and 18th centuries. The first National Health Policy was put forth in 1983, aiming at provision of primary healthcare with referral systems. Thirty-five years later, the World Health Day theme for the year 2018 Universal Health Coverage – Everyone, Everywhere brought in a ray of hope, as well as made us aware of the challenges in health sector for our country. The issues of affordability, adequacy of resources, and accessibility still remain. Though these are discussed at length at several forums, the parameters pertaining to quality of care need urgent attention.

The Government of India has made tremendous efforts toward establishing health and wellness centers (HWCs) for delivery of comprehensive primary healthcare, under the Ayushman Bharat project.

In spite of the persistent efforts by the government to enhance the healthcare infrastructure, the perception of the common man toward public health system is not good. Lack of well-trained human resource in rural areas is a burning problem. We are entangled in a vicious cycle of non-availability of basic sanitation facilities, accommodation for healthcare personnel in villages, leading to lack of interest in the young medicos to serve the rural population. Quality of care is an extremely important benchmark for stakeholder satisfaction. Good quality will come with accountability, cooperation between public and private sectors, and above all, ethical practice. It is here that the role of the healthcare industry assumes a key focus.

Public-private partnership model of healthcare is the need of the hour. All healthcare initiatives by the industry should focus on the needs of the common man. The cities are flooded with continuing education programs with lavish lunches and dinners. The outcomes of these scientific deliberations may have an element of bias. The objection here is not for the events to be held in cities. But can we take a pause and think of our priorities and our role in helping the government than simply criticizing it? Can we provide access to basic and advanced knowledge to our professional colleagues working in the rural set-up?

The Association of Surgeons of India and several other professional bodies have taken initiatives in this regard. Few pharmaceutical companies have also come forward to help the professional organizations in promoting academics. However, persistent efforts on part of the healthcare industry, with effective proposals to work with the government sector, are desirable.

The role of the healthcare industry is clearly indicated in the spheres of education, research, and patient care. All this needs to be done with an ethical umbrella. Retraction of papers from prestigious research journals has raised eyebrows and given a serious wake-up call. Professionals do believe Publish or else you will perish. Adherence to ethical principles without succumbing to external pressures is extremely crucial. An unethical act will remove the professional from the arena of good standing. The Make in India call by the government needs to be looked at by the industry and professionals with a balanced view. The models related to marketing and sales are changing.

The Code of Conduct for healthcare professionals is already in place. The treatment prescription should be a scientific document and not an advertising channel. This is the sensitive domain of healthcare delivery at the moment. Everyone and everything is being viewed with suspicion. Who is responsible for this? No individual. The systems got disrupted and the cycle worsened. In fact, we speak of fractured doctor-patient relationship. The current situation warrants an urgent attention to this facet of healthcare.

All of us, the government, healthcare professionals, and the health care industry need to make a concerted effort to wipe off any stains from the garment of ethical professional practice. Technological advancements will always be there. Remember, the technology of today can be the error of tomorrow.

The gadgets provided by the industry are a useful aid to the clinical diagnosis, but certainly not a substitute for clinical skills of a professional. The usual explanation by the professionals in this regard is with reference to medico-legal issues, that a battery of investigations is asked for, to be legally safe.

However, it is extremely crucial to note that each and every act of ours needs to have a scientific basis. Clinical evaluation and diagnostics will go hand in hand. It is beyond doubt that we as medicos will establish evidence-based guidelines and not create so-called evidence.

We still have a long way to go as far as our health infrastructure is concerned. Our National Health Programs have remarkably controlled the communicable diseases. However, the non-communicable illnesses have been doing a great damage, with ignorance regarding importance of lifestyles coming to light.

The industry has a major role to play in the use of appropriate online technology to deliver the best of healthcare models. Adequate and correct awareness regarding health insurance packages is vital. Partnership ventures can initiate meaningful start-ups in the true sense. The industry can play an active role in providing an integrated platform, using alternative systems of healthcare.

Time has come to change the mindset of the common man, who chooses the public health sector for treatment out of compulsion. Who is to change this perception? It is the government and the private healthcare industry, who need to work together with effective validated schemes for the benefit of stakeholders.

The story does not end here. The temples providing education, the medical colleges. and attached teaching hospitals have their own ailments. The problems are again different with the government and private colleges. The government colleges are overburdened with patients to the extent of having the need to provide floor beds.

The private colleges may have the best of infrastructure, but lack in clinical material for their students to learn. What an irony! Here is the role for a meaningful partnership. With over 500 medical schools in the country, the imbalance in providing quality medical education needs to be addressed on priority. A sound investment in medical education will give us rich dividends.

We all are looking forward to facilities for medical tourism. Indeed, a feast for all….! But first we need to provide the best of basic healthcare to the citizens of India. Let us not wait for pandemics and cyclones to teach us lessons. These prove to be too costly.

Judicious amalgamation of systems of medicine, public-private partnership models of healthcare, correction of regional imbalances in healthcare infrastructure, and adoption of villages will definitely help to nurture the much-needed ethical and purely scientifically driven recipes for healthcare.

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