Thursday, January 19, 2017

Consumer is king.....but what about patients?


The Tide of corporatisation of healthcare has swept over India in the last decade. From being sanctuaries in the middle ages to being temples of healing in the last century, hospitals are now evolving into commercial centres. Patient is cast as a ‘consumer’ while healthcare professionals are ‘service- providers’. Today the hospital is designed like a factory with its staff as workers. Unfortunately, health can neither be manufactured nor be bought. In this fact lies the irony- while patients’ narcissism is massaged by advertising spiel- the larger population have not understood what to really expect. 
Consumer- patient
No human willingly chooses to become a patient. (Only exception, being the cases of psychological disorders in which persons are fascinated by doctors and treatments. Let’s leave this category aside.) For illness is an unwanted imposition to be got rid of as soon as possible. In the best cases it is treated as a character- building adversity.  So a person just happens to become a patient. A patient becomes a consumer when he chooses to ‘buy’ healthcare ‘products’. This product maybe an investigation, treatment, therapy, convalescence or palliation.
Service- providers or expert professionals
 The difference between corporate medicine and rest of corporate India is vast. Except few administrators and expert doctors all other staff are either contracted, interns, students or observers. Every corporate hospital runs its own nurses training, post graduate medical training and other courses- the students provide free or cheap labour to run the hospitals. While rest of corporate India enjoys a 5- day week, corporate hospitals work 6 days (the hospitals are manned by rotation duties. These rotations are done every 6 days with one day off). Mandatory 36 days paid leave, maternity leave, on site child care, medical facilities- are not usually given.
The problem is the problem
Common complaint against corporatisation is high expenses. This is a genuine problem and activists are working on it. Bigger concern is changing framework of illness and its treatment. The reality about illness and treatment is this- one cannot choose the illness, its timing or intensity. Similarly no patient can hope to recover by mere administration of treatment without an interest or effort on part of the patients. Corporate healthcare is trying to actively hide these facts.
Advertisements make tall claims about prevention of illness by undergoing battery of diagnostic procedures. No tests can prevent illness. If you become ill at an inconvenient time, the corporate hospital promises to give you treatment without a break in your commitments. A part of this is the active encouragement given to patients to arrive late for appointments and to not be compliant towards treatment recommendations which get in the way of their life (eg alcohol use during treatment). Has anyone ever heard of a running car being repaired? But corporate healthcare promises that to humans.
As stated earlier, health is a commodity that can neither be manufactured nor bought. A few lucky people are born with good health and continue to enjoy its benefits without much effort. Many of us are able to cultivate healthful habits. Yet for most of us illness is inevitable. Patients have to approach for help. The responsibility of arriving on time, reporting problems honestly, taking treatments as advised- is completely with the patient. Going to a corporate hospital with excellent quality ratings alone, never helps. Patients should learn to differentiate between hospital and hospitality and between treatment and pampering. In this lies the difference between a common patient and a wise one.
Conclusions
The trend of corporatisation has given a false sense of security that they will be assured of good health with payment of steep charges. But no illness can be treated just from the outside without participation of the patient. Patients should be willing to do their part of the hard work to recover, merely throwing money will get them nowhere.


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