The Dilemma of Single Speciality Hospitals

A recent cover story in Business World highlights the growing influence of Single Speciality Hospitals (SSH) in India. I read the story carefully. First and foremost, I was delighted to see a cover on healthcare in Business World. It is not often that the business of healthcare gets prominence in a widely circulated and highly respected business weekly. That, BW decided to do this story is a testimony to the growing importance of the private healthcare sector, which is something to cheer about.

SSH’s make good business sense at least in some specialities. The investment required is low compared to a large Multi Speciality Hospital (MSH), funds can be accessed through PE firms and financial institutions, the hospital can be set up quickly and if one ropes in a well known medical luminary of that particular field, it is not too difficult to fill up the beds. Once the operations stabilise, one can consider franchising or expanding by setting up super specialised centres in large multi speciality hospitals. Specialities like Ophthalmology, Dentistry, Obs and Gynaecology (remember the neighbourhood mother and child centre) have always had Single Speciality Hospitals and clinics.  The trend is now towards large SSH for Oncology, Urology and even Day Care Surgeries.  

These hospitals are presently being set up by eminent doctors, who are partly putting in their own money and getting PE funds and financial institutions to invest in their ventures. Thus these SSH’s are hugely dependent on the goodwill and equity of the owner-doctor. Also one is not sure, how capable these hospitals are of attracting the best medical talent and thus providing high standards of care to patients. Typically, in a doctor owned SSH set up, it is rare to find other doctors of similar or higher capabilities than the owner. The fear of always being eclipsed by the owner-doctor drives other talented doctors to MSHs, where the canvas is bigger and the environment less claustrophobic.

From a consumers perspective SSH’s are a huge dilemma.

My father, now in his seventies suffers from an enlarged prostate. This is a problem that most elderly men are likely to have. Like most people he is terrified of surgery and has been on medication for the last few years. However, we know that surgery can only be postponed for a while and sooner than later he will have to go under the knife. Now should I choose a RG Stone Clinic, which is a well known SSH for Urology, or do we go to the multi speciality Max Hospital. While RG Stone may have better and more advanced equipment for the treatment of his condition (some fancy lasers), I am not sure they are equipped to handle complications, which may happen. The last thing one would want to deal with is an emergency requiring shifting him to a larger hospital after the surgery.

Also, I am not sure about the credentials of the doctors in RG Stone clinic. On the other hand MSHs like Max and Fortis and Apollo are well established brand names, have systems and processes (Apollo is JCI accredited and the others are in the process of accrediatation) and some of the most well known surgeons in the city are associated with these hospitals. From a cost perspective RG Stone might be cheaper, but if the patient is fully covered by health insurance (as my father is), expenses are the least of ones concerns.

Thus, in a situation like this, I will be inclined to go to the bigger MSH and I would reckon most of you will do the same.

And here is than the lesson for the SSH’s. They need to establish themselves as a far superior option in their chosen speciality. They need to invest in the brand, move away from the perception of being owner-doctor driven centres, hire the best talent by offering a great work environment and competitive salaries and establish systems and care protocols comparable to the best in the business.

SSH’s must convince me, the consumer, that they really are super experts, before I can seriously consider entrusting them with my care.