Private Hospitals Improvement - Solutions

A) Information and transparency : it should be mandatory for all hospitals to publicly disclose the following :

- how many doctors have referred patients to them and what % of revenue has been paid to doctors in the form of referral fees (by whatever name called and in whatever form paid).
- how many doctors are paid variable pay basis business they generate and what is the % of revenue
- how many free beds are allocated and how many patients have been treated from economic weaker sections on a daily basis and what is the total revenue earned from EWS patients in any form whatsoever.
- corporate structure of a hospital and business entity associated with it, with clear linkage between asset ownership and revenue etc. And how the profits are distributed / retained between the trust and business entity
- the share of revenue incurred from insurance (all hospitals lobby with insurance companies to get their rates approved at the highest level) and how much is walk in and from CGHS (most hospitals have differential rates for CGHS as they get only that much from govt)
- how much beds are charged higher due to higher category and how much extra is charged to higher beds category on account other than room rent (why should doctor fees be different for different room categories ??? )
- there can be several other specific disclosure requirements which can be identified and a hospital entity shall be obliged to file a social responsibility report along with their annual report)
- if any fees is paid or received by doctors or hospitals to any lab, the same needs to be reported. Every lab also needs to disclose referral fees paid to doctors

B) Peer review system- in this system, every case should be obligated to be referred to another team of doctors from an other hospital if the patient demands for it after the treatment is completed. In the event the treatment is found to be unnecessary or flawed, then not only the entire money shall be refunded but criminal action can be initiated in case of loss of life etc. This should be applicable and available in 100% of cases to the smallest to largest cases

C) Doctors shall not be allowed to prescribe medicines by the brand name, they should only be allowed to prescribe the medical name (salt etc. For example they can only prescribe paracetamol and not the brand). Likewise no hospital can make buying the medicines, medical consumables or surgery consumables compulsory to be bought and provided by hospital. Every patient to have a right to buy from where ever they want to buy the same.

D) THIS IS THE MOST IMPORTANT AND RELEVANT SOLUTION: Break the nexus of doctors and hospitals. In most countries, hospital companies are allowed to work only as infrastructure providers and any doctor can come and perform in the hospital based on patient request, wherein patient hires the hospital for infrastructure and have a separate arrangement with the doctor for medical treatment. Doctors are not allowed to disclose the fees charged to the patiento, to any hospital and vice versa. And patients can choose any doctor and any hospital in any combination. So very clearly medical and administrative aspects of the hospital are completely de linked. Singapore, South Africa and many other developed countries follow this model.I can even choose best doctor in the city but an average nursing home or even govt hospital to get the treatment and neither hospital nor the doctor can refuse it. more  

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----- Reply message -----
From: "Nitin Gupta" <>
To: <>
Subject: Commented on "Private Hospitals Improve..." in [Citizen Oriented Healthcare in Delh...]
Date: Wed, Jun 3, 2015 2:01 PM more  
Bottom line remains that there needs to be a mechanism to bring in greater transparency, greater responsibility on the part of medical and administrative processes and greater accountability. As of today, the patient has no clue if he is being taken for ride or being even given right treatment. Commercial economics are also forcing the doctors to give into the practices of the hospitals, which they themselves are not likely to approve of. Interview 50 random doctors, without asking them to disclose their names, and they would confirm that many of the practises of even the most reputed hospitals are unethical but the environment/ system make it compulsory for them to follow it.

Peer review and breaking the nexus between the doctors and hospitals can only be sustainable solutions. In the immediate short term, bringing in transparency through disclosures on both the part of hospitals and doctors can be brought in. more  
This is not the criteria for malpractice! To be rich is mø crime

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----- Reply message -----
From: "Umesh Kumar" <>
To: <>
Subject: Commented on "Private Hospitals Improve..." in [Citizen Oriented Healthcare in Delh...]
Date: Tue, Jun 2, 2015 12:05 AM more  
It will be difficult to verify. One alternative is to verify top doctors' last 3 years ITR, Assets expenses, expenditures, foreign visits, holidaying, addition of fixed assets, assets in lockers to find out these malpractices. more  
Neelam ji- I have full sympathy for all the things that you have undergone. But kindly write the name of the hospital . and do not make an opinion about all the private hospitals. I request all those who are on this forum to write more about first hand experience of pvt hospitals - if they have appreciations allso do write it and if you felt disgusted about the events - write them also. But here I want to elaborate that there is a team of doctors who is working round the clock - there are junior doctors and a battery of nurses and lots of investigations are required to monitor the patient in ICU.In old age it is multi organ disease - heart ,lung , kidney and liver etc . To save the life - one has to monitor all these. But still I will try to find out the facts- kindly write the name of the hospital and dates when your father was admitted . more  
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