The much needed both-and model

I thought your hospital was a charitable one but I find it a sleek, good looking facility – a middle-aged man, who visited the hospital where I work, exclaimed. I got into a discussion with him – the two do not have to be mutually exclusive. What the gentleman expressed parallels the general misperception of how healthcare facilities are or ought to be. Sleek facilities for those who can afford and cattle class facilities for those who cannot! But is it possible to replace the either-or with both-and? Is it really feasible? If you earn less than `50K per month, do not bother going to that hospital was something, which was said about a certain five-star healthcare facility. There may be nothing wrong with that in a capitalist society; but the overall contribution to the society from that model is limited, and its relevance hamstrung. Our own experience has been that it is possible to marry successfully and intentionally, the two.

Arrive at the right proportion. Our model 35 percent higher-paying private patients and 65 percent general no-frills patients (who may be further subsidized if need be) has worked out to be a viable combination or proportion. The winning combination may turn out to be 30–70 or 40–60 in different settings; this may also vary according to the geographic location, socio-economic makeup of the community served, and the nature of services offered.

Quality where it matters. No compromise on quality where it matters. In the long run, this is the heart and soul of the organization. It is by word of mouth that secrets are revealed about the real quality of essential services in the institution. For example, the quality and brand of the multi-para monitors in the ICUs, the quality of critical care beds, the anesthesia workstations, OT equipment, and the diagnostic equipment are not as obvious and evident to the customer as the upholstered sofas in the registration lobby. The former is what matters, though the latter is not to be neglected. Sooner or later, the heart of the matter will be known and understood by most. Often, the staff themselves become brand ambassadors. A secret is defined as something you tell only one person at a time!

Staff retention. When there is true and genuine philanthropy expressed in the course of regular service, there are those who join in and partner. You will suddenly realize you are not alone in this journey or endeavor. In fact, this results in better staff retention because there is greater job satisfaction, which is of great value. You also tend to attract right-minded people who bring much worth to the table. In the long run, this is what defines the organization and gives it its true character.

Community participation. There is so much of goodness in the community around. One pleasantly surprised to see one’s credibility attracts folks with similar intent. Donors and partners who walk alongside are a great encouragement. Engage with the community; no one has ever lost out in life because of giving!

Economy of scale. There is enormous bargaining power that comes with an augmented scale. It is a viable economic model to be relevant to a larger number of people. With fixed costs static, or barely moving up, increase in variable costs is manageable. Being relevant to a larger number of people is a better long-term strategy as compared to the boutique model.

A guiding principle. Bangalore Baptist Hospital’s (BBH) vision is Healing and Wholeness in the Spirit of Christ and its tagline, Quality with Compassion. Being relevant to the disadvantaged is the stated aim of BBH.

It is imperative to state one’s vision, and remind oneself of the same often. The focus of one’s actions must be aligned with the stated vision. Discuss it, chew it, and deliberate on it. If community-relevance is your aim, consider embracing the both-and philosophy.

In conclusion, let me submit that one does not have to shun those who cannot afford to stay viable as a business model. It is not a choice between the two ends of the spectrum. Both-and is a model that is dynamic, practical, and relevant to our country.