few random thoughts about medical care in Hyderabad.

It  is  34 years since  I  graduated from  Osmania medical Medical College with an MBBS  degree.

In those days there were only two corporate hospitals on was Apollo the other was Medwin. As the years went by there has been a mushrooming of hospitals both of the corporate kind and small privately owned nursing homes and medical centers.Anybody and everybody opened a so-called multi-speciality hospital in places unsuitable for a hospital in general.

Recently I retired from the Dallas VA medical center after working there for last 14 years.

I am reading about the delivery of medical care services in general and also researching about medical services in Andhra Pradesh and Hyderabad in particular.

One of the major findings in my research is that the prices for physician services actually goes up as the number these doctors and specialists who are available to provide the services increases. This is contrary to the general economic theory. I was surprised to know that this was presented in the paper in January 1979 when paper was presented in a Blue Cross Blue Shield sponsored conference in Miami Florida. There are also some other assertions which seem to do not hold true when it comes to medical services in Andhra Pradesh an Hyderabad in particular.

The patient-physician relationship is presumably based on trust and the belief that 

the physician is acting in the patient‘s best interests. 

  (Even today this may be true of most physicians and patients I need to research much more in detail regarding this to decide whether this has radically changed)

 The canons of ethics of medical and clinical professionals have historically 

frowned upon advertising of any kind, but especially price advertising. (I think this has significantly changed as I see more and more advertisement from weightiest doctorate hospitals all over roadside in Hyderabad.

 Consumers are unable to judge the quality of medical care. Except for word-of-mouth and the effect of paper magazine and television advertisements and the so-called talk shows by experts there is no way for consumers to judge the quality of medical care because no systematic auditing of the services is done in any of the hospitals. Both private and public hospitals and teaching institutions.

 In the absence of other ways to judge the quality of medical care, they are likely to rely on price as an indicator. This creates a vicious cycle

 Waiting time and convenience issues i.e. non monetary aspects may out weigh and 

substitute for monetary aspects in influencing demand. Soon after I completed my MBBS I along with two other friends of mine opened a small clinic. I was a total greenhorn because nothing is taught in the medical college about the business aspects of medicine.

No wonder it was an utter failure!

In those days all we needed was an rental agreement with the landlord for a shopfront also called a Mulgi, Few folding chairs and examination table and then execute to chair and a table for the physician. A small boat with the name of the doctor, name of the clinic with a small red light bulb.(I will write some time later about the significance of this event lightbulb) I do not know whether this is still true anywhere in Hyderabad.

As my reading and research progress is will be writing more detail Blogs about my findings