This evening I had a situation at Latur (I run my out reach cath lab every Wednesday), where a patient travelled from Bhosiri (near Mumbai) to Latur to get an angiogram done by me. He was so pleased to meet me on the cath lab table and had travelled 600 km to get the procedure done by me. I was amused because here is a scenario where a doctor travels 300 km to perform angioplasty procedures and the patient travels 600 km to get the procedure. I was pondering why do patients need to travel to get treated. Having been in this business for the past two decades and having extensively travelled all over the globe there are compelling and not so compelling reasons for medical travel.
In India patients travel to nearby cities to get treatment where super specialists are available in various corporate hospitals. There is a feeling patients are being over investigated and over treated at these swanky units. This is partially true but can’t be generalized. Twenty-five years ago when I was at the All India Institute of Medical Sciences, patients from Bihar used to constitute a majority. When I questioned a politician from that state “Why don’t you build a top class medical institute so that the hardships of travel can be avoided?” He replied, “Doctor, if I build such a facility how can people from my state have an opportunity to visit Delhi?” I was aghast at the answer. Even now the facilities in that state are not on par with privileged states.
The travails of a patient from a village to a city for medical treatment are many. They are not aware of which specialist they should consult for their ailment, where is this particular doctor available, what about the competence of the doctor, are they getting the correct treatment for the disease, where can he get an economical “package”. All these are tough questions for a diseased person, more so if it is unfortunately an emergency. It is at these vulnerable moments they fall prey to agents and unqualified doctors who accompany them to the hospital and collect their “percentage”.
Apart from these, the challenges of stay, food, transport, searching for blood donors, consulting their elders on phone and most importantly obliging the unqualified and unsolicited advice by an acquaintance etc. are mind boggling.
To traverse this maze we need certain guidelines to choose an appropriate facility.
1. Doctor should be qualified to treat the disease. Always check the doctor who is performing the test has a qualification that is recognized by the Medical Council of India and this degree has been registered by the state medical council,
2. Always choose a doctor who is available full time at that facility, as this will ensure focus of the doctor on the case.
3. Do not hesitate to ask your doctor his experience about managing such a case and his success rates especially over the last 2 years and any deaths or complications in that particular disease. You must also make sure that the doctor is certain about the diagnosis
4. Verify that the hospital has accreditation by National Accreditation Board for Hospitals (NABH) or JCI etc. Periodic monitoring by these organizations ensures that the facility has adequate support staff, appropriate infrastructure and maintenance of the same, fire safety, bio-medical waste disposal systems etc.
5. Seek a facility that has the full gamut of investigations, on site blood bank etc. as one need not run around for getting the tests done. Also verify that laboratory is accredited by the National Accreditation Board for Laboratories (NABL).
6. Always choose a facility that you trust (like my case this evening) and don’t bother to travel far for the right treatment. I saw at Cleveland Clinic hoards of Arab people coming for treatment for simple ailments! This is because they trust the facility.
I am sure there might be many more criteria but I tried to enlist the most important ones so that one can choose a good hospital in a tough scenario.
Finally I suggest one needs to do some homework when he is healthy to choose a hospital before he becomes ill. Are we not choosing a comfortable multiplex for viewing a movie? Why not for health? This will help you to make your own choice rather than depending on some one’s advice at a critical hour.