Over the last few months, I have had an opportunity to present my thoughts/views on the state of Healthcare Services in India in different types of people settings – big and small/formal and informal – including the one which I described in my previous blog post.
At a crossroad
Based on my observations and my views (and after validation from various different sources), I had mentioned that I sincerely felt Healthcare Services in India is at a crossroad in its phases of evolution. Many had asked me why I felt that way. To explain my reasonings and arguments for such observations is the motivation behind writing this post.
Before I make my case, I hope you have had an opportunity to read various of my other previous blog posts about Healthcare in India. Hopefully, after reading those you would have realized that I am no medical practitioner nor do I have any association with any policy making organization. My views are more from my observations and experiences from Healthcare Consumer perspective.
‘Being at a crossroad’ for me means that the contrasts between the state of various things or options starts becoming so evident that people dealing with it (be it individuals or society or a country) have to very often face or deal with options and associated consequences of each option. In some sense it is about making a selection which potentially would determine the direction in which we as individuals or society would go. In the healthcare case, in some symbolic sense, I felt that the state of matters or the options provided by the Indian Healthcare Services seems to have started showing various different signs of contrasts. Hence my argument for Healthcare Services being at the crossroad!
Components of Healthcare System
To look at the contrasts one has to have an objective view. A view from a 10000 feet! From such a high view, IMO, if we were to look at the ‘state-of-the-union‘ of the healthcare system – I felt that we can see distinct two categories – the ‘good news‘ category and the ‘bad news‘ category. The ‘good news‘ bucket has the real progress which the country has made in comparison with the previous decade/s. And the ‘bad news‘ category contains the increasing developments which in some sense the dampens the ‘good news‘ category.
When you look at the baggage which India carries (over-population, years of apathy towards infrastructure development, traditional social lack of awareness towards health management, etc.) and then put things into perspective – one cannot miss out the noticeable growth and progress being made in the last decade in the area of Healthcare. And it is continuing. At a national level, India is among the top contender for the destination in the area of Medical Tourism.
Medical Tourism Booming
If I were to look at the local level – especially at my home town – the medical specialists and the treatments which were only available after traveling more than 400 miles to the West, is now available within miles. Indian Medical System seems to have gotten into a factory-like approach in churning out specialists in a recurring way. The private hospital chains (Apollo‘s, Max‘s of India) seems to have started taking steps in providing healthcare management facilities (although still affordable to a subset of the population) which even the respected Government-run medical hospitals (AIIMS, KEM, etc.) seemed to have ignored over the years. Recent news about Max investing in Electronic Health Records (EHR) mechanisms or Apollo venturing into advisory services in helping other nations to open up the hospitals are some big validations of the progress. Investments in this field are coming from all corners with McKinsey predicting that the Indian Healthcare market would grow to about $52 billion in 2012 (from the current $35 billion) and to about $150 billion in the year 2017.
Spinning the Money
Indian government (possibly under pressure from World Health Organization too) have been increasing the number of medical colleges by more than 12-15% year-by-year since the last few years. Increasing population, increasing income, increasing reporting of medical ailments can only be good news to any investor (pun intended!). So in a sense there is a big air of optimism around which one can certainly feel if one looks around.
India Short of 6 Lakh Doctors
However along with the above sense of progress there are also instances or developments which are so visible around which makes one think that many things are also ain’t going the right way from the healthcare perspective in India.
Basic Doctor Mistakes
Progress made in the healthcare options is not yet reaching to all in the society at the pace it should ideally be. 80% of the Healthcare providers and specialists are concentrating on the 20% demography located in the urban areas (hence the rural areas continue to suffer). Common basic mistakes in medical treatments which probably would be synonymous to the state of medical system in a third-world country are still being made (e.g. babies being declared dead only to found alive after couple of hours, incidences of some doctors refusing to treat HIV patients because of social taboos, etc.).
Indian Medical Journal of Medical Ethics
The relationship between the doctors and the patients have increasingly started coming under big strain (both ways) with increasing number of incidences where law-of-the-land have been broken by either parties.
Cases of medical malpractices which frequently comes to the fore typically leaves a stink and big blot with the progress. Accountability is a key component in any progressive system and Indian healthcare system continues to lack in that to a big extent. My personal confidence in the maturity of the Indian Healthcare system maturity also got shaken when I read that Indian Medical Association (IMA) itself came forward and said that they have lost track of number of doctors in the country in the recent years. I had also recently blogged about my apprehensions of the Indian Healthcare System during the H1N1 outbreak few months back.
More afraid of medical errors
I am not sure how many of you have also noticed this contrast the way I am seeing it. Please do not get me wrong here. My intention is not to paint a black or a white picture here. In my conversations with many on this topic – that is lot of contrasting opinions out there about the state of the things. And hence the extra motivation to my point of this post. Because of such visible contrast, my opinion is that India’s Healthcare System is at a critical crossroad as it continues to evolve fast. The steps it takes in the next few years would determine its long-term success. But the good news is also that such contrasts opens up lots of new opportunities too.
Your thoughts and comments are welcome.