What Makes a Hospital Great

We are finally on the last day of the year and the decade too. This is usually a time for reflection and I too have been thinking about my good fortune in never having been admitted to a hospital so far. God has indeed been kind and merciful. However, while I have been able to avoid a visit to the hospital so far, I have spent most of my working life and almost all of the last 10 years roaming the corridors of hospitals all over the world. This has been a great privilege for someone who isn’t even a clinician. I have been a part of teams trying to create wonderful hospitals that patients would love to come to. This quest continues with the realization that patients do not love to go to any hospital, whatsoever. They go there under the force of circumstances and are keen to return home as soon as possible.

So, what would constitute a hospital that one wouldn’t mind going to if the situation so demanded? Here are some thoughts.

The first and foremost is the obvious. The hospital must have great clinical expertise. This essentially means that the hospital should have a great set of clinicians well trained and experienced in their areas of medicine. It should also be equipped with some of the best medical gadgetry to allow the medical wizards to treat patients safely and to the best of their ability. This is relatively easy to achieve. The really difficult part is to get the great clinicians and the nurses and everybody else who delivers care to work together in the best and abiding interest of each patient. It takes years for a team to tango together. Large, successful hospitals are busy places, filled with thousands of patients demanding attention and care round the clock. For most patients a hospital visit or a surgery is perhaps a once in a lifetime experience. For busy clinical teams, scores of patients everyday is the norm. In all this a great hospital would be one where care and attention is lavished on each patient as she is the only one under their care that day.

Apart from providing great medical care, I would truly treasure a hospital that talks to me as a partner and treats me as an equal stakeholder in my own care. Very often this is a neglected area in most of our hospitals. Rarely, clinicians take the trouble to explain to the patients the medical conditions they have been diagnosed with, the treatment plan, the prognosis and the complications that may arise. There are many reasons for this – doctors are extremely busy juggling multiple balls all the time, do not consider this conversation as very important one, believe that patients do not have adequate medical knowledge to benefit much from this discussion and some, dare I say, are just not trained to address all the queries the patient may have. In a great hospital, medical teams must spend time with each patient, explaining and answering their questions as best as they can and with candor, empathy and respect.

There is something else that as a patient I rarely get to see or know but is absolutely critical for my well-being. This is the effort and investment a hospital makes in ensuring patient safety. Hospitals are inherently dangerous places teeming with germs and instruments, which are used for jabbing, invading and cutting open patients. Of course, all this is done in a controlled and highly sanitized environment, yet chances of someone slipping somewhere, making a grave and maybe an inadvertent error is always round the corner. The trick is in trying to eliminate these errors as far as possible through technology and stringent process controls. Ultimately, patient safety is an organization wide effort to establish a culture, which looks at learning from mistakes all the time. Great hospitals are obsessive about patient safety and treat even the smallest transgressions with utmost seriousness. To them nothing is more important than ensuring that the patient comes to no harm in the hospital.

Everything else to me in a hospital is a given. I would expect the hospital to be clean, the food to be of decent quality and served on time, the air-conditioning to be working well, the nurses to be responsive and the staff pleasant. I would greatly value efficiency in a hospital and wouldn’t like to wait endlessly for things to get done. I do expect the hospital to transparently charge me for its services and make a reasonable profit for its share-holders. A great hospital is also one, which does all of this effortlessly and as a matter of course.

As the new decade begins, I would certainly hope not to land up in a hospital in the next 10 years too. Yet, if it becomes unavoidable, I would certainly want to be in a hospital, which does all of the above rather well.

Here is wishing all of you a wonderful new year, filled with good health, happiness and much joy.

The views expressed are personal

When Journalists Pronounce Patients Dead

Quite often these days one comes across screaming media headlines about hospitals keeping dead patients alive on ventilators and other life-support paraphernalia. The headlines almost always accuse hospitals and doctors trying to make more money by keeping the patients in the hospital, even when the chances of their survival are minimal. Strangely, they always mention that the patient is already dead and the hospital is treating them unnecessarily.

This has always left me wondering as to how the journalists filing these reports and the media-houses publishing such drivel know that the patient is alive or dead. Since when have we handed over the responsibility of declaring people dead to journalists? Many of these worthies wouldn’t even know how to record a pulse, leave alone pronounce people dead. Yet, the media-houses carry these stories with aplomb, merrily destroying reputations and widening the gulf between the patients and the hospitals.

The laws in India on this are clear enough. Hospitals cannot withdraw life-support from a patient, howsoever sick he might be just because the patient’s families believe that there is no further chance of the patient’s recovery. The patient’s families often find themselves in a difficult situation wherein the patient remains alive on life-support in an ICU, with very slim chances of survival and the hospital bills keeps mounting. I can understand their dilemma well, to them it may appear that spending large amounts of money, when the patient has a very poor prognosis is futile. The attendants start pressurizing the hospital to hasten the inevitable. This is of course completely illegal and hospitals usually do not comply with these requests. This leads to bad blood between patients and hospitals, media gets called and accusations of making money by keeping the dead alive fly thick and fast.

With the media pressure mounting, the hospitals are forced to waive-off their charges and suddenly, hospitals find themselves in a better place. Patient’s angry relatives are no longer as difficult, they suddenly have a better ”understanding” of the hospital’s compulsions and they now urge the hospital to do whatever they can to ensure that the patient’s suffering is minimized. This drama plays out in our hospital corridors quite often.

Media’s role in this is quite suspect. They deliberately publish inflammatory and baseless reports of the dead continuing to receive treatment. They rarely carry statements from the treating doctor, even if they do, these are tucked away or played out in a manner that does little justice to the treating clinicians. The only objective is to put pressure on the hospitals and get the concessions for the patient and paint the hospital as the devil incarnate.

Hospitals can avoid this by taking a view that when patients are so sick that they have no chance of survival, they would on their own waive off their charges till the inevitable happens. This, of course, hurts their revenues and it isn’t really fair to them to continue providing a service free, but there is hardly a choice here. The inevitable media hoopla, which is far more unfair and even damaging can perhaps be avoided in this manner. They also have an opportunity of earning goodwill from the relatives of the patients, who one assumes would be grateful for this help in difficult times.

The other alternative is really a change in the laws of the country, which in a manner of speaking is underway. Do Not Resuscitate (DNR) guidelines have been given legal form through a judicial pronouncement. These though still remain nebulous and much more needs to be done to publicise the new laws, at least a good beginning has been made. Laws regarding the end of life care need to be framed with complete clarity and any loopholes regarding potential misuse must be plugged.

Till such time, this happens, doctors and hospitals will continue to be at the receiving end of a biased media in search of lurid stories and patient attendants, who see little point in continuing to pay for a relative who is unlikely to make it.

The views expressed are personal











The Myth of Overcharging in Private Corporate Hospitals in India

Why is it so easy for us to believe that corporate hospitals ‘overcharge’?

If one was to poll educated, middle-class Indians, mostly professionals and smart and rational people, most would unhesitatingly aver that private corporate hospitals in India inflate their bills and take patients for a ride. If one was to ask them the same question with respect to a five star hotel, a dinner at a fancy restaurant or even an airline, where fares vary on a daily (and sometimes on an hourly basis), the answer would usually be that, yes they are expensive, but than they do offer certain comforts. I am yet to hear someone moan about a luxury hotel, overcharging.

One of the reasons for this perhaps is because expenditure on healthcare is almost always a forced expenditure. No one goes to a hospital to enjoy a few days of surgery, rest and recuperation. We spend in a hospital only because we do not have a choice. This expenditure is also usually unplanned, which means that it is an unwelcome drain on one’s savings. Thus, we hate to spend in a hospital, anyways.

To make matters far worse, the expenses in a hospital are also uncertain. They also do not guarantee the desired outcome. Thus, it is possible that in a hospital we may end up paying far more than what was initially indicated and we may also end up not fully regaining good health. Sometimes, we may end up paying an obscene amount and also lose a loved one. In these situations, it is almost certain that we will blame the hospital for ‘overcharging’ and not providing proper care.

Then there is the old inherited belief that healthcare is a noble profession and the providers of healthcare services should aim to serve the society rather than try and make some profits for their shareholders. This belief is so ingrained in our psyche, right from our childhood, that it is impossible to reconcile to the present day reality of private healthcare is as much a business as any other. An entrepreneur invests a very large sum of money upfront in creating infrastructure, buying state of the art equipment, hiring highly skilled and experienced clinicians and sustaining cash losses for many long years before he makes a profit. Yet we grudge him this and believe that since he has chosen to invest in healthcare, he must continue to serve humanity without expecting a reasonable return on his investment.

This sadly is the perceptual reality of private healthcare even amongst the well-educated, well to do people in our contemporary society.

Juxtapose this with the reality of high-end quality tertiary care in India being the cheapest in the world. Thousands of people travel from all across the world to avail of India’s high standards of healthcare at prices, which by global standards are almost unbelievable. Yet, in India, private healthcare institutions are reviled as expensive, profiteering and seen as overcharging. I remember meeting a CEO of a private insurance company in the US. The meeting happened at a global conference on medical value travel.

‘So, where are you folk, from’?

‘We are from New Delhi, India’.

‘Aha, India, so tell me something about your hospital’

The usual spiel about the hospital followed. I talked about some great work we were doing in Cardiac Surgery.

‘So do you guys do ‘bypass surgery’

‘Yes, we do. In fact a lot of it’

‘In a month, how many cases, would you be doing in your hospital?’

To keep things simple, I told him that in just one hospital we do about 10 surgeries a day. The gentleman clearly thought I had no idea of what I was talking about.

‘That seems a lot, how much does a bypass surgery cost?’

I thought, I should not tell him the real cost of USD 4500, lest he thinks that I was completely unaware of the cost of a bypass surgery.

‘Sir, we charge USD 10000 for the surgery’.

‘Well, that is impossible, it is humanly not possible to perform successful bypass surgeries for USD 10000 anywhere in the world’.

‘So what is your success rate?’

‘Well, it is close to 99%’.

‘That is simply impossible, we don’t have these kinds of numbers even in the US’.

I hesitatingly asked him, what in his opinion, would be a reasonable estimate for a bypass surgery in the US.

‘Well, I would say anything below USD 100000, would be difficult’.

‘But, you just can’t do this for USD 10000, there must be a catch somewhere’

By now, I was becoming a little hot under the collar. I told the gentleman, that we would be delighted to host him at our hospital in India and show him how the impossible is done. He would still not believe me.

Finally, I told him that just as he doesn’t understand, how the surgery can be done for USD 10000, I fail to understand, how does it cost upwards of USD 100000 in the US.

The gentleman never did accept my invitation to travel to Delhi to see how we worked. This is a true incident, and I narrate it only to underscore the point that while the world wonders at how private healthcare in India is able to deliver high-quality medical care at such low prices, patients in India, believe that the same healthcare services at even lower price points are obscenely expensive.

Private healthcare costs, though rising, still remain one of the lowest in the world. Large corporate hospitals have well-defined billing policies and most of the bills are generated through a sophisticated HIS system. After having worked for over 15 years in large private corporate hospitals in India, I am yet to come across a stated (or even unstated) policy, which says that let us overcharge for our services from our patients. The pricing is usually based on a cost-plus model and the ceiling is determined by the competitive situation in a particular market. Finally, the consumers always have a choice. If they find a particular hospital expensive, they can choose to go to the one that they believe is rightly priced.

Private corporate hospitals in India usually provide world-class care, medical outcomes comparable with the best in the world, highest possible service levels and at prices lower than anywhere else in the world.

By clamoring for more, let us not destroy that we should all be rightfully proud of.

The Importance of the Culture of Caring

Last year my father was diagnosed with cancer. The doctors devised a treatment plan, which included chemotherapy and radiation therapy. As a caregiver, I had to take my father to the hospital for his radiation sessions. I opted for an early morning slot, which would have us in the hospital at around 7 every morning. I would drive up to the porch of the hospital, find a wheel-chair, get him on the chair, leave him for a while to go and park my car and would wheel him over to the radiation department for his sessions to commence. While, the hospital employed General Duty Assistants (GDA’s), who would normally wheel patients around the hospital, their duty hours began from 8 in the morning. My routine lasted only a couple of days as I soon discovered helpful hospital security staff, who would happily wheel my father as I went to park my car.

This simple act of caring and kindness spoke eloquently about this hospital’s shared culture. Here, even the security guard at the hospital’s door exhibited behaviour, which showed that he and the hospital cared. Thus to me, he repeatedly demonstrated that in the life of the hospital, it is not only the medical folks, the doctors, the nurses and the paramedics that deliver care, it can almost be anyone.

I believe for a hospital to be successful, it is imperative it has a culture of ”caring” ingrained in its very DNA. A hospital apart from being a repository of cutting edge technology, monumental medical knowledge and expertise must essentially be a caring institution. It is true that one goes to a hospital only when laid low by a debilitating illness, that one often needs the high-end diagnostics and surgical technology that modern hospitals are crammed with, the fact remains that more than anything else, one craves for great care during this period of uncertainty.

This is largely because most patients do not understand the intricacies of their scans or the technical difficulties of their surgeries, what they do understand are simple gestures of caring and support at a difficult time in their lives.

Healthcare organisations must aim to build a distinct culture of caring. This is far easier said than done. A culture of caring must flow from the top. Every individual in the organisation must understand that aside from whatever role they have in the hospital, the biggest role that they all have is to care for the patients in the hospital. The medical folks of course grasp this naturally, they are trained to care for their patients and they are also at the forefront of the delivery of care in the hospitals. However, it is not all that easy for others. The senior management team of the hospital, must ensure that there is clear communication down the line to everyone that they have a role to play in patient care.

The hospital leadership team should also step up and demonstrate their roles in patient care. The hospital policies formulated by the leadership team should have patient care policies right at its core. The patient care initiatives should be highlighted and communicated often, and those who go the extra mile in caring for the patients should be recognized and rewarded without hesitation.

Everyone who works in the hospital should fully understand what is expected of them vis-a-vis patient care. The folks at the front office should know that they must speak with the patients politely, demonstrate caring by helping and guiding patients to various part of the hospital. The F&B service should understand that they can demonstrate care by ensuring that the food served is piping hot, tastefully presented, delivered on time and served with a smile. An extra portion of desert for a patient with a sweet tooth (and of course no Diabetes!) will also help demonstrate patient care. The house-keeping detail too can underline care by keeping the room spick and span and by dusting the corners and those hard to reach places, that hide many unseen specs of dirt.

The most important element in building a culture of caring in the hospital is by communicating. Nothing showcases the culture of caring better than a little chat, whether it is the doctor stopping by for one after her rounds, or a nurse delivering a message of hope as she goes about her work. A GDA can demonstrate care by engaging with the patient as he wheels him around the hospital, a billing clerk can do so by explaining the components of the bill and listening to patients, who believe they have been over-charged and even a valet parking service attendant can demonstrate caring by bringing over a shiny car, when the one he received from the patient was caked with dirt.

A culture of caring is also rooted in a culture of empowerment. As far as patient care goes, every individual in the hospital should be empowered to act and help deliver great care. There should be no ifs and buts here and those so empowered must clearly know, without an iota of doubt that as long as their actions  result in better patient care, they will only be appreciated.

All good hospitals know that their success and even their profits are derived from the care that they deliver. A culture of caring and empathy must be a  hospitals most cherished and enduring asset. Unlike everything else, it can not be bought, it has to be built, brick by brick, over a long period of time and then it has to be zealously guarded from complacency, which often is, ironically a by-product of the hospital’s success.

The Healthcare Marketer’s Life

Yesterday evening while I was returning from work a friend called. He has recently taken over as the Head of Marketing Communications at an upcoming hospital. I had met him a few weeks ago to congratulate him on his new assignment and he seemed quite kicked about his new role. He had grand plans of changing the way the hospital communicated with its patients and other stakeholders, he wanted to run customer facing programs, drive relationships with patients through effective engagement and deliver uniformly great experiences to those who touched the hospital.

Yesterday over the phone Ajay felt he had made a big mistake by joining the hospital. I was quite flummoxed by this turn-around. Further inquiries revealed a familiar story. The hospital has a brand new CEO, someone who has worked for many years in hospital operations but have no knowledge or appreciation of communication. However, like most folks he too believes that marketing communications is hardly something to be left to experts. In fact the CEO believes that he knows exactly how a piece of advertising or a brochure should look like. Download the text from the web, adapt it by rewriting some of it, slap a few images downloaded from the net and include the mandatory images of some if the hospital doctors, run it past a few senior hospital bigwigs and, voila the ad or the brochure is ready. As far as hospital signage are concerned, the CEO feels that they really are meant to provide legible directions to the patients and fussing over them, their aesthetics and design is a gross waste of time, energy and money. Well I might be exaggerating a little here but this is really the long and short of what Ajay felt his CEO was doing and no wonder he had started feeling frustrated in the set up.

Marketing folks in hospitals always grapple with the problem of every one who is anyone coming up and advising them on how to create a piece of communication. Some doctors love to see their pictures in the ads and some other feel great if gory images of them operating heroically could be included in the communication. The CEO’s love to mutilate the advertising copy, insist on correcting perfectly well written text, increasing or decreasing the font and of course having the logo bigger, bolder and always 2mm to the right! Many a times the marketing communication executive has to sweat many hours trying to accommodate the conflicting wishes  of the CEO, the star surgeon and his favourite flunky. All in a day’s work for the intrepid marketing guy, who can be forgiven for wondering if he is the only one who knows nothing about marketing communications.

Those who have worked in hospitals long enough know how to maintain a fine balance. They will wait till the last-minute, before asking a doctor to go through the text and approve the ad, they will sneak it past a doctor who they know is not too interested in the brochure’s finer details, they will get the mailer made and when a livid doctor would approach them on their failure to show it to him, they will deftly show an e-mail sent a few days ago knowing fully well that the doctor rarely checked the mail. Tricks of the trade, which one learns on the job.

Well, while all this may sound hilarious, the fact is that a hospital marketer’s life is not easy. If the hospital is doing well, his budgets are the first to be cut (why do we need to spend money on advertising, we have hardly a bed to spare!) and God forbid, if the hospital is not doing too well, the marketer knows that the hospital can hardly spare cash to blow its own trumpet. The doctors and particularly who head various departments are always after his life to see their ads in the newspapers, whether the marketer has the budget for such advertising is of course none of their concern. The CEO is always looking to pinch a few more pennies from a meager budget and he insists on stretching the money to impossible levels.

Such is than the life of a healthcare marketer.

Usually, in all this the silver lining is a boss, who understands the inner dynamics of the hospital, who knows how to work with medical folks without unnecessary confrontations, who lets the marketing guy go about his job without much hindrance and steps in to resolve conflict as it arises. He is the one who understands the aspirations of a good marketer as well as the concerns of the medical folks in the hospital and strives to achieve a balance.

At the end of the day, and in like most other things in life, a fine balance is the key.




The Perils of Standardized Health Care

Can healthcare delivery be standardised? This is the question, which has been bothering me this week.

The thought itself was triggered by a report in ‘Mint’ earlier this week titled ‘Government plans common healthcare standards’. (http://www.livemint.com/2010/08/24233218/Govt-plans-common-healthcare-s.html)

While the report portrays the benefits of standardization of care with millions of patients receiving standard care prescribed by the government thus saving them from being shortchanged by unscrupulous doctors and mercenary hospitals, there is also a flip (and a more real) side of the argument that we must understand.

While the government pushes through the Healthcare Standardization agenda, one wonders how can the delivery of healthcare be standardized across all medical facilities in the country? Every individual is different, reacts differently to treatments, the doctors are required to take decisions based on their experience and training and not on the basis of a set of guidelines decided upon by the government. If I was to fall sick, I would want my doctor to treat me based on his knowledge and experience and do what he feels is the best for me rather than stick to a standard set of guidelines mandated by the government. All doctors and medical establishment should have one guiding principle – the interest of the patient must be supreme and if there is a situation of uncertainty, I would want my doctor/hospital to always err on the side of caution.

Also, the healthcare delivery model in the country is hugely diversified. In its current form with poor regulation and monitoring it just does not lend itself to any standardization of care.The government-run tertiary care hospitals in large cities are filthy and over-crowded with patients and over-worked and under-paid doctors. The government run district hospitals as well as Primary Health Centres are even worse off with out dated equipment, poorly trained doctors, who often do not even show up for work. The private healthcare is dominated by secondary care establishments (usually called nursing homes), which have 10-50 beds and are usually owned by a doctor or a group of doctors. These are mostly mom and pop establishments, where owner doctors reign supreme and are answerable to none. Quality of care in these establishment is of dubious standard and these are neither properly regulated nor monitored vis-a-vis outcomes or treatment protocols. Christian missionaries and other charitable institution also run a large number of hospitals and now we have a nascent category of corporate style hospitals coming up in large cities offering cutting edge care. My point-all these hospitals are differently equipped, have differing goals  (for profit, non-profit, govt. owned etc.), have vastly different resources at their disposal, have different cultures and widely varying medical expertise available to each of them. How on earth can they all provide standardised, similar quality care to their patients?

Last December my father underwent a prostate surgery in a hospital in Delhi. Elderly men usually require this surgery at some point in time in their lives. Now, while I researched the treatment options for him and took surgeon’s opinions I discovered that we had several options. Our surgeon felt that the best and the safest alternative for him would be a laser surgery involving a cutting edge holmium laser. Now, this option is not available at most of the hospitals even in a city like Delhi, thus it can safely be ruled out from the ‘standardised treatment guidelines’ that are being framed by the government. In a situation like this, will it mean that patients like my father will be denied this option and he will have to endure the conventional surgery with its attendant risks of infection, excessive bleeding and a much longer hospital stay?

Let us now also look at the genesis of all this.

The health insurance companies (mostly state-owned)  want treatment protocols for some common diseases to be standardised so that they can fix a rate for these procedures, irrespective of the hospital and the doctor one chooses to go to. For the insurance companies this will lead to a state of nirvana, as they would be required to pay a fixed lump sum to the hospitals irrespective of the bill a patient runs up. They can then squeeze the hospitals further and make greater profits. Now, I am not against profits, however the problems that I see in this arrangement is that the patient will suffer, the quality of care will go down as hospitals will try to manage the delivery of care with in the financial limits set by the insurance companies (after-all they also need to be profitable). This is clearly hazardous.

One buys a health insurance cover  to ensure that in the time of need, financial constraints do not come in the way of accessing the optimum quality healthcare. The operative words here are ‘optimum quality’ and not ‘standard quality’ as mandated by the government. To equate these two will be a great folly. If the insurance companies believe certain hospitals are taking advantage of the situation by excessive billing (which I submit happens), they must put in place strict monitoring mechanisms including peer group reviews of treatment provided by the hospital. A healthcare regulator needs to be set up by the government to arbitrate between insurance companies and the hospitals. The regulator can possibly frame broad treatment  guidelines, which can serve as references in case a dispute arises between a patient, the hospital and the insurer.

Standardizing treatment protocols in a healthcare environment as complicated and as unregulated as ours is a dangerous and mostly an impractical idea. We need to first standardize our healthcare delivery systems before even thinking about standardizing treatment protocols. Paying hospitals based on these standardized treatment protocols because it makes health insurance companies profitable is inviting hospitals to cut corners. Once this happens, it will lead to serious erosion in the quality of care and even more  importantly a big trust deficit between patients and hospitals will emerge.

That would really be the ultimate irony, for if a patient does not trust his doctor or hospital, he really would have nowhere to go.

The Necessity of Sunday OPDs

The other day a colleague called on a Sunday morning. He was hoping to meet a doctor in a hospital OPD and was seeking directions to the hospital. The colleague, whom I will call Sanjay here, had recently joined work and was for some reason feeling a little under the weather. Nothing serious, but the usual stresses, which are so familiar to sales people in the month of March. When he shared his symptoms with me, I advised him to see a doctor and on this Sunday morning he was headed to the hospital.

However, much to his dismay I informed him that hospital OPD’s are generally closed on Sunday mornings and he might as well head back or he was really unwell he could visit the emergency services. ‘Listen, I really do not think I need to go to the ER, can you help me find a hospital, where in a physician can examine me, check my BP and hopefully start me on some medication that can take care of my niggling symptoms?’ hollered Sanjay over the phone.

Here is why I believe Sunday OPD’s are a great idea.

Most people like Sanjay, who lead busy overworked lives find it difficult to take time off from work and visit their physicians, particularly for small niggles except on Sundays. A lingering cough, a bad cold, a running nose, a painful joint, a niggling back ache are pretty much part of the power packed 9 to 9 week. Most people ignore these or try self medication to keep going till the weekend. (I know they shouldn’t, but they do). If things haven’t taken a turn for the better by then, Sunday mornings are the time to see the doctor. Thus, for a hospital running Sunday OPD’s, would mean offering a great convenience to its customers.

Saturdays are generally the busiest in a hospital. The simple reason is that in many work places, Saturday is a holiday and customers get an opportunity to visit the hospital to see their doctors, get the pending diagnostic tests done, get the physiotherapy they need and attend to their own and their families healthcare needs.  For the same reason, Sundays can be even busier.

While I worked at Artemis Health Institute in Gurgaon, we had started doing a “Public Forum’, on Sunday mornings. This involved inviting our customers and pretty much the public in general to come to the hospital and listen to doctors discuss common medical conditions in layman’s terms. Post the presentations we had an interactive session, where the doctors took questions from the audience. The sessions ended with brunch, which afforded opportunity for people to interact with the doctors one on one. When the idea was first mooted, I must confess, I was not sure of the kind of public response to expect. My fears evaporated on the morning of the first day that we held the forum. We had a house-full with people standing in the aisles of the 270 seater auditorium we had in the hospital. We not only generated a full-house, we also generated lots of goodwill from the local community.

Thus Sunday OPD’s are not only a revenue opportunity, they also are a wonderful opportunity to generate the goodwill of the local community. It is also an opportunity for the hospital to communicate that it cares.

With all this going for a Sunday OPD, why do hospitals are still chary of having a full-fledged Sunday OPD?

The answer is that they can not get the doctors to come out and work on Sundays. Most doctors love their Sunday mornings as much as you and I do and hate to work (just like you and me, I guess!) Sundays. Hospitals have tried cajoling and even forcing them to attend to Sunday OPD’s but have met with no success. They have offered other weekdays as holidays in lieu of Sundays, which too hasn’t worked.

The only way to convince the doctors to do a Sunday OPD is to convince them of its immense value both from a business as well as a customer need point of view. The hospitals must also make it worth the while for the doctors by handsomely rewarding them for attending OPD’s on Sundays. Last but not the least the hospitals must spend big bucks in marketing the Sunday OPD’s. Once the patients start trickling in, the doctors too will not mind spending their Sunday mornings in the hospital.