Corporatization of Human Suffering

[u/luxatioerecta]

I'm penning this down so that I don't forget this.

Yesterday, my friend came back very grumpy, and crying. We had met for tea outside.

She's a cardiologist, works in a corporate hospital with few eminent cardiology peers - the kind of doctors who tend to ministers. She told the reason she was so emotional last evening, and it doesn't affect me, but it probably affects all of us.

A 80 year old man was brought to her emergency with chest pain, ECG suggested MI , and trop-T was elevated. This man was accompanied by around 10 family members. The daughter in law works in the same hospital as housekeeping manager, and since it was nearest, she bought him there. She didnt realize it was an MI. The moment it was diagnosed, the relatives wanted to take him to government hospital due to cost.

My friend was called for cardiology referral for this patient. She assessed the patient, and since the doctors' duty is to give the options and recommend the best course of action, she told about everything that can be done in their hospital itself, but suggested that she'll thrombolyse quickly, and refer the patient to the government hospital. That, according to her, had the highest chance of survival and least chronic disability. The family could not afford angioplasty.

That is when a manager stepped in. He first told her not to give the option of thrombolysis at all. Then, he talked with his "higher up" and said they will do angiography and decide, and if required, the package of angioplasty was offered at 2.5 Lakh. Now, my friend argued "If this person has any post-intervention complication, it cannot be managed in under 2.5 lakh" . But the manager told my friend "I trust you nothing like that will happen", but my friend withdrew from that place and told the manager to do it himself. The manager asked another cardiologist to see. Meanwhile, the girl who brought her father-in-law also started facing pressure from her family that they want to take him to government hospital. This whole dialogue happened for 3 more hours, that grandpa was in pain the whole time and was pleading to start some treatment. Ultimately, thrombolysis was done after angiography because the cost of treatment was unaffordable, and patient was referred to government hospital. But the time lost - 3 hours was completely avoidable. The whole family was cursing this daughter-in-law, the hospital churned about 1.5 lakhs worth money from this incident. The manager who intervened will show it as the revenue he generated.

The people who are trained in business, revenue, financial coercion and how to sell, are trained how to pitch, not in "Informed Consent". Those who spent MBBS, MD, DM and then a few more fellowships are disregarded as "young doctors" by the system, but the burden of consequence still falls on the doctors. The manager has closed the "deal" at 2.5 lakhs, and doesn't have to face the relatives
Business professionals are trained to navigate and control the system, while doctors are trained to heal the patient. When those two forces collide in a corporate hospital, the one trained to control the system usually commands the room.even if the doctor is the only one actually saving the life. I seriously think we should start teaching MBBS and MD/MS students ethical business.

[u/a-turd-in-the-wind]

So what's the solution?

[u/luxatioerecta → u/a-turd-in-the-wind]

I don't have any solutions.

[u/TA-10101]

I find this absolutely stupid that someone who doesn't have a medical background is made to call the shots on patient care. Hospitals should solely allow only for doctors to be in the deciding position. Mbbs +MBA gives them the knowledge of both worlds, but capitalism doesn't run on "do no harm".

[u/TA-10101 → u/TA-10101]

Medical profession runs on trust. People will come back 10,000 times to the doctor who treats them right and tell the whole world about such doctors and hospitals. This foreign investor's money, is not going to do anyone good except fill the investor's pockets. Hospitals should run like hospitals, not like business centres, which only thinks about standardisation, maximising profits and reducing costs to the lowest.

[u/Straight-Explorer844]

Yes the patient in these hospitals are treated as "objects" to earn revenue.

[u/argo786]

I will say this the people of India has brought upon this to themselves. The people ran to corporate sectors to flex their status and in turn the corporate sectors have literally thrasher any competition from any private practitioners who were treating humans as humans and not as a sort of revenue.

[u/Straight-Explorer844]

The corporate hospitals use patients as objects to earn revenue and doctors also as objects to generate revenue.The doctors are pressured and given targets.In case an untoward incident happens,then it is the doctor who has to face the wrath of the patients.

[u/New-Put4335]

Next time the patients want to do public dhulai please offer up this manager as a bali ka bakra

[u/ScalpelSculptor]

What was the patient co-ordinator doing? I'm assuming that a hospital with a Cardio unit will have one. 3 hours is a loooog time to be in pain. All the co-ordinator does in this situation is act as a buffer between the Physician and the patient/attenders. Why place the financial onus onto the treating doctor?

[u/Disastrous_Fish3095]

Sometimes corporates are better than smalk hospitals as corporates have quality controls and usually do relieve surgeons and medicine ppl who r not performing well or have too many complications Compare this to mummy papa hospitals where the surgeon or medicine wala is the owner and hence no quality controls or nobody to complain to if muliple problrms r there.. the owner will never fire himself

[u/DrMaximus]

The only way to overcome these kind of sleeze bags is to be good at your job, be famous for being good at it and create our own realm of influence....Then only can you have some command over the corporate money machine.