changing expectations in the healthcare scenario

CHANGING EXPECTATIONS OF HEALTH PROVIDERS & HEALTH SEEKERS

Quality Management in HospitalsFr. Muller Hospital, Quality 7th August 2006

The Big business

• Healthcare is the largest industry in the world.( $2 .8 trillion worth of revenue)

• In India next to IT more than 60 lakh people directly employed

• Annual growth of 17%

Exciting decades for Health

• Huge demand and supply Gap• 200 million of middle class • Increased income level• Increasing life-style

diseases(hypertention,cancer etcc..)• Poor public health system• Better care by private players – 87 %• Increased knowledge and demand of health

seekers…

1970 Doctor! I’m not able to Doctor! I’m not able to see well in both eyes. I see well in both eyes. I have come here to see have come here to see

you what best you you what best you could do? You are like could do? You are like

my God!my God!

What is your

problem?

2005….Doctor! I have immature cataract Doctor! I have immature cataract in my right eye and please do in my right eye and please do phaco with foldable lens and let phaco with foldable lens and let me know what lens you are going me know what lens you are going to put?to put?

What is your problem?

Doctor as rarestatus symbol

Doctors in surplus

Total submission

Optional who is competent and

confident?

Health Care

Health Internationa

l

Health Foundation

20051970

Trust in

Clinical knowledge of Doctor

Trust in

Sophisticated equipments

with computerised reports

20051970

Patients were patient

Patients demand fast service & Quick result

20051970

Doctor’s Time More of Doctor’s Time

Considered Precious Demanded

20051970

Family Doctor Fragmented health care service

Our family shop where I get all I need….

specialists even in subspecialties

I’ll buy rice here. For dal and oil I go to dal and oil

vendor

20051970

Holistic approach towards patient’s problem

Non Clinical Expectations

Hospital as Worship place

More emphasis of good Medical outcome

Hospital as five star hotel

Medical Cure

Services at Door - step

20051970

Change In Attitude of patientsDoctor as God Doctor as Businessman

Treatment

Who cures

Selling his treatment

20051970

Mishaps Mishaps

Accidental

As Fate As legal treasure hunt

20051970

The Changing Expectation of Patients

Are due to

• Well informed “Customers”

• T.V., Websites

• Medical camps

• Health Journals

What about doctors?….

• Have they changed?

• Have the patients gone

away

from us recently by heart?

YES…….

• Doctors Accepted slow modest professional growth

• Doctors want : quick growth, quick money

quick fame

20051970

Doctors

Sowed clinical knowledge

Watered with hardwork & clinical skill

Enjoyed the fruits

Served people

Looked upon as God

1970

LOANS

Posh buildings +

Sophisticated equipmentsto attract the crowd

Earn and struggle to pay back loans

I’ll soon cross the ocean!

2005

Result• Imbalance in the family • Not enough attention to

children

Satisfied patients did publicity Doctor’s do publicity

2005

Dr. Y, MS., (Gold Medalist)

International

• Two minute

• Computerized eye testing…

• No hole surgery

1970

How ?

Have DoctorsBecomecommercial ?

Have the patients

become demanding

customers ….

Touchy…. And

egoistic?

Or

Who changed first ?

Did we change because patients have changed ?

Did patients change because we have changed?

Or

That’s a Himalayan Question!

Which came first?

Why break our heads ?

Let’s arrive at a simple practical solution….

Hen needs the egg for procreation

The egg needs the hen to become a chick

Develop long term sincere relationship with the patient and the family

Patient Explanation

Clear Communication at every stage

Clear information from A to Z especially financial matters

Transparency

Aim for Quality Clinical & Surgical Work

Changing Expectation of Patients

• In a simple uncomplicated

patients - Investigations

should be very minimal

Prompt referrals when necessary

Do not feel egoistic when you need a second opinion

Changing Expectation of Patients

• I need a good comfortable clean

place with western toilet

• And hospital staff should treat me

with Compassion

Our Customers Are

• Patient

• Close relatives and friends

• Referral doctor

• People who motivated the patient to visit us (satisfied customers)

• Our own staff (internal customers)

Security

Reception

Registration

Consultation

Investigations

Admission counterWard

OT

Postoperative ward

Counseling

Discharge + money

payment

Home

Patients Satisfactions

AtVarious Stages

A change in our attitude will take care of the changing expectations of our patients

CLINICAL RESULT

SINCERITY

COMPASSION

AFFORDABLE COST

Finally

GADGETS

MRCO

FRCS

MS

DO

Happy satisfied patients

Boon to our service

That will give us

Quality (Performance) is a combination of knowledge , skill and attitude

Reference 1. Dr. Ravindran, Aravind eye Hospital,

Pondichery2. Dr. Jane Shaw, Leeds University

3. Mr. Justin Jebakumar, Christian Medical Association of India, New Delhi

Thank you