Patient Centric Healthcare

200308966-001Patient Centric Healthcare is fast becoming a much abused term . Most hospitals that I know here in Delhi prefer to call themselves Patient Centric, but none really is. Many, I suspect do not know what it means to be truly ‘Patient Centric’.

Patient Centric to me would imply a hospital, which has systems, processes and people oriented towards patients. The people including the medical folks are trained to understand that the Patient and his needs must come first. The hospital processes and workflows  are designed around patients and their needs. And most importantly their are systems in place, which monitor the efficacy of these processes, capture patient feedback and cycle them back as implementable inputs. A truly patient centric hospital would be the one, where the responsibility of patient care lies not only with medical folks, but with each and every individual working in the hospital.

Will you call a hospital patient centric if it refuses patients for elective surgery on Sundays? I recall the great fuss I had had to encounter, when I asked that a surgery be posted on a Sunday because the patient wanted it that way. All hell immediately broke loose. How dare I do something like this? Docs and OT staff need rest on Sundays and if it is not an emergency there is no reason for the surgery on a Sunday. How dare I call surgeons and anaesthetists on their day off? What about the incremental costs?  My plea that a patient is a customer and if he wants his surgery on a Sunday, than we may as well do it, did not work. Even the CEO, who also happened to be a surgeon (and his wife the anaesthetist) rapped me on the knuckles and instructed that I dare not do something like this again.  

Have you ever tried organising an Out Patient Clinic on a Sunday? Common sense would indicate to me that many people, having minor complaints and symptoms might want to visit their doctors on a Sunday, mainly because that is when they have some time at hand. I have done this often enough when I have postponed seeing a doctor, hoping to visit him on a Sunday. However, most hospitals do not run a Sunday clinic, mainly because they can not persuade doctors to come on Sundays. Now, my argument is not that doctors work round the week, they can take turns doing a clinic on a Sunday and take some other weekday off in lieu of working a Sunday. Somehow it never works like that.

Thus the ineveitable question, why is it so difficult to be patient centric?

Being patient centric means additional expense. Hospitals love to pontificate on the desire to be patient centric, but would not invest in the processes that make them patient centric. Investment would also be needed in training caregivers and developing patient information literature. It is really being penny wise pound foolish but no one realises it, simply because the cost is quantifiable and now, while the returns a little vague and much in the future.

Being Patient Centric means going beyond the call of duty, everytime the need arises. It requires a rare level of committment and passion.

Being Patient Centric would require a change in age old mindset, which tells the medical folks in a hospital that they are the lords and the masters of all they survey and the poor patient must be grateful for whatever assistance and help that he gets from them. Very few hospitals are willing to walk the talk here lest they offend powerful doctors. I would love to add that things are changing and the balance of power is shifting towards the patient. However, this shift for the moment is far too gradual.

Patient Centric would also mean empowering the patient through information and knowledge about the diseases, treatment options, risks  and the like. Hospitals in India still prefer to work cloaked in secrecy as many a times they have things to hide. 

These are big barriers, but the biggest is a deep rooted apathy for the patient/customer and the lack of will to bring about a change.  The patient must remain patient and suffer in silence because we with the power to heal and care are far superior in knowledge and skill. As long as this remains the mindset of our hospitals, we can never hope to be truly patient centric.

PS: While this is largely true of most hospitals in India, I must add that I personally know many doctors and surgeons, who would readily go out of their way to be patient centric. Unfortunately they are by far in the minority.





One thought on “Patient Centric Healthcare

  1. Dear Anas,
    True healthcare is a 24/7 industry and balancing it with the established norms & schedules of the society is always a challenge. Even in acute cases there is enough published literature suggesting that for similar presentations the medical outcomes significantly worse on the weekends compared to the weekdays (probably more so in the west were hospitals follow the traditional 5 day week). I guess it is also a demand and supply thing; as the balance tilt more towards the patients the hospitals will have little choice but to give in and make services available at all convenient times for patients. However this should not be attempted and achieved at the cost of time that the staff otherwise gets to ‘unwind’ or else this could turn into a self defeating endeavor. Any day I would be prepared to wait rather than be operated by fatigued, edgy and disinterested surgeon and his team.

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