Private Hospital Standards
One of the circle members Shri Nitin Gupta had shared these inputs in Health circle of Delhi NCR. The same may be considered for making hospital standards by BIS.
A) Information and transparency : it should be mandatory for all hospitals to publicly disclose the following :
- how many doctors have referred patients to them and what % of revenue has been paid to doctors in the form of referral fees (by whatever name called and in whatever form paid).
- how many doctors are paid variable pay basis business they generate and what is the % of revenue
- how many free beds are allocated and how many patients have been treated from economic weaker sections on a daily basis and what is the total revenue earned from EWS patients in any form whatsoever.
- corporate structure of a hospital and business entity associated with it, with clear linkage between asset ownership and revenue etc. And how the profits are distributed / retained between the trust and business entity
- the share of revenue incurred from insurance (all hospitals lobby with insurance companies to get their rates approved at the highest level) and how much is walk in and from CGHS (most hospitals have differential rates for CGHS as they get only that much from govt)
- how much beds are charged higher due to higher category and how much extra is charged to higher beds category on account other than room rent (why should doctor fees be different for different room categories ??? )
- there can be several other specific disclosure requirements which can be identified and a hospital entity shall be obliged to file a social responsibility report along with their annual report)
- if any fees is paid or received by doctors or hospitals to any lab, the same needs to be reported. Every lab also needs to disclose referral fees paid to doctors
B) Peer review system- in this system, every case should be obligated to be referred to another team of doctors from an other hospital if the patient demands for it after the treatment is completed. In the event the treatment is found to be unnecessary or flawed, then not only the entire money shall be refunded but criminal action can be initiated in case of loss of life etc. This should be applicable and available in 100% of cases to the smallest to largest cases
C) Doctors shall not be allowed to prescribe medicines by the brand name, they should only be allowed to prescribe the medical name (salt etc. For example they can only prescribe paracetamol and not the brand). Likewise no hospital can make buying the medicines, medical consumables or surgery consumables compulsory to be bought and provided by hospital. Every patient to have a right to buy from where ever they want to buy the same.
D) THIS IS THE MOST IMPORTANT AND RELEVANT SOLUTION: Break the nexus of doctors and hospitals. In most countries, hospital companies are allowed to work only as infrastructure providers and any doctor can come and perform in the hospital based on patient request, wherein patient hires the hospital for infrastructure and have a separate arrangement with the doctor for medical treatment. Doctors are not allowed to disclose the fees charged to the patiento, to any hospital and vice versa. And patients can choose any doctor and any hospital in any combination. So very clearly medical and administrative aspects of the hospital are completely de linked. Singapore, South Africa and many other developed countries follow this model.I can even choose best doctor in the city but an average nursing home or even govt hospital to get the treatment and neither hospital nor the doctor can refuse it. more
A) Information and transparency : it should be mandatory for all hospitals to publicly disclose the following :
- how many doctors have referred patients to them and what % of revenue has been paid to doctors in the form of referral fees (by whatever name called and in whatever form paid).
- how many doctors are paid variable pay basis business they generate and what is the % of revenue
- how many free beds are allocated and how many patients have been treated from economic weaker sections on a daily basis and what is the total revenue earned from EWS patients in any form whatsoever.
- corporate structure of a hospital and business entity associated with it, with clear linkage between asset ownership and revenue etc. And how the profits are distributed / retained between the trust and business entity
- the share of revenue incurred from insurance (all hospitals lobby with insurance companies to get their rates approved at the highest level) and how much is walk in and from CGHS (most hospitals have differential rates for CGHS as they get only that much from govt)
- how much beds are charged higher due to higher category and how much extra is charged to higher beds category on account other than room rent (why should doctor fees be different for different room categories ??? )
- there can be several other specific disclosure requirements which can be identified and a hospital entity shall be obliged to file a social responsibility report along with their annual report)
- if any fees is paid or received by doctors or hospitals to any lab, the same needs to be reported. Every lab also needs to disclose referral fees paid to doctors
B) Peer review system- in this system, every case should be obligated to be referred to another team of doctors from an other hospital if the patient demands for it after the treatment is completed. In the event the treatment is found to be unnecessary or flawed, then not only the entire money shall be refunded but criminal action can be initiated in case of loss of life etc. This should be applicable and available in 100% of cases to the smallest to largest cases
C) Doctors shall not be allowed to prescribe medicines by the brand name, they should only be allowed to prescribe the medical name (salt etc. For example they can only prescribe paracetamol and not the brand). Likewise no hospital can make buying the medicines, medical consumables or surgery consumables compulsory to be bought and provided by hospital. Every patient to have a right to buy from where ever they want to buy the same.
D) THIS IS THE MOST IMPORTANT AND RELEVANT SOLUTION: Break the nexus of doctors and hospitals. In most countries, hospital companies are allowed to work only as infrastructure providers and any doctor can come and perform in the hospital based on patient request, wherein patient hires the hospital for infrastructure and have a separate arrangement with the doctor for medical treatment. Doctors are not allowed to disclose the fees charged to the patiento, to any hospital and vice versa. And patients can choose any doctor and any hospital in any combination. So very clearly medical and administrative aspects of the hospital are completely de linked. Singapore, South Africa and many other developed countries follow this model.I can even choose best doctor in the city but an average nursing home or even govt hospital to get the treatment and neither hospital nor the doctor can refuse it. more
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Suggestions under'A' above can never be accepted as such acts are illegal and punishable under law. Other suggestions are good and if accepted will go a long way in bringing transperancy in medical line and giving substantial financial relief to common man followed by quality services, more
May 07
TAKE THEM TO COURT.Sent from my Samsung Galaxy smartphone. -------- Original message --------From: RN Chopra Date: 5/3/19 09:04 (GMT+05:30) To: v_kumar3@yahoo.com Subject: "Private Hospital Standard..." more
May 06
The compliment box is for patient redressal of issues during admission. more
May 05
Somewhat confusing to me! Admiring or praising a redressed issue in a Compliment Box could be after the discharge of a patient. A redressed issue is a grievance/complaint a patient or attendants experience at the time of admission in Emergency Ward/Patients' Ward. And, nobody from the hospital services would make available the Compliment Box to the patient to write a grievance or complaint so easily.
At the most, the hospital staff may advice in a format to the patient or attendant to give a feedback on the experience one had from the time of admission to the time of discharge, which is not a redressal of issue but the one for awakening of the hospital management to attend to the feedback on priority. more
At the most, the hospital staff may advice in a format to the patient or attendant to give a feedback on the experience one had from the time of admission to the time of discharge, which is not a redressal of issue but the one for awakening of the hospital management to attend to the feedback on priority. more
May 05
I do not understand why the term 'practitioner' is being interpreted for a trainee or an intern and not a professional after having attained the degree of MBBS (a General Practitioner - a "jack of all trade" in medicine). After MBBS one does a post-graduation in a special subject, say, Gynae, with a MD Degree, and is a specialist (not called perfectionist as this is a subject on which nobody can claim to be a perfectionist). Please, do not bring in any confusion in these terminologies. Insofar as the referral cases are concerned, all cases referred to by a doctor from a government hospital or a private hospital, say, from Lucknow or Patna to the All India Institute of Medical Sciences in Delhi, must give reasons of incompetency of the hospital administration and or the treating doctor over and above whom there is none to supervise and guide locally. While doing the referral the discharge sheet from the treating hospital doctor must also give the details of the expenditures incurred by the patient-attendants including the fees till then. more
May 04
dear Mr Chopra: Are u in India or elsewhere..??.. what ever u have suggested, is all well and good but - how will it work in Indian conditions..??.. Doctors do not allow you or your relatives to even look at the " treatment analysis " pad, left near each 'in patient' in a hospital. In fact, in some big private hospitals, the relative of a 'in patient' is not allowed to be near the patient's bed, when the attending doctor is on his/her daily rounds. They are advised to talk to the doctor privately and seek clarifications when the doctor is in his chamber. Half the time, the doctor does not bother to explain to the patient or his/her relative, the course of treatment. Health is a State subject and hence, the State Govt. should take strong steps to bring some control over the unfortunate happenings in the Hospitals set up but, they keep quiet because the hospitals are under the management of some very big and powerful person of the ruling party. more
May 04
