Healthcare “Industry”

Healthcare is no longer a simple “Patient – Doctor” relationship. Gone are the days where a doctor used to check the patient’s pulse, use a stethoscope, come to a diagnosis and give one of the limited treatments available. Now our diagnostic armamentarium has increased, and the treatment options also have increased many folds. Now there are several stakeholders in healthcare provision, many of which are individual industries themselves like the Pharmaceutical industry.

Private tertiary care hospitals can be seen as star hotels with added healthcare provision. The stakeholders are – patients, doctors, nurses, paramedical staff, ambulance services, people in training, hospital management, countless support departments, insurance companies, organizations who have tie up with the hospital for provision of healthcare to their employees, diagnostic centers, pharma industry, medical representatives, biomedical equipment companies, health department officials, other government regulatory bodies, media, NGOs etc.

In addition to providing the required services towards provision of efficient healthcare, all these stakeholders have their own selfishness in the form of income, growth and long-term survival. In private enterprises, the payment structure is always linked to the work throughput and expertise. Even for people on fixed salaries like medical representatives, they need to show year on year growth to get bonuses and to stay in the “business”. The providers in the system wish to get more money out of it, whereas the users want to get the services for as low cost as possible, if not for free. Sadly, in our society there is nothing called “fair trade policy”.

Either at individual level or at organizational level, people try to exploit each other. It is a common practice to take insurance policy after having diagnosed with an ailment that requires costly treatment. It is equally common practice for the payers to disallow various things on some pretext or the other. The same medicine comes in different packaging by different companies and is sold at various prices. The same test is priced variously by different establishments. Part of reason for this is the belief in society that something that is new or more expensive is better! Many patients do not like to pay for doctor’s consultation. They feel that they are not getting anything back in kind. They do not mind paying for a test or medicines, which is a contributory factor in getting unnecessary tests. Some patients demand tests for “peace of mind”!! Doctors do not like being honest in reporting adverse events for the fear of backlash, which is leading to suspicion in the society. So many such things across the board.

All in all, the healthcare and allied industries are not healthy for a variety of reasons. Public and patients still think the doctors are in control of healthcare industry. It is not at all so. Doctors, especially the youngsters, have no say in a big multi-specialty hospital, whether it is a private set up or a government hospital. Doctors have become a small cog in the massive healthcare industry. Due to this helplessness or due to their selfishness or greed, many doctors have failed to be patients’ advocate. This has led to ever worsening “Doctor-Patient” relationship. Despite all these factors doctors are still seen as the “leaders” in healthcare industry and are held accountable to many things beyond their control.

All these things will take considerable understanding from all the stakeholders and a concerted, decisive action from all. That may or may not happen in our lifetime. That is the reason individuals must take care of their health and make provision like adequate insurance in the event of ill health. Some people have the misconception that hospitals will give unnecessary treatment to patients who have good insurance coverage. In majority of the situations, it is not so. Despite all the hardships, for majority of the doctors, patient welfare is still the core philosophy. There may be some unscrupulous elements everywhere. That should never be a deterrent to have a good insurance policy.