Cos try to improve image by making staff more sensitive, addressing issues

What do Indians think about private medical care? Going by anecdotal evidence and data, the answer seems to be that they need it more and more but that they have their reservations. Some hospital chains such as Max Healthcare, Manipal Hospitals and Fortis Healthcare say they are trying hard to reduce this trust deficit.

For instance, Max Healthcare CEO Ajay Bakshi asked doctors last year to take what he calls a family test every time they prescribe anything.

"Just imagine that your action or decision impacts one of your dearest family members. If you feel uncomfortable…Do not do it," he wrote to Max doctors, citing the "general misconception" about "all corporate hospitals" on how they "encourage people towards unethical things – unnecessary tests and hence increasing unwanted expenditure".

This has now become part of the vocabulary at the hospital network, with doctors often discussing whether a certain line of treatment passes the family test, Bakshi said.

Manipal Hospitals has a phone number and an email address that it displays in its establishments where patients or those accompanying them can complain.

Any complaints that can be verified through CCTV footage – cameras have been installed at various locations – are acted upon immediately, said Sudarshan Ballal, medical director at Manipal.

People admitted at Fortis hospitals are visited by a patient welfare officer who becomes the one–point contact for all information. "Patients are encouraged to contact the relevant guest relations officer for any problem they encounter during their stay," said CEO Aditya Vij. Indian hospitals have considerable ground to cover, at least according to the findings of consumer review website mouthshut.com. Site founder Faisal Farooqui made his team parse more than 10,000 reviews of over 200 words in 10 Indian cities for ET. The dissatisfaction rate was 72% for non–medical and paramedical aspects such as misbehaviour of staff, quality of nursing care and billing. More worryingly for the hospitals, 67% were dissatisfied with medical care.

"Negligence and apathy were some of the most commonly used words in such posts," said Farooqui. Not good news for establishments that are also seeking to attract overseas patients.

Still, it should be pointed out that the reviews covered all hospitals and most people who take the trouble to post their views may be motivated to do so as they have something to complain about rather than have a positive comment to make.

Any move by the companies to make their internal processes fairer should be welcomed, given that the dependence on non–state healthcare looks to be increasing.

Already, the private sector provides two–thirds of all hospital beds in India today, up from half in 2002, according to a Confederation of Indian Industry–McKinsey & Co report released last month.

Bills remain a major bone of contention for customers, more so because 78% of medical expenses in India are out–ofpocket. And, according to health economist AK Shiva Kumar, about 39 million people are pushed into poverty annually in India because of ill health. Meanwhile, private health insurance is only slowly gaining ground in India, although consumer complaints here too are rife.

This is the overall context in which the government is seeking to provide universal health coverage for its 1.2 billion people, an initiative in which the private sector will have to play a critical role. The deadline for such coverage, initially set at 2017, isn’t clear now owing to the lack of funds and squabbles over how to achieve the goal. The three hospital chains cited above are strengthening billing and estimates to allow for greater accuracy in letting patients know how much they could end up paying at the time of admission, instead of being landed with an inflated list of charges. Max checks the billing for similar cases in the last six months and senior management constantly monitors gaps between bills and estimates, with an eye to reducing the margin of error, according to company executives.