Sunday, August 23, 2009

Naresh Trehan, brain behind ‘Medicity’: Interview and few thoughts on it

Naresh Trehan, an eminent cardiologist and the brain behind the Medanta Medicity project has answered questioned from a variety of people in the Indian Express this sunday. Following is the short summary on a few items that he has talked about along with my personal views on them.
  • On the motivation behind creation of medicity:
Creation of a healthcare facility that is patient driven, than target driven. A health care set-up which maintains a high level of transparency, in its governing practices, billing systems and patient outcomes. Also, on top a health care facility that is world standards but still accesible to the possible widest strata of the society and not just a select few.
  1. His mention about publicizing patient outcomes and maintaining atmost transparency on this is a very important thing. Infact, he also mentioned that the outcome studies needed to be presented with a local context. Let me share a personal experience of mine, to better understand this point.
Once an aunt of mine had fractured her leg and there was a blood cot in the knee. We initially took her to a hospital to get the diagnosis, but for a variety of reasons we did not want her to be treated there and decided to move her to a bigger hospital in another city. Trying to hold us in the same hospital, the doctor told us about the risk involved with clots, that they have a tendency to move and can lead to brain stroke or cardiac arrest. We were scared of moving her from that places due to the risk. I then called up our family doctor and enquired about the risk involved in moving her. He said, there is definitely a small% risk involved, but I have not experinced in my medical carrer a patient where the clot due to hurting the leg has moved and led to a cardiac arrest, but you cannot come and blame me tomorrow if such a thing happens in your case because there definitely is a chance, but a chance event that I have not come across in my 15years of medical practice. So putting a statistical data into a context was re-assuring for us to evaluate the risk vs benefit that we gain by taking that risk.

Also on the target driven health care, unfortunately due to the heavy corporatization of the health care facilities in our country, doctors are functioning based on set target of having to accomplish a certain number of surgeries and whole lot per month to show corporate results. I hope this motivation as outlined in this inititaive will set a role model for other hospitals.

  • On the issue of affordable health care:
On a related note, he states that many of the medicinal practices that are followed in the country(on diagnosis, treatment approaches) are blindfoldedly followed based on the data available in the west. This is also an area where he states that MediCity would standout of the rest. I do not know whether use of indigineorus technology, and integrating other indian medicine practices also fir into his goal on affordable health care.

He says lot of health care cost burden can be brought down through dealing with it in the prevention phase. And the use of mobile health disbursal system to adress the rural health care needs.

I think his suggestion that satellite mobile medical mission with the help of qualified doctors instead of rural posting makes a lot of sense.

As regards the accountablity of the doctors his opinion was that doctors should be included in the professional regulatory body.

No comments: