Challenges faced by the Health Care Industry and the Way forward
Dr. Sandeep Chatrath , Director/Central Regional CEO, Apollo Hospital and a Hospital Management Consultant is a specialist in helping hospitals improve their profitability through fast pace business development, strengthening processes and systems, enhanced asset utilization, implementing cost reduction strategies, helping design dashboards for monitoring and reviewing key performance indices of hospital assets and improving service delivery level. In this excerpt from an interview with him read about the challenges being faced by the Health Care industry and the way forward.
What are the key strategic challenges faced by your industry and organization?
- Getting and retaining specialist doctors: In a hospital system, NABH (National Accreditation Board for Hospital and Healthcare Providers) defines the quality parameters. I have been an assessor for this. The main challenge in our industry is getting and retaining specialist doctors. India has a scarcity of specialized and super-specialized doctors. New hospitals coming up make retaining doctors more difficult as they offer attractive packages due to which doctors switch hospitals once in every 2 to 3 years.
- Capital intensive technological upgradation: Technology gets outdated every 3 to 4 years. Heavy investment is needed to bring in new technology. Small hospitals are unable to put in the huge amount of time, money and effort required for technological upgradation, which is imperative for offering the best treatment. For instance, with the latest technology, invasive procedures like Angiography can be managed in a non-invasive manner.
- Cost Control: Running a hospital involves high costs of drugs, consumables and man power. These costs need to be well controlled to run a hospital profitably, which is difficult due to multiple internal and external factors.
- Improvement in quality of care: Quality of care is the most critical element requiring investment. This increases costs in a hospital. Health Care is a peculiar industry where even the rich would like to go to Charity and Government hospitals as they feel it is a luxury to spend on health care. There is a lot of manipulation with regard to BPL Cards. Even those people who have a very good income get these cards made and go to Charitable Hospitals. Government is spending less than 3% of the GDP on health care. There is a huge scarcity of beds, especially Government beds and lack of quality care. Majority of Indians do not have healthcare insurance which makes affordability and payment for health a very big challenge.
What role can people play in addressing these challenges?
Get themselves health insured: Today is the era of roti, kapda, makan and insurance. Health needs to be seen not as a luxury but as an essential. We find that people want to spend on less important needs rather than their own health. There is need for an awareness /awakening. The idea that health is the basic necessity has to sink in.
Do you think people are becoming more conscious about their health these days?
Not much, there is still a lot of scope. We have seen an increase of only 10% in this practice. Only 20% people have health insurance cover which is very low. The Government has not been keeping up with all the big promises that it has been making. Schemes like Universal Insurance need effective implementation. Until the Government takes very aggressive steps around this, we will not be able to meet the needs of the masses and classes. The Government expenditure on health, needs to increase from less than 3% now, to 5%+. At the same time, to run Private Hospitals you need the best technology which comes at a big price. Therefore the challenge of affordability still remains.
What can the industry do to popularize insurance?
It is all about spreading awareness. Any super-speciality costs Rs. 3-4 lakhs which people cant afford. Actually, insurance premium of Rs. 20,000 a year is not high. People still prefer to spend more on recreation, week-end shopping and gadgets etc as compared to their own health. So awareness needs to increase. Lack of awareness is a challenge that all the major stake holders will have to collectively deal with. Also the Government has yet to objectivise insurance policies. The schemes that have been announced have meager benefits due to poor implementation. In fact, the Government needs to further incentivize on income tax as insurance premiums get relatively lower exemption or benefits.
Despite so many Medical Colleges and so many doctors churned out every year, what do you think is the reason for non availability of specialist doctors?
The challenge is that 70% of India lives in villages and doctors are in cities and metros. The tier 2 or tier 3 cities, where health care is actually required are facing scarcity of doctors as doctors like to live in metros, aspiring for a certain quality of life.
How many hospitals does Apollo have in tier 2 or tier 3 cities?
About 40 to 50% of our hospitals are in the tier 2 and tier 3 cities. However we are yet to reach peripheral villages and tribal areas. We are leveraging on technology and trying to provide the best health care. We have begun to bridge through tele-medicine. Now we have 100 tele-medicine centres all over the country.
How does the tele-medicine work?
People can come to the rural centres. Patients are connected to doctors in metros. Doctors can see the patients, talk to them, and collect medical history. Reports of procedures like X-Rays and Scans of patients are easily shared with doctors so that they can prescribe medicine or treatment. Connection is established through satellite or internet. Therefore tele-medicine seems to be one of the great solutions to this big challenge.