Archive for the ‘Healthcare in India’ Category

India Healthcare – McKinsey Report on Indian Pharmaceutical Market

December 20, 2010

For those who are following Indian Healthcare Market with great interest – the recent McKinsey Report & Predictions on Indian Pharmaceutical Market would be of interest to you.  I tried looking at this report at the McKinsey India web site but did not find it there. However, here is an alternate location from where you can download the PDF Version of the same report titled “India Pharma 2020 – Propelling Access and Acceptance, Realizing True Potential”. LiveMint also did a great job in summarizing this report in their daily edition (the graphics from LiveMint are here –  PDF – 1, PDF – 2, and PDF – 3).

For me the following were the quick takeaways from this report –

  • Over the last 5 years, the Indian Government spending on Healthcare has increased by a healthy 20% ($6.7 Billion to $11.7 Billion)
  • Coronary Heart Diseases and Diabetics are the two prominent disease areas to see an increase of about 30-40% in the next decade.
  • The data shows a steep rise in the number of people covered by healthcare insurance in the last 5 years (and is targeted to cover 45% of the population by 2020) – however important thing to note is that this steep rise is due to government-sponsored insurance coverage for below poverty-line population.
  • Selling margins in India are lower compared with other emerging markets (~20-25%)

[Note – Send me an email if you have problems accessing the PDFs linked above. I have these PDFs locally stored with me.]

Suffering from Cyberchondria? Then you should know this –

November 18, 2009

“Chondria what? What did you say?” I can literally hear you saying! “All I had always heard was about hypochondria!”.

This week Washington Post staff writer – Carolyn Butler – posted an interesting article titled “A glut of Google can give you a virtual fever” (registration may be required to read) in which I for the first time came across this term – cyberchondria. Yes, I somehow had missed on that! Wikipedia defines cyberchondria as –

“Excessive preoccupation or worry about having a particular disease based on medical information gleaned from the Internet”

Cyberchondria - Escalation of Medical Concerns (img src -

Cyberchondria - Escalation of Medical Concerns (img src -

Seems like this word (derived from the word hypochondria) was keyed around at the start of this decade but got into prominence after two Microsoft Researchers – Eric Horvitz and Ryen White – released this study titled – “Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search” and New York Times carried a follow-up article about the same. This paper from Microsoft Research studied various patterns of web searches associated with healthcare information and found that people’s medical concerns got escalated because of the kind of results shown by the web search engines. These researchers concluded this when they saw that the online healthcare information searchers started searching for and reviewing content on serious and more rare conditions that were linked with their symptoms in the same web surfing session. The paper is an interesting read and I would recommend you all to read it. I am also capturing some of my learnings from the paper below –

  • Majority of us tend to miss out on checking key quality indicators for any online health information – As I had mentioned in my presentation about Healthcare from Consumer Perspective too, this paper also confirms that substantial number (more than 70%) of internet users search for healthcare related information on the web. However more than 75% of these searchers also fail to check for the key quality indicators such as validity and creation date of such information. (Some additional studies have pointed out that more than 70% of the healthcare content on the internet may not be of appropriate quality)
  • Online search results tend to over-exaggerate possible causes based on symptoms –  The probability of a cause for a particular symptom based on what seems to be implied from web-based search results and the probability of occurrence of the same cause in real world seem to be differing dramatically. Sounds slightly confusing? Let me simplify it. For example – as the paper points out – for a symptom such as headache if you were to search it through a search engine – you might feel that there is a 3% probability of you having a brain tumor. Whereas the actual occurrence rate for brain tumor is possibly less than 0.001%. This over-exaggeration due to coarse linkages done by the present-day search engines between the symptoms and the content tends to increase unwarranted anxiety among the web searchers.
  • Cyberchondriat’s trust in Doctors is minimalistic – Studies have shown that Cyberchondriats – assuming that they suffer from hypercondria – typically tend to express doubt and disbelief in their physician’s diagnosis and typically are not easily satisfied by their doctor’s reassurances.
  • Mapping a disease online based on symptoms is inherently flawed – Having hung around a family of doctors and seen them practicing – I personally had always been skeptical (and thought it was risky too) about the increasing number of healthcare websites which have mushroomed on the “you tell us your symptoms” and “we will tell you what you suffer from” information model. Diagnosing (will be blogging more on this in future blogs) as done by doctors requires intricate probing and building an hypothesis around the subtleties of the symptoms and various findings – along with giving enough consideration to characteristics of the patient (typically done face-to-face). This is not feasible with the web-based search. Well, atleast the ones which are available today!  Almost all of the search engine or querying mechanism today are not designed to perform coherent diagnostic or probabilistic reasoning (a key tool for medical diagnosis). Cyberchondriates need to be aware of this.
  • Individuals themselves have core biases while pursuing for online medical diagnosis – The authors of the paper point to studies in Cognitive Psychology wherein they had presented evidences that humans tend to employ heuristics or speculative approaches in determining likelihood of a particular theory when presented with large amount of possibilities. Authors believe that this tendency of human beings plays a big role in cyberchondria too. Because of this habit – human beings tend to be biased towards certain medical content – which in turn drives their assumptions of what they suffer from.
  • Lastly, there seems to be more online information on Rare Diseases than to Common ones – The authors believe that for the sake of garnering more attention (nothing wrong in that though), there is a lots of literature and online discussions devoted to rare disorders than to common ones. However, the flip side of this is that this abundance of information may lead to biasing the search engines and ultimately the online searchers towards the possibility of they getting diagnosed with a more critical or serious disease.

Personally, I have always been vary of the potential use of the abundant healthcare related information which is available freely and easily on the internet today. My challenge is not against the content part – but on the context part! How does that content or the information apply to the individual himself/herself? This article clearly alludes to my fears – that increasing amount of healthcare information on the internet while needed can also bring in side-effects too.

Thoughts and/or comments are most welcome!

Healthcare System in India seems to be at a crossroad!

October 14, 2009

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

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

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

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

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

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

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

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.

Doctors protesting

Doctors protesting

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

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.

[Startup Saturday – Delhi] Healthcare in India – Consumer Perspective

October 12, 2009

This weekend on Saturday, I presented a talk titled – “Healthcare in India – Consumer Perspective – Opportunities!” at Startup Saturday – New Delhi. The talk was more about my thoughts on what kinds of healthcare opportunities from the consumer perspective exist or will exist in India. Many of the attendees (and also some who missed the talk) requested me for the slide deck. For them I am putting it here.

(Does not seem like SlideShare did a great job in properly converting the ppt. Please feel free to reach out to me in case you have questions on anything specific)

For those who missed it out – it was fun talking in front of the lively audience with many questions and strong view points. Some key highlights of the questions/discussion points –

  • There was a lot of debate on my “Good News” and “Bad News” slide and why I felt about it in that way. I will be putting my thoughts on it in a separate blog post.
  • Interesting debate when I said that India was a Developed country. (Needed help from the politicians there)
  • Few misunderstood that I was encouraging opportunities for replacing the doctors. No folks! Doctors cannot be replaced! Few in my own family would have killed me if I had that view.
  • Many felt that the healthcare domain was difficult to crack considering the insufficient domain knowledge they had. My suggestion to the wanna-be entrepreneurs was not to build any solutions by excluding the doctors.

Look forward to hearing your thoughts and/or views too!

Swine Flu vaccine test results so far.. Help is on the way!!

August 22, 2009

Just a quick note. New York Times reported the Swine Flue vaccine test results till date. Very encouraging. Help is on the way!

Read the article at -“No Side Effects So Far in Trial of Swine Flu Shot” (Registration may be required)

In case you don’t have login access to this article, I have created a PDF of the news article – Swine Flu Tests Results So Far – Aug 21 2009 (PDF)

I wish Media also pushes such kind of positive news to the already panic-struck crowd.

[Update, Sep 11, 2009] Associated Press (AP) has reported further encouraging update – “Studies: 1 dose of swine flu vaccine works“.

Doctor’s View – Paternalistic Model of Healthcare in India!

August 17, 2009

Many of you might have read my views on the Paternalistic Model of Healthcare being prevalent in India few weeks back. I had blogged my views from a Consumer i.e. from a patient perspective. Seems like this post of mine triggered a reaction from my brother – Mukesh – who as I had mentioned in one of my previous blog is a Medical Practitioner himself. You can view his feedback on his blog post titled “Paternalistic Model of Healthcare in India – Doctor’s View“. I would encourage you all to read the same.

When I wrote my blog, I had few purposes in my mind. First, ofcourse to express my personal thoughts on this topic. Second – and an important one – to encourage an awareness/debate on this topic. Awareness more from consumer’s side and debate from medical practitioner’s side. Knowing Mukesh for years now – I had an inkling that he would have an opinion on this topic and I am so glad that he expressed the same.

One of my fear was that Doctors would outright reject this idea or become defensive or God forbid some of them may go ballistic even. However, I sincerely appreciate Mukesh’s balanced view point on this. I know that Mukesh has kept up with the changing times (his opinions reflect that). However, it is also my sincere hope that many of his peers would also have a similar thought.

I realized this after I wrote this particular blog post. When I had talked about challenges of paternalism, many may have construed my views as a coercion for patients to take the decisions rather than the doctors. Mukesh may have too. I was not intending to pitch the patients against the doctors. Increasing number of research/surveys have shown that patients themselves are not keen to decide and they depend on the doctors to take the decisions on their behalf. However, they want to be informed. They increasingly want to participate in the decision-making process and this is where the degree of paternalism comes into picture, IMO.

Many a times I get a feeling that the gap between the doctor-patient relationship seems to be widening in the recent years, especially in India. For any healthy relationship, it is important for all parties to participate in a meaning debate and while understanding other’s view point, get an opportunity to express theirs too! From that perspective, I sincerely appreciate Mukesh’s opinion from a doctor’s point of view.  I am looking forward to engaging in more of such discussions with him in future too.

Swine Flu in India and the Cracks in the Indian Healthcare System!

August 13, 2009

India finds itself in a strong grip of Swine Flu scare this week. Looking at the building hysteria in the country, with both valid and invalid emotions around it, I could not resist myself in adding my own 2-cents worth of thoughts and comments in the already heavily-crowded rants about this topic. So here it goes –

To the best of my memory, after a long time India (along with many Asian and African countries) finds itself in a unique situation where it is dealing with a healthcare epidemic which is not its own creation. Traditionally, the West had always been vary of the developed countries in the East for posing these kinds of risks; however this time the table seems to have turned. Not surprisingly, for a country which is typically geared to handling home-grown health issues; India finds itself grappling with the “deer caught in the headlight” problem.

In my personal opinion and the history of past health-epidemics makes me confident in saying this – the Swine Flu scare is a temporary thing and India (along with the entire World) will get its arms around it eventually. As was the case in the past epidemics – it will take its toll though in terms of health, unfortunate loss of lives, and also financially. But the world will sail through this. Mankind has sustained some worst healthcare epidemics and with all due respect to people who have suffered through this, Swine Flu outcomes certainly does not measure up close to many of them.

Having said the above – my point in this blog is also to reflect upon how many cracks has this Swine Flu event exposed in the Indian Healthcare System. In one of my previous blog on “Healthcare in India – From Consumer Perspective“, I had talked about a similar point. India certainly has an ever-improving healthcare system in terms of facilities and brain – but I feel that the same system failed quite badly to deliver its services to its Consumers in Swine Flu’s case. To blame on any one party would be to simplify the issue, IMHO. Government were in a reactive mode rather than a proactive mode; Healthcare Service Providers seemed to be overwhelmed and more satisfied in testing the patients rather than educating them; and Pharmaceutical companies did not seem to assure the consumers regarding the status of the remedial drugs. To a big extent even the Consumers have their share of blame for not educating themselves and for reacting in a ‘herd’ way. The only one who seemed to be having a regular field day on this seemed to be the Media. Talk about a proverbial perfect storm!

It would be foolhardy to blame anyone for not predicting this before; but going forward Indians (the Government, Doctors, or the Consumers) will have to learn as to how to react and handle healthcare issues. Proper communication, analysis, and cordination is the key to handle this. I know it is easier said than done especially in circumstances like these. However, many baby steps can help. Here are some examples –

  • Share key data associated with the patients – As I write this, reports are coming in about the death of the 16’th victim. As a concerned individual, I am keen in knowing more about them so that I can compare myself with their health conditions. Is it the swine flu virus itself which is lethal (as far as I have read it is not lethal if proper drugs are taken) or is it the combination of health disorders which affected those unfortunates? Why were the President of Hondurus or the Harry Potter star able to recover from Swine Flu and why these people could not? Is there something more to the story? It is my strong belief that being open and sharing data can calm people’s concern to large extent.
  • Talk about people who have recovered and how did they do it – Talk about successes while also talking about failures! My understanding is that there are plenty more people who have recovered from H1N1 than who could not. How did they manage to? Share that and make press/media releases out of them. That will certainly help others learn from their experiences and self-manage accordingly.
  • Learn from others – Swine Flu came to India relatively later compared to many parts of the world. Shouldn’t that be to our advantage? Shouldn’t we be learning from other countries (United States, Mexico, UK, etc.) as to how they are handling it or have handled it? Scanning through the local newspapers in these countries do not seem to communicating similar kind of panic as what India is going through currently. What has worked for them and what has not? Healthcare systems need to use this information to assure its citizens.

I am sure many of you have additional suggestions about what the Healthcare machinery should have implemented or should be implementing (post them in the comments section if you do) to handle outbreaks like H1N1. The point I am trying to make here is that it is high time that we all change our habits to handle rare diseases outbreaks like these. In healthcare challenges like H1N1, the top-down (service providers reaching out to patients) or the bottoms-up approach (patients accessing doctors for remedies) are very in-sufficient. We need to go beyond regular paternalism. The online or the TV media could use collaborative learning techniques in a responsible manner at a national level to help facilitate the outbreak.

Thoughts, comments, and/or fires are most welcome!

Is Paternalistic Model of Healthcare effective in Modern India?

July 20, 2009

I had mentioned in one of my previous blog about me writing on some of my thoughts from a Consumer perspective on the Healthcare scenario prevalent in India. This blog is a continuation along that line.

In this blog, I wanted to talk about the typical doctor-patient relationship model which I have seen being prevalent in India. Let me say on the onset that the purpose of the blog is no to opine on any one particular approach – but to lay forward the pros and cons and the factors governing them.

Almost everyone whom I have talked to (again from a Consumer perspective) are in common agreement that their typical experience of visiting a doctor in India is along the lines of following vignette

“Mr. Patel is suffering from a disease which is critical but not life-threatening. This particular disease has several treatment options which Mr. Patel is not aware of. Mr. Patel visits a specialist Dr. Shah who is known to specialize in the area of this particular disease and is aware of all the treatment options available. Dr. Shah believes one particular treatment option to be in the best interest of Mr. Patel and prescribes the same to Mr. Patel with little or no discussion about the other options.”

Note that in the above scenario – I am not implying that Dr. Shah had any ill-intentions or Mr. Patel suffered because of the prescribed treatment. However, just wanted to mention that this particular approach where the patient typically plays a passive role is termed as Paternalistic Model of doctor-patient relationship. The foundation of this model relies on the values such as personal loyalty and unquestioning obedience from the patient’s side and un-ending benevolence i.e. disposition to do good from doctor’s side.

Plenty of studies have shown that the Paternalistic Model of Management or Interaction is highly prevalent in almost all kinds of disciplines in India – be it in a Corporate settings or an Academic settings or as in this case even the Healthcare settings. Similar studies have also shown that such paternalistic model has traditionally worked favorably in Indian/Asian context with all the parties involved showing preferences for it. Also, as a Society, I have always believed that Indians – who have always traditionally been part of the collectivistic culture – have found the safety in relying on the paternalistic leaders for care, support, and protection. This has led to high paternalistic values in Indians. As a society, India’s culture values respect for hierarchical relations, strong family, and personal relationships assuming that there would be an affective reciprocity amongst all. This also fueled into India’s inclination towards paternalism into work places and institutions.

I strongly believe that at the core, the success of Paternalistic Model requires an effective leadership. From that point of view, I like the triad model which B. S. Cheng and D. Y. Jiang (you will have to do a Google search on this) presented about Paternalistic Leadership after their study in China. Essentially, they conceptualized Paternalistic Leadership as a three-dimensional construct involving –

  1. Benevolence – Holistic concern for dependent’s well-being.
  2. Morality – Demonstrating superior personal values
  3. Authoritarianism – Authority and control over the subject matter or the dependents.

This now brings me to the main part of this blog – is an Paternalistic Model of Healthcare effective in Modern India? My answer to this is ‘yes‘ and ‘no‘ both. I think as a society, India will soon have to find a middle ground on this. Here are my reasonings for it –

  • Rampant Illiteracy or Reducing Illiteracy – One of the common reasoning given in India for paternalistic approaches in Healthcare is rampant illiteracy. There is a strong belief amongst Healthcare providers (and many a times rightly so too) that such patients are unable to understand the nuances of medical treatment, procedures, and drugs and hence are unable to make the right choices for themselves. Hence the paternalistic view is taken. The corollary of this then is that such view then should not be taken with sufficiently literate patients or such view should be on its way out as the illiteracy levels in India reduces over a period of time (which is true!)
  • Human Body is one complicated piece of Machinery – I am sure, like me, many of you would have gone through the enormous amount of brain scratching (and stress) with or without your mechanic to figure out what is the matter with your car for not giving the mileage you desire. And we are talking about a machinery as simple as a car here (pun intended!). Complexity of Human Body machinery increases to the n’th level as compared to the cars. Except the run-of-the-mill problems, majority of problems in human body are complicated and requires a joint partnership between a doctor (or several doctors together) and the patient. In my opinion, one individual (be it the doctor or even the patient) providing the authoritative leadership over the subject matter of human body is just not humanly possible. There are limits of healthcare alternatives. It is not an exact science. Neither patients should believe that nor should doctors make their patients believe that. Hence paternalistic model of healthcare has its inherent limitations, IMHO.
  • Benevolence from Doctors – In my experience, Indian Doctors are typically extremely stressed with the work overload. Keeping an expectations from them to continiously have an holistic view of the patient’s health (it does take substantial time to do a good checkup of a patient, BTW) is being extremely unfair to them. I am saying this with the deepest amount of respect to the doctors. This is where, IMO, patients have to play an equal role in their personal healthcare. Rather than simply playing a passive role, they need to be the facilitators to the doctors so that the doctors can suggest proper decisions. Doctors on the other hand also need to be open and honest about this kind of expectations with their patients.
  • Morality – Paternalism rides upon enormous amount of faith and trust in the leadership. In this model of relationship, the expectations of patients are similar to the ones as to what a son would have from his father. In the same way as parents make decision for their children, doctors are supposed to make the decisions for their patients. Unfortunately, in the recent times, this aspect of relationship and/or trust seems to have taken a major beating for the worse in India. Hence the role of complete paternalistic model might be under question in healthcare in India.
  • Finally, it is “my body” – Majority of the doctors will continue suggesting what is the best for your body in the same manner as banks/financial institutions would continue taking care of your earnings. But this should not imply that you or me – as the individual owner of our body or our financial investments – do not have any responsibility. In my personal opinion, patients too have to rise up to take up the responsibility of owning what in reality only belongs to them.

Several literature in the West have gone to the extent of terming Paternalistic Approaches in Healthcare as an endemic. I would not go so far in terming it in that way considering that there are enough valid reasons for its existance today. However, as the Society in India evolves, an hybrid approach has to make its way.  Even the Prime Minister of India has acknowledged about this need in his address to AIIMS few years back.

I would love to hear your thoughts, comments, and fires on this topic. Depending on which shoes you wear, I have seen that this topic does induce a lot of passion.

[Update] – To read a Doctor’s perspective on this topic – please refer to my new blog post – “Doctor’s View – Paternalistic Model of Healthcare in India!

Healthcare in India – From Consumer Perspective

July 12, 2009

Many of you might find this to be slightly away from usual categories of topics which I typically blog upon. Over the last few years, having gone through some experiences and having had interesting conversations with many in the area who are associated with healthcare (both as a provider and consumer) – made me think a lot of about how healthcare is being dealt with in India. When I say how it is dealt with – I mean really at the ground level. I mean how people like me (as a consumer) get what we need from healthcare perspective and also how majority of providers like my brother provide their services.

Before I write further, let me say that I come from a family of doctors.  My Uncle is a practicing Medical Practitioner. In my generation, my brother and his wife are. Many of my childhood friends are also now in this profession. So if you were to visit my folks, it is very common to participate and hear conversations around various healthcare issues and practices around the dinner table.  So needless to say that I have nothing but respect for the providers of medical services.

Although I referred myself as a Consumer above, let me confess that I am not completely sure if I can characterize myself as the majority of consumers of medical services in India. As a consumer of any service  (and this applies to products too), one has to figure out which particular service fits his/her needs; search for who can best provide it; and then have the service to be delivered in the best possible manner. Majority of the medical services consumers in India go through this on a day-to-manner. For me this process, however, has typically been very simplified. A phone call to my brother or uncle; I know what I have to do next and where I have to go; and I have the access to the best possible service. However, when I talk with many of my friends and colleagues – I do realize that I probably may not completely match with the most common persona of a typical medical consumer in India. They go through a different drill. However, I also find myself having the ability to understand what are the challenges and possibilities of an efficient healthcare system and what it means for both the Consumers and the Providers.

Healthcare in India as a ‘Product’ has grown leaps and bounds over the years in India. However, as a ‘Service’, my opinion is that Healthcare Services in India – not just from Providers side and but also to the same extent even from the Consumers side too – needs a serious relook (and in many scenarios – a reboot!).  To a large extent Healthcare Services in India seems be centered around the Provider i.e. the Doctor. But as any successful consumer offering in the world would tell you – this service needs to be around the individual who needs it – the Patient.  Please note that when I refer to a Service – I am not just referring to a scenario simply about how a patient gets treated by a doctor – but the complete process of how the consumer (patient in this case) goes through the process of figuring out what he/she suffers from; services best for them and their providers; and then getting the best and optimal service delivery. On my blog I am keen in communicating some of my thoughts on this topic and also getting your inputs on the same. I will be writing many posts on this topic going forward.

This week, I am also happy to see that my brother – Dr. Mukesh Rathi – also starting his own blog. As I had mentioned above, he and his wife are practicing Gynacelogists with a very modern setup along with a recurparting hospital. Whenever Mukesh and I meet – in addition to various conversations around our families and our work – we also talk a lot about what he is seeing happening around in the healthcare system today; how is the medical profession changing today; what kind of opportunities and challenges he sees around; and more specifically what it means to the consumers/patients in India. I am hoping that I will be seeing many such thoughts posted by Mukesh on his blog. You can read his blog at

More on this topic in future blogs.