Hospitals and Luxury Hotels

Yesterday I came across a piece in The Hindustan Times, which talked about the ‘luxury’ that a hospital now offers. The piece had snaps of fancy chefs offering a choice of cuisine to patients, nurses ‘requesting’ young patients, mostly kids to have their medication and the pretty front office executive (with her ‘May I help you badge’ in place)making ‘guests’ welcome.

This made me remember my grandmother, who is all of 104 years old narrating to me her escapades in hospitals run by the British in colonial India. She had great admiration for the no nonsense English doctors, the stern nurses, who followed orders and paid little attention to patient grievances. She remembers these episodes with a mixture of nostalgia and respect for the efficiency that this system stood for. The food was always what the doctor ordered, the medicines were given like clockwork and chores like sponging were a must-the patient had little choice in the matter.  

The Goody Thing

So Jade Goody wants to go out with a big bang, right on television watched by millions, one last hurrah in front of the ever familiar Television audience. 

To most people this would appear macabre, quite insane. Death, like life must be respected and to make a spectacle of it is wrong. Cancer is a terrible illness. It is relentless, painful and debilitating. It must be fought with courage and dignity and most importantly in private. Losing the battle on television with millions watching is akin to gaining some really cheap publicity and sympathy.

Hospitals where Jade is undergoing treatment must stay away from all this. To allow cameras and lights while Ms. Goody receives her chemotherapy, in the ICU, where she lies emaciated and spent with a feeding tube and where she breathes her last, would be a great injustice to the noble science of medicine. It would be like the hospital colluding in this great farce. 

Hospitals must never move away their solemn duty of caring and nursing sick patients to health, providing succor to those afflicted by terrible diseases, giving hope and courage to those terminally sick so that they face death with courage and equanimity. For a hospital to veer away from this and participate in a circus on national television, just because a patient desires so, would be very wrong.

I wish Ms. Goody would get some sane advise from her friends and care providers so that she spends her last few months in the privacy of her hospital room and home  surrounded by people who love and care for her.

Mocking and demeaning death by making it a sordid ‘tamasha’, a reality show with an inevitable tragic outcome is a bad idea.

 

 

Incubating New Ideas in a Hospital

New Product and service lines always provide an opportunity for healthcare marketers to reconnect with their customers. A good marketer must always be on his toes looking for opportunities to connecct and communicate with his customers. Sometimes in the course of the evolution of the hospital’s services such opportunities present themselves, often the marketer has to create and then sustain them.

A new hospital keeps adding new services in the first few years and these provide the opportunities for the marketers to talk about them. For example Artemis Health Institute in Gurgaon opened a ultra modern blood bank a year after its formal launch and added a Lasik in the Ophthalmology service. These are occasions for the healthcare marketer to communicate with its customers. As the hospital matures and grows older, the addition of new services slackens and thus the marketers need to create these for continuous engagement with its customers.  

The Ram Sene Agenda

 

Here is an account  of what the venerable Sri Ram Sene resolved the other day in their ‘Leadership Team’ Meeting. With this, they hope to win the next general elections scheduled in May this year.

1. Ram Sene has decided that if voted to power it will ban Internet access to all Indians as it pollutes their minds by bringing to their homes alien images and content, which is completely at odds with the Indian culture. The Sene has decided that all Indians will now be able to access only one website, which will showcase Indian Mythology, an assortment of stories and images from the Ramayana, The Mahabharata, the Vedas, the Upnishads and other ancient texts.

2. The Sene has resolved that women and men in India will no longer wear western clothes. All men are to wear kurta and dhoti on all occasions. It would be best for women to stay indoors and not step out. However, if they have to it they must wear sarees with a 2 ft pallu. 

3. The Ram Sene has also resolved to ban hospitals following the western system of medicine. They will restore Ayurveda to its lost glory in 3 months by converting all hospitals in the country to its ayurvedic system, which has been in existence for centuries and can cure everything.

4. The western music popular with the youth of the country and the pub culture, which it has engendered will be banned. All Indians must now only listen to the classical ragas at their homes. The Sene will also launch a talent hunt to identify the new age Tansen to take Indian music back to the future.

5. The usage of the English language in any form of communication will be stopped immediately. Sanskrit will the language of choice as it is the mother of all languages. All English and other language books will be dumped in the holy Ganges and India will thus be rid of their polluting presence.

6. The Ram Sene will immediately ban ‘democracy’ and will establish Ram Rajya, with HE Pramod Muthalik, the chief of the Sene as the first avatar of Lord Rama ruling the land. Thus these will be the last general elections in India.

7. It will also reestablish the age old caste system, where in the so called ‘dalits’ will be shown their proper place. The Sene will do away with the contentious reservations policy benefiting the dalits and it will ensure 100% reservations for upper caste folks in all government as well as privately owned institutions

8. Bollywood will be shut down. The real popular Indian entertainment comprising of ‘nautanki’, ‘kathputli’, lok-natak will be available to all in their neighbourhoods.All these famous Bollywood personalities can now be performing in the neighbourhood nautankis.

9. In the arena of sports, India will focus on excelling in wrestling in the mud, kabaddi, gilli- danda and malkhambh. All other sports will be banned.

10. Finally all the Universities will be closed down and Gurukuls will be established throughout the length and the breadth of the country. The students will be provided ancient Indian education and centuries old wisdom as enshrined in the ancient texts. 

Jai Ho…

Pricing Healthcare Services

The pricing of services in a hospital is perhaps one of the most complex and difficult exercise undertaken by the hospital managers. Pricing is  usually a Marketing function in most industries and the final call would usually rest with the Marketing chief. However, in hospitals this seldom happens. Pricing issues are generally discussed and debated in the executive committees and the leadership teams, views are sought from senior medical leaders and usually a consensus is arrived at. l,

Many hospitals follow a ‘market based’ pricing model, which simply means they comb through the pricing policies of their competitors, get pricing data from various labs and other diagnostic centres through their referral sales teams and establish their pricing either basis a premium or a discount from their chosen competitors.

Very few hospitals have a ‘cost plus’ pricing system. Developing an accurate costing of all medical procedures is next to impossible. This is simply because the medical consumables used vary from doctor to doctor and also depend on the complexity, age and general condition of the patient. The cost is also invariably a function of the training and competence of the concerned doctors and medical staff attending on the patient. Thus the cost of a bypass surgery may vary dramatically depending on the condition of the patient, the competence of the surgeon and his team and co-morbidities like diabetes.

The calculation of a price is usually based on a ’surgeon’s fee’. On top of this is added the cost of anaesthetic gases, the anesthetist’s fee, an OT fee and OT consumables. The surgeon’s fee is usually checked with the hospital’s surgeons and if it is Rs. X, the fee for surgery inclusive of gases, anaesthetist’s fee and the OT charges usually adds up to Rs. 2X. 

The patient on top of this is charged room rent depending on his choice of the hospital room, the cost of medicines and room/ward consumables and all diagnostics. The hospital also charges exorbitant consultant’s visiting fee every time he/she visits a patient in the hospital. (Some hospitals like Artemis cap this to a maximum of two chargeable visits). Strangely all hospitals charge a premium on all services if a patient chooses a single or higher category rooms. This simply means that if one opts for a single room one pays higher for everything, the surgeons fee, the cost of surgery and diagnostic tests. Most people do not know this and believe that the hospitals charge a premium only on room rent. Many would consider this a pernicious practice simply because a surgeon’s skill and time, which are the determinants of his fee has nothing to do with the room category a patient is in.  

Compulsory Rural Postings after MBBS

The Hindustan Times reported on Friday that the Union Health Minister Dr. Anbumani Ramdoss has announced that young medical graduates, fresh out of medical schools will now have to mandatorily serve one year in rural and semi-urban centres in India.

Dr. Ramdoss believes that this will help in augmenting healthcare services in these parts of the country. It is well known that in the Indian hinterlands the availabilty of healthcare services is pathetic.  In villages, where more than 66% of India lives, it is rare to find a qualified doctor. In semi-urban centres too modern, good quality and reliable healthcare is largely unavailable.