The Hindu Business Line : Unhealthy health business

"Dr Kamle's prescription for sick hospitals is simple. "A hospital is an integrated system where patient flow has to be well organised. Its marketing strategies should not compromise on medical ethics, but attract patients with good services, great infection control rate and a competitive pricing structure," he says.

A sick hospital is an establishment where promoters have bought costly equipment like MRIs without carrying out a detailed study of the demographics or MAF (market assessment and feasibility) study of that area. The pricing structure may also not be commensurate with market demands.

His checklist of CQM (Continuous Quality Management) principles includes:

* Quality must be built into a product service.

* Positive reinforcement — demonstrating excellence within the current system.

* Examine the system for overall improvement, and not just focus on getting rid of the `bad apple'.

* Standards must be set, reviewed, explained and implemented before holding any one accountable for them. "All personnel involved must be educated about the standards. Each time a standard is changed, that change must be effectively communicated to all personnel involved," he says.

* Expect, but limit variation: Anyone can have a bad day or a good day. The trick is to improve the system to ensure that even on a bad day, patient care is acceptable and the variation between good and bad is minimal.

He recommends a good information management system to enable the hospital to save on resources. That coupled with aggressive marketing would help increase revenue.

Financial and other constraints

The need of the hour, he says, is the establishment of a hospital finance corporation, which can be a step towards an integrated approach to a perfect healthcare system.

"Bankers say hospital finance is their last priority. Breaking even has longer gestation periods in the healthcare industry. There is a need to understand how hospitals function. Unless that is understood, funds will never be forthcoming, especially in a country like India where one is funded either by political influence or when it involves vested interests of the issuing authorities," he adds.

He feels that the health business in India isn't as healthy as it should be, as there is no clear direction to the health delivery system. "Primary healthcare should be the task of the government. Tertiary care must be given to private players. In India, we need to develop the concept of home physician to take care of, say, 200 families of an area. We are unable to tackle the problem from the grassroots levels. Most village hospitals are very tardy in their management. People are afraid of government hospitals even though they are equipped well."

Kamle emphasises that all healthcare institutions should aim at providing the best services. TQM and accreditation are extraordinary management tools for organisations, including healthcare institutions, to survive and thrive in an era of globalisation.

Yet, as he cautions, technologies, tools and standards are not necessarily transplantable. While some need certain modifications before implementation, some may not be adaptable at all.

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