Private Hospitals in Delhi - Input on Solutions

Below is the list of key issues and their root causes at private hospitals in Delhi as outlined by you.

Kindly review them and help identify specific Solutions. We will then share the compiled whitepaper with Minister of Health and the leadership team for actions.

Dept of Health & Family Welfare

Private Hospitals in Delhi - Root Causes

1. Private hospitals are run like business houses with profit being the main focus
2. Focus is more on sales rather than customer service
3. Private hospitals use many unethical ways of working and try to keep it hidden from the patients
4. Doctors are given targets to generate revenue for the hospital
5. Private hospitals have a corrupt nexus with insurance companies
6. Lack of Government regulations to control the fees charged by the doctors in private hospitals
7. Private hospitals invest heavily on ambiance and hence charge accordingly
8. Patients treat doctors as god and keep following what they say
9. Doctors operate by invoking a sense of fear in the patient
10. No cap on the room rent charged by private hospitals


Private hospitals in Delhi – Key Issues

1. Private hospitals charge exorbitantly
2. The grievance cells in private hospitals are terrible
3. Customer complaints are not addressed properly
4. The private hospitals in Delhi lack transparency
5. Patients are asked to get admitted even if they don’t really need admission and room
6. Patients stay in the hospital is unnecessarily prolonged for additional revenue
7. Unnecessary tests are ordered just to increase revenue
8. Consultation fees in private hospitals is high and now 1000-1500
9. Room rent in private hospitals is steep
10. The rates of tests are also very high in private hospitals compared to the outside labs
11. They take a long time to admit emergency accident cases
12. Patients with insurance are charged more compared to the others
13. Patients from EWS section entitled to treatment are discouraged by making them buy expensive medicines/paperwork
14. Doctor's compensation is linked to revenue contribution in many private hospitals more  

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There is a via media - use speed post. The general availability of healthcare, countrywide, is in the private sector, thru medical practitioners, private doctors and the like. Hospitals in urban cities, whether tier I or II cater to a very small proportion of the populace that needs medical care. On a macro level, there is need to improve public health care, standards or hygience, both personal and public - all menfolk urinate in public with gay abandon ( do not complain there are not adequate sauchalayas - the women folk display far greater discipline), so that the standards of general well being community wise improve. It is precisely for the reason that medicare infrastructure does not exist in adequate capacity to meet the needs of people in general, that there is on over whelming need for improving public hygiene and public healthcare. Several studies already exist to show the gross inadequacy of medical doctors and specialists, not only currently but also in the future. The government is required to spend 3% of GDP on healthcare, but it rarely crossed one and half percent. There is simply no escape to improving public and private healthcare, and lifestyles. Over the long term the country simply cannot afford the lifestyle diseases that have made their way into our lives, cities and societies. more  
I always have a feeling - Government Hospital - give the service required by the patient - at least mentally. Private Hospital will be forced to charge 50% of Government charges. You know its simple story of supply and demand. Give better service as compared to Private hospital and that too at a reasonable rate. I am a small businessman - and I have to send lot of letters - I pay Rs. 50.00 each to DTDC but only 5.00 to Indian Post. Still use DTDC. Fist Private hospital - create confidence in the mind of patient. more  
Having worked closely with the sector, I can think of following solutions: 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  
Start Alternate therapy centres in every hospital by allowing Lions Clubs International to train school drop outs or war widows in Art & Science of Self Healing to work as complementary treatment centres. When people experience instant relief from pain, better than taking painkillers, their faith in Alternate therapies will go up. They will start treating themselves as they can learn how to depend on using methi, mung dhana and other items used in kitchen. Their expenses on medical care will go down so also of the Government. Why not give a try, after all AAP Government is of the people and for the people! more  
I am senior citizen.Can I get an appointment through Internet from Govt.Eyes Hospitals including Dr.Rajendra Eye Hospital-AIIMS,New Delhi ? more  
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