The Mission Hospital, Durgapur: Following Ethics

 

Dr Satyajit Bose

Unlike in the rest of India, super specialty healthcare in this part of the country has developed only within the city limits of Kolkata.

The demographic clinical flow of ‘elective’ healthcare would be a local consultation, followed by a referral to one of the tertiary centres in Kolkata. Most of these hospitals are unfortunately not manned by full time salaried doctors, do not stress on quality and treatment options are often guided by ‘fiscal’ end points, rather than clinical. Patients have been quick to realise this, and this has resulted in diversion of traffic more towards southern India. With so many hospitals coming up in Kolkata, with enhanced capex, they resort to a lot of strategies and promises to attract patients. More often, they are not able to adhere to the promises made. This creates an intense vicious cycle, wherein patients get diverted to distant destinations for healthcare, even for basic illnesses, and for more money. This results in a considerable drain in state exchequer. Healthcare as an industry, alone, contributes maximally to the GDP of a state. Drainage of patients elsewhere, increases inconveniences and has resulted in significant negative fiscal implications.

‘Emergency’ patients in far flung areas, are in the mercy of their own pre-decided fate and God. Qualified doctors, with inadequate infrastructure, are left with no option but to refer them to Kolkata. This creates a serious gap in patient satisfaction, both in government sector as well the private. Moreover, many perish on the way.

The Mission Hospital, was set up in Durgapur, in 2008 with certain aims of providing futuristic infrastructure, and brilliant minds behind them, with kindness,ensuring transparency of cost, and clinical protocols in line with the best practices of evidence based medicine.

Our stress has been on quality, kindness and end-point based packages. We also encouraged a policy of cross subsidy, benefitting poorer people. We ensured, that a patient coming to the OPD was greeted with a smile, had minimal waiting times, was ushered to the right place by well mannered volunteers, their reports printed within two hours and sent home with a proper diagnosis and treatment options within three hours. 99 per cent of outpatients would fall within these benchmarks. Optimal patient information and communication has been our mainstay in our success story as well.

Implementation of the pneumatic chute and PAX system has also shortened the journey from the imaging and lab department to the clinician resulting in faster diagnosis and cure.

The overall patient satisfaction has been excellent and that has led to the development of departments of excellence in the areas of cardiac surgery, cardiology, orthopaedics and joint replacement, neurosurgery, gastroenterology, nephrology, urology and kidney transplant, cosmetic and plastic surgery, critical care and pulmonology, emergency medicine etc.

We, at The Mission Hospital (TMH), Durgapur, in our five years of existence have done 5000 heart surgeries, most of them being at high risk, of which about 2000 have been complex cyanotic congenital heart diseases. The results have been at par with international standards. Similarly, cardiologists have quietly performed close to 2500 angioplasties and pacemakers without any major fanfare and publicity. The patients are admitted under the Institute of Cardiovascular Sciences, wherein cardiac surgeons and cardiologists collectively take a decision regarding the mode of revascularisation chosen.

Scores of patients have been adviced medical management who have been proposed urgent angioplasty or CABG, elsewhere, and are doing well. Every evening, there is a cath meeting, where all cases are presented and clinical decisions are taken as a collective. Pre-operative team meetings, followed by patient counselling are given prime importance for improved clinical outcomes. There is an additional operation team who looks after the non-medical needs of the patient. There is no incidence of unwanted procedures in this hospital.

About 100 critical beds in TMH cater to the entire community and this has changed the definition of critical and emergency care in the region. To maintain quality there is a training programme (Master in Emergency Medicine) in association with NSLIJU, New York.

In our country, only 0.3 per cent of people have health insurance. For the rest of the people, there is no health budget. When faced with an acute emergency, they do not have enough to pay up huge bills involved in complex procedures like primary and elective angioplasty, pacemakers and valve replacements. For this, The Mission Hospital has also set up a strategy, wherein one could make some part payment and pay off the remaining in equal monthly installments, of even less than Rs 1,000 per month. In case, the patient, expires, the heirs do not have to continue paying thereafter.

This has enabled many patients to save lives. Gradually, over a period of time, we will extend this facility to other departments as well. Till now, we have facilitated more than 800 procedures in this scheme (Christened ‘Healthy Heart for All’), and there has been no defaulters.

One of our key CSR activity has been heart surgery for children. We operate on 500 kids per year absolutely free of cost, as a ‘give back’ to society. Our motto, is not to say ‘no’ to any child suffering from congenital heart disease. We feel very empowered when we look back and realise the smiles that we have been able to bring in so many people in such a short time.

Though we are committed to provide healthcare to every individual irrespective of socio-economic back ground, we are the one of the best in the industry when it comes to financial indices.

Buoyed by the financial models and success, we have dared to scale up in newer geographical areas. We are almost on the verge of constructing another hospital in Siliguri, where we will give similar commitments. We will also start another hospital in Ranchi and a ‘Transplant’ hospital in Andal, Sky City in association Bengal Aerotropolis. In Durgapur, we will start a cancer hospital, with two linear accelerators and PET CT, whose necessary permissions have been obtained and will start construction after the monsoons.

Moreover, Dr Jaideep Bhaduri has joined the hospital as Medical Director. He brings with him an experience of 22 years with leading healthcare organisations of the country. Dr Bhaduri has been given the following mandate in his appointed role to make TMH, the preferred multi-specialty tertiary healthcare facility for patients all over the country, to ensure accreditation of TMH with bodies like NABH, NABL. He will also initiate clinical research programmes and ensure academic development of the staff at TMH with well structured programmes.

To summarise, we at The Mission Hospital are driven by clinical excellence and quality, and not by numbers and financial end points. Innovative strategies, association with NGOs and organisations have enabled us to reach out to even the lowest economic strata.

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