The “Amar Uchala” Way

When I was in college almost 20 years ago, we had a popular Hindi newspaper called Amar Ujala. This was well-circulated in western UP and was a staple amongst students at the ubiquitous ‘dhabas’, which ringed the campus of the Aligarh Muslim University, Aligarh. We all loved to read its over the top reporting, brazen twisting of facts and its economy with the truth. Affectionately the newspaper was called ”Amar Uchala”.

Those were the days of innocent fun and we hardly realized that how insidious and damaging this kind of reporting can be. It struck home to me when I came across this piece of reporting on its pages recently.

Amar Ujala report

Let us look at this report from the Amar Ujala. The headline says that in Gurgaon 11 people die every day in private hospitals. The report cites the response of the Municipal Corporation of Gurgaon (MCG) to an application under the Right to Information Act filed by one Mohit Khatana. The entire story is based on this RTI response and paints an extremely negative image of some of the most well-known hospitals in Gurgaon.

The report without any comparative basis, claims that these hospitals have very high mortality rates and publishes data on the number of death certificates issued by MCG on the request of various hospitals in Gurgaon. It claims that the data shows that the mortality in these hospitals is very high. It also makes wild allegations against private hospitals claiming that the hospitals admit very sick patients knowing fully well that these patients are unlikely to survive and in the process, they make a lot of money.

It also quotes Mohit Khatana claiming that it seems that the larger the hospital, more are the number of deaths.(I don’t know how can it be otherwise!!!) The report also claims some unknown experts saying that mortality is far worse in these hospitals as the numbers cited do not include those who are sent LAMA (Left Against Medical Advice) and die at their homes.The report, of course, does not present any point of view from the affected hospitals.

Now let us examine facts.

Medanta is the largest private sector hospital in Gurgaon with over 1000 operational beds. It is also a referral centre for tertiary and quaternary care and receives patients from all over the country. It is a major hub for medical value travel with sick patients flocking to its doors from all parts of the world. With such a large number of very sick patients coming to Medanta, it is only natural for it to report the maximum number of deaths to the Municipal Corporation of Gurgaon (MCG). How can this be a point of contention is beyond comprehension.

Let us look at some other facts. The MCG records deaths reported by various hospitals. The data includes those who are brought dead to the hospital ER, those who die in the ER before they could be admitted for treatment, stillborn babies and even those who are certified dead at their homes by doctors of these hospitals. All these deaths are reported to MCG by the respective hospitals and a death certificate is issued by the MCG basis this information. These are not mortality figures of the hospitals.

I happen to have the data for Max Hospital in Gurgaon. The hospital reported 73 deaths out of 7609 patients that were admitted to the hospital in the period of Jan 01 2017 to Nov 30th, 2017, which makes the mortality rate under 1%. I am sure other hospitals too will be maintaining their mortality data and with a little bit of effort, the journalist from Amar Ujala should have been able to access this information. In the finest tradition of his newspaper, he never bothered.

To make matters even worse, the mortality data from these hospitals are not even comparable. The mortality in any hospital is a function of the number of patients handled as well as the service mix of the hospital. Thus, a large hospital, attracting a greater number of patients and providing advanced services such as cancer care, high-end cardiac care, and transplants will have a higher mortality than let us say a secondary care hospitals with a lesser number of beds. Thus, one fails to understand how can one compare mortality at Max Hospital, Gurgaon which is an under 100-bed secondary care facility with Medanta Hospital, which is quaternary care hospital with over 1000 beds.

Finally, the conclusions drawn are just as ridiculous and mendacious. Even if one was to assume that this data is comparable and accurate (which it most certainly isn’t), how does it indicate that hospitals are admitting and keeping sick patients who have no chances of survival?

Pray, what else is a hospital supposed to do – turn away the very sick and admit the relatively healthy? If Medanta Hospital is admitting the very sick knocking at its doors and trying its best to save their lives, what is wrong with that?

This kind of perverted reporting, completely one-sided and meant to only cause discord between patients and their clinicians and hospitals is lamentable. The journalist is not only ignorant of facts, sadly he doesn’t seem to be interested in the truth either. He has to find a ”sensational” story to file and this seems juicy enough, the facts be damned.

Amar Uchala, too hasn’t changed much in these 20 years.

The views expressed are personal

Dr. Naresh Trehan at the HT Leadership Summit

Dr. TrehanI had the privilege of listening to Dr. Naresh Trehan at the HT Leadership Summit organised by the Hindustan Times in New Delhi on Oct 30th and 31st 2009. The Leadership Summit has over the years become the marquee event in the city’s calendar and leaders like the Prime Minister, the Finance Minister and a former US President (George W Bush) addressed the gathering, which was composed of the who’s who of the Delhi elite. Dr. Trehan, who is widely regarded as one of the most accomplished cardiac surgeons in the country, was invited to speak on the challenges that the healthcare industry faces and how he saw things working out by 2020.

Dr. Trehan spoke with great passion and expressed anguish at the huge gap that exists in the supply of healthcare to the haves and ‘have nots’  in our country. “While Delhi draws thousands of patients from across the globe, 50 kms outside the city, one would struggle to find a qualified physician. India has some of the finest healthcare facilities, comparable to the very best anywhere in the world, which offer services at a fraction of the cost in the west, yet most Indians can hardly access these. The real challenge is how do we bridge this huge divide”, pointed out Dr. Trehan.

The prescription that he had for the malaise was simple enough.   Continue reading