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There has been little attempt to evolve a protocol of standardisation of treatment based on specific parameters of diagnosis. No two specialists in India seem to agree on the same type of treatment for a specific illness. The noted cardiologist Dr S Thanikachalam pointed to such a procedure mandatory in developed countries. In these for a given set of diagnostic results, treatment is the same but it is not so in India.

Surgery is the last resort in the US; in India in most super specialty hospitals it seems the first option. I had the experience of three well-known specialists recommending three different treatments for tackling a shoulder pain. The first suggested  surgery. The second physiotherapy and some electric pulse treatment. The third suggested some simple exercise, explaining this as part of ageing that will be set right by self-correction. I opted for the third and have no complaint on this for some three years now!

Against the old practice of experienced physicians taking time to examine understand the cause and effect of a certain malady, modern hospitals prescribe a plethora of tests that involve high costs. When these are prescribed, on expectations of getting quick relief the patient has little choice. Another sad aspect is the refusal of most corporate hospitals and leading medical practitioners to accept the test results done in a different hospital; they suggest repeating these tests all over again.

The first question asked at the time of admission relates to whether insurance cover is available for the patient. Surprisingly, costs quoted differ for with and without insurance cover for the same treatment.

There is little transparency on the components of the charges. Reddy of Apollo Hospitals often used to explain the high costs of surgical components like implants, sutures... that are mostly imported. (producing these to small volumes within the country oftentimes makes them more expensive).  I understood to my horror a humongous mark up in the prices of medical aids. I cite a recent experience: after testing, a leading centre for audiology suggested use of hearing aids each to cost Rs 62,000 and a pair of these were suggested at a total cost of Rs 124,000. Until recent years, there has been little facility to check the prices. With internet and e-marketing, I checked the price with Amazon and found the price for each at just Rs 19,000! I couldn’t understand the need for a 200 per cent plus mark up. I understand such humongous mark ups are made by corporate hospitals and specialist service centres on implants, stents, valves... With knowledge on these on the part of the average consumer still very limited how could he be protected from such pricing?

Leaders in the profession like Reddy who have made enough and more money for decades should set apart some of their time for bringing about ethical practices in keeping medical costs low. They would certainly be doing a great service for the suffering patients and their families.


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