[{"value":"utm_source","text":"00N0I00000KT1fD"},{"value":"utm_medium","text":"00N0I00000KT1fI"},{"value":"campaignname","text":"00N0I00000KT1fN"},{"value":"uterm","text":"00N0I00000KT1fS"},{"value":"adgroupname","text":"00N0I00000KT1md"},{"value":"keyword","text":"00N0I00000KT1mx"},{"value":"creative","text":"00N0I00000KT1nR"},{"value":"devicemodel","text":"00N0I00000KT1ng"},{"value":"placement","text":"00N0I00000KT1nq"},{"value":"target","text":"00N0I00000KT1ot"},{"value":"device","text":"00N0I00000KT1o0"},{"value":"network","text":"00N0I00000KT1o5"},{"value":"matchtype","text":"00N0I00000KT1oA"},{"value":"gclid","text":"00N0I00000KT1oF"},{"value":"campaignname","text":"00N0I00000KT1nM"},{"value":"term","text":"00N0I00000KT1n7"}]
Dr B. Somaraju | Dr Rajeev Menon
September 2021
With growing commercialisation, is the healthcare industry losing its sheen? Does the triad of people, profits and planet have the power to go hand-in-hand? Dr B. Somaraju and Dr Rajeev Menon from AIG Hospitals delve into the cracks and reflect upon how strategic thinking and management can yield economically sustainable and viable solutions for the healthcare sector, when based on the tenets of knowledge-sharing, patient-centredness and teamwork.
The field of medicine has always been considered as one of the highest professions in the public eye—the power to heal others is a gift, and doctors are considered next only to God, almost universally. In yesteryears, the debate was often if medicine was an art or a science. However, in more recent times, healthcare has become a business where personal interest has taken over and the basic tenets that lent uniqueness and authenticity to the profession seem to be getting lost.
In his book, Harrison’s Principles of Internal Medicine, 1950, Dr Tinsley Harrison, says, “No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician. In the care of the suffering he needs technical skill, scientific knowledge, and human understanding. He who uses these with courage, humility and wisdom will provide a unique service to his fellow man and will build an enduring edifice of character within himself. The physician should ask of his destiny no more than this and he should be content with no less.”
In earlier days, we thought scientific knowledge and technical skills are difficult to acquire, and human understanding was easy. However, the truth is that human understanding is a lifelong skill, not easy to master. When Dr Harrison talks of ‘courage,’ we now understand it is the courage to see patients in the face of a pandemic, courage to make less money and still treat all patients, without worrying about profitability. Though not stressed enough, empathy and patient-centredness are fundamental to medicine.
We ought to be able to deliver ‘safe, effective, efficient, equitable, timely, and patient-centred’ healthcare.[1] These form the pillars of quality healthcare delivery, and the way we see it, this is not happening today. What are the possible solutions to fix these?
When COVID-19 struck, healthcare in general, and medicine in particular, had an opportunity to reestablish its lost trust in the public, but unfortunately, in India, it was not used to advantage by both public and private organisations. Public apathy and private greed took over with a few exceptions. As people scrambled to get medical care, it was getting costlier to get hospitalised and access care in public systems. Affordability and availability of critical medicinal supplies in the current scenario became the biggest concern.
In a developing country like ours, the cost of care needs to come down in order to make any real-time impact for the general populace and it is indeed achievable via knowledge-sharing and teamwork. Here’s how.
We would like to talk about the ‘Kalam-Raju stent’, which is a perfect example of indigenisation and cost-effective solutions, leveraging technology for a massive health requirement. Introduced in 1998, the Kalam-Raju stent was the first indigenous low-cost coronary stent, priced at ₹15,000, which transformed the treatment of heart attacks back in the day. It was Dr Kalam’s vision to leverage defence technology in the field of medicine for the good of the larger public. A unique thought process which believed in knowledge-sharing as opposed to working in silos brought down the cost by almost 75% and benefitted thousands. A team of several technological scientists and doctors managed to give shape to this vision after almost five years in the days when the internet wasn’t even around, and knowledge-sharing was a very concerted effort.
Back in the 90s, as doctors, we never refused an emergency patient. We went by the fundamental principle that finances should never be the reason for a patient lacking adequate healthcare. However, with newer models of third-party investors and corporate hospitals coming in, last quarter profitability has taken precedence over the quality of healthcare in board-room discussions. In order to bring about a real change, it is imperative to understand that financial issues like the cost of land or construction of the hospital are secondary. The most vital asset is the human resource and knowledge quotient which does not comprise doctors or nurses alone but multi-specialty and interdisciplinary groups too. The philosophy of patients and employees-first, rather than investors-first, needs to be deployed.
During the pandemic, doctors and hospitals made a lot of money for a disease that does not have a cure yet. A lot of hit-and-miss experiments occurred, and mindless usage of drugs like steroids, in some cases, ended up harming patients rather than helping them.
“Today, CT scans are among the commonest tests prescribed by doctors, which in my opinion is improper, as it has heightened the possibility of cancer cases in the next few decades.”
-Dr B. Somaraju
Social good and profitability don’t necessarily go against each other; it is the greed to make money at the expense of everything else that constitutes the problem. There is, therefore, a thin line between profitability and insatiable greed. But medicine as it stands today, has ample opportunity to do good in the social sector, while making adequate profits and ensuring sustainable organisations.
“In our experience, the pandemic did not really change much for us as there are still higher number of patients lined up to see Dr Somaraju than me, be it online or offline.”
-Dr Rajeev Menon
However, the upside of it is the avenues that this has opened for the public. The sheer ‘reachability’ of online consultations is a massive advantage for patients making it possible to get the care they need, even from the remotest corner of the country at the click of a button. It cannot replace the face-to-face interactions, physical examinations or even the banter, but it is surely beneficial to see a doctor online versus not seeing one at all. Technology has, therefore, revolutionised doctor-patient interactions and this hybrid model of consultations will continue in the post-COVID era too. It has also had a positive impact on medical education, opening it to students across the globe.
While technology enabled us to fill in the gap via online consultations, telemedicine is no answer to the problems at hand. For instance, when a patient comes to the hospital with chest pain, it could be anything from a serious heart attack to a tear of one of the major blood vessels or something as trivial as muscle pain. The possibilities are enormous and nearly 12 to 15% of patients still go undiagnosed. One of the most common causes for medico-legal issues in American medicine under emergency medicine is chest pain. Patients are told that they are good to go after some tests and a complete physical examination, and yet some of them succumb at home. If these are the possibilities in an average physical examination, one can only wonder what would happen online with limited clinical skills. Pattern recognition, eye contact and physical examinations remain critical and thus, telemedicine is an answer to a limited category of patients, not all.
When we speak of affordable healthcare, the entire healthcare delivery system needs to be redefined. Healthcare is not just what is delivered in tertiary hospitals and intensive care units (ICUs)—that is merely the tip of the iceberg. The health of the community is not dependent on the number of ICUs or critical care beds but the social determinants of health (SDH)[2]—the socio-economic conditions influencing health outcomes—that remain unaddressed. For instance, we only deal with patients who come to us in person. When they leave after the consultation, we do not have any way of knowing if they will schedule a follow-up, or if they will survive. Despite this, outpatient departments continue to operate.
Moreover, we do not address healthcare at the community level, right from prevention to primary care, secondary care, and long-term follow-up of chronic diseases from birth to death. As per World Health Organization (WHO), research[3] has shown that the social determinants may be more crucial than healthcare in influencing health. Multiple studies suggest that SDH account for 30 to 55% of health outcomes. This is why we need to redesign the current delivery systems, starting from the root cause, across both public and private sectors to make it more affordable. The American Medical Association (AMA) has recently come out with a solution—the health system sciences model—which seems likely to work due to its all-encompassing approach of understanding how healthcare is delivered, the role of doctors in delivering that care and the ways of improving it.
Since the 60s, the emphasis has been on biological and clinical sciences, which is no longer adequate. The current times call for a more holistic approach, and capitalising on other disciplines—namely the social sciences, economics, mathematics, physics, chemistry, information technology, along with experts from other sciences which are traditionally not a part and parcel of medical education. In this light, education and healthcare delivery cannot be separated, but need to be an amalgamation of diverse perspectives.
“Have you identified someone who can do the work you are doing as well as you or even better than you? If the answer is yes, then you have done well. If no, you have a long way to go.”
-Dr B. Somaraju
To build strong teams that deliver their best, the real investment lies in people—nurses, doctors, housekeeping and support staff, and multi-specialty experts—who are the backbone of healthcare delivery systems. The sense of belonging and shared income (not only material gains but also fame and recognition) go a long way in building robust teams. Today, this mentoring and sharing needs to be broadly inclusive, involving the wider healthcare delivery system, not doctors alone, but all the unsung heroes across the spectrum.
In terms of skill set, doctors must learn management skills and managers need to understand medicine in order to make effective teams. The current crisis showed us that doctors alone cannot change the face of healthcare delivery, it needs to extend beyond borders, involving a liberal sharing of best practices. Advanced technology and innovative solutions need to be brought forth via collaboration. Investment models are to be designed in a manner that they do not look at high profitability in areas like healthcare and education.
Collaboration across primary, secondary and tertiary care, including community hospitals, telemedicine and home care will bring about enduring long-term changes, even if they appear difficult to measure now. The infinite game of medicine cannot be expected to yield overnight returns. It is about building sustainable systems for future generations, and not short-term quantitative gains.
“It is about a cooperative model—a group of like-minded people—willing to be the change. We are looking forward to having people from different walks of life join us in this infinite journey."
-Dr B. Somaraju
[1] Institute of Medicine (1999). To Err Is Human: Building a Safer Health System. https://www.nap.edu/resource/9728/To-Err-is-Human-1999--report-brief.pdf
[2] SDH Examples by World Health Organization (WHO)—Income and social protection, education, unemployment and job insecurity, working life conditions, food insecurity, housing, basic amenities and the environment, early childhood development, social inclusion and non-discrimination, structural conflict, access to affordable health services
[3] World Health Organization. (2021). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
[4] Sinek, S. simonsinek.com. https://simonsinek.com/the-infinite-game?ref=home
Healthcare, healthcare delivery, affordability, teamwork, knowledge-sharing, social good, sustainability, commercialisation
Dr B. Somaraju, Director, Division of Cardiovascular Sciences, AIG Hospitals
Dr Rajeev Menon, Head, Division of Cardiology, AIG Hospitals
In the Financial Times Executive Education Custom Programmes Rankings released today, ISB Executive Education has been ranked #1 in India and #38 globally.
May 23, 2022
In the Financial Times Executive Education Custom Programmes Rankings released today, ISB Executive Education has been ranked #1 in India and #38 globally.
23-May-2022
KNOW MOREThe Indian School of Business has been ranked #1 in India and #44 globally among the top 100 business schools in the Financial Times (FT) Executive MBA Ranking 2022 released today.
October 17, 2022
The Indian School of Business has been ranked #1 in India and #44 globally among the top 100 business schools in the Financial Times (FT) Executive MBA Ranking 2022 released today.
17-Oct-2022
KNOW MOREIndian School of Business today celebrated its graduation ceremony for the PGP Class of 2022 and its 20th anniversary, presided by the Hon'ble Prime Minister of India, Shri Narendra Modi. 923 students graduated from the School today.
May 26, 2022
Indian School of Business today celebrated its graduation ceremony for the PGP Class of 2022 and its 20th anniversary, presided by the Hon'ble Prime Minister of India, Shri Narendra Modi. 923 students graduated from the School today.
26-May-2022
KNOW MOREISB's Post Graduate Programme in Management (PGP) has been ranked #32 globally in the Financial Times (FT) Global MBA 2022 ranking.ISB has been ranked #11 globally in the Poets & Quants (P&Q) composite ranking of the top international MBA programmes 2021-2022.
February 14, 2022
ISB's Post Graduate Programme in Management (PGP) has been ranked #32 globally in the Financial Times (FT) Global MBA 2022 ranking.ISB has been ranked #11 globally in the Poets & Quants (P&Q) composite ranking of the top international MBA programmes 2021-2022.
14-Feb-2022
KNOW MOREThe Indian School of Business (ISB) is ranked #6 in the Asia-Pacific region in the Bloomberg Businessweek Best B-Schools 2022-23 rankings released today.
September 15, 2022
The Indian School of Business (ISB) is ranked #6 in the Asia-Pacific region in the Bloomberg Businessweek Best B-Schools 2022-23 rankings released today.
15-Sep-2022
KNOW MOREThe Indian School of Business (ISB) has been ranked #1 in India, #5 in Asia and #75 globally in The Economist: Which MBA? 2022 Full-time MBA Ranking released today.
June 22, 2022
The Indian School of Business (ISB) has been ranked #1 in India, #5 in Asia and #75 globally in The Economist: Which MBA? 2022 Full-time MBA Ranking released today.
22-Jun-2022
KNOW MOREBloomberg Businessweek, in their global ranking of best business schools has ranked the ISB's PGP # 5 in the Asia-Pacific region and #1 in India.
September 15, 2021
Bloomberg Businessweek, in their global ranking of best business schools has ranked the ISB's PGP # 5 in the Asia-Pacific region and #1 in India.
15-Sep-2021
KNOW MOREProfessor Madan Pillutla formally takes over as the 6th Dean of The Indian School of Business (ISB)
July 01, 2021
Professor Madan Pillutla formally takes over as the 6th Dean of The Indian School of Business (ISB)
01-Jul-2021
KNOW MOREThe research by the Marketing Department of the Indian School of Business (ISB) has been ranked #1 in Asia and #44 globally in American Marketing Association (AMA) 2020 DocSIG research productivity rankings.
February 18, 2021
The research by the Marketing Department of the Indian School of Business (ISB) has been ranked #1 in Asia and #44 globally in American Marketing Association (AMA) 2020 DocSIG research productivity rankings.
18-Feb-2021
KNOW MOREThe Indian School of Business (ISB) has been ranked #1 in India and globally at #44 in the Economist Full-time MBA Ranking 2021.
January 22, 2021
The Indian School of Business (ISB) has been ranked #1 in India and globally at #44 in the Economist Full-time MBA Ranking 2021.
22-Jan-2021
KNOW MOREIndian School of Business inks comprehensive partnership with University of Sydney Business School
June 09, 2021
Indian School of Business inks comprehensive partnership with University of Sydney Business School
09-Jun-2021
KNOW MOREISB's DLabs Incubator has been awarded INR 5 crores under the 'Startup India Seed Fund Scheme' by the Department for Promotion of Industry and Internal Trade
September 26, 2021
ISB's DLabs Incubator has been awarded INR 5 crores under the 'Startup India Seed Fund Scheme' by the Department for Promotion of Industry and Internal Trade
26-Sep-2021
KNOW MOREThe Indian School of Business (ISB) today announced the appointment of Professor Madan Pillutla as its 6th Dean.
December 30, 2020
The Indian School of Business (ISB) today announced the appointment of Professor Madan Pillutla as its 6th Dean.
30-Dec-2020
KNOW MOREThe Indian School of Business (ISB) achieves AMBA accreditation and becomes 100th triple-accredited Business School in the world
May 01, 2020
The Indian School of Business (ISB) achieves AMBA accreditation and becomes 100th triple-accredited Business School in the world
01-May-2020
KNOW MOREISB’s PGPMAX ranks #1 in India and 53 globally in the Financial Times 2020 EMBA ranking
October 26, 2020
ISB’s PGPMAX ranks #1 in India and 53 globally in the Financial Times 2020 EMBA ranking
26-Oct-2020
KNOW MOREFirst Class of Post Graduate Programme for Working Professionals, ISB's first Weekend EMBA programme started in the Hyderabad and Delhi
January 01, 2018
First Class of Post Graduate Programme for Working Professionals, ISB's first Weekend EMBA programme started in the Hyderabad and Delhi
01-Jan-2018
KNOW MOREISB ranks #26 in the Financial Times Top 50 MBAs for Women Ranking 2018
March 01, 2018
ISB ranks #26 in the Financial Times Top 50 MBAs for Women Ranking 2018
01-Mar-2018
KNOW MOREJoins select list of schools worldwide with both AACSB and EQUIS accreditations
March 01, 2017
Joins select list of schools worldwide with both AACSB and EQUIS accreditations
01-Mar-2017
KNOW MOREISB Celebrates 15th Anniversary, the President of India graces the occasion as the chief guest
November 20, 2016
ISB Celebrates 15th Anniversary, the President of India graces the occasion as the chief guest
20-Nov-2016
KNOW MOREISB Launches MFAB – Management Programme for Next Generation Leaders of Family Businesses
December 10, 2012
ISB Launches MFAB – Management Programme for Next Generation Leaders of Family Businesses
10-Dec-2012
KNOW MOREISB hosts the President of India at the event commemorating its tenth year
July 14, 2011
ISB hosts the President of India at the event commemorating its tenth year
14-Jul-2011
KNOW MOREISB Becomes South-Asia's First Business School To Earn AACSB Accreditation
December 02, 2011
ISB Becomes South-Asia's First Business School To Earn AACSB Accreditation
02-Dec-2011
KNOW MOREISB inks MoU with the Wharton School for the 'Max Institute of Healthcare Management'
April 04, 2011
ISB inks MoU with the Wharton School for the 'Max Institute of Healthcare Management'
04-Apr-2011
KNOW MOREISB Mohali foundation stone laying ceremony held
August 11, 2010
ISB Mohali foundation stone laying ceremony held
11-Aug-2010
KNOW MORELaunch of Dr. Reddy’s Cell for Employability and Skilling
July 11, 2010
Launch of Dr. Reddy’s Cell for Employability and Skilling
11-Jul-2010
KNOW MOREFirst class of PGPMAX started on campus with 66 students
August 18, 2010
First class of PGPMAX started on campus with 66 students
18-Aug-2010
KNOW MOREISB inks MoU with the Fletcher School, Tufts University for the Bharti Institute of Public Policy
December 07, 2010
ISB inks MoU with the Fletcher School, Tufts University for the Bharti Institute of Public Policy
07-Dec-2010
KNOW MORELaunch of Post Graduate Programme in Management for Senior Executives (PGPMAX)
December 03, 2009
Launch of Post Graduate Programme in Management for Senior Executives (PGPMAX)
03-Dec-2009
KNOW MOREInauguration of the Centre for Emerging Markets Solutions (CEMS)
March 01, 2009
Inauguration of the Centre for Emerging Markets Solutions (CEMS)
01-Mar-2009
KNOW MOREISB becomes first Indian B-school to be ranked in the top 20 in the Global Top MBA rankings by Financial Times, London.
January 08, 2008
ISB becomes first Indian B-school to be ranked in the top 20 in the Global Top MBA rankings by Financial Times, London.
08-Jan-2008
KNOW MOREInauguration of the Indu Centre for Real Estate and Infrastructure
November 05, 2008
Inauguration of the Indu Centre for Real Estate and Infrastructure
05-Nov-2008
KNOW MOREInauguration of the Centre for Leadership, Innovation, and Change (CLIC)
February 01, 2008
Inauguration of the Centre for Leadership, Innovation, and Change (CLIC)
01-Feb-2008
KNOW MOREAgreement for second ISB campus at Knowledge City, Mohali, was signed
November 12, 2008
Agreement for second ISB campus at Knowledge City, Mohali, was signed
12-Nov-2008
KNOW MOREGeorge Bush, former President of the USA, visited the ISB
March 01, 2006
George Bush, former President of the USA, visited the ISB
01-Mar-2006
KNOW MOREInauguration of the Srini Raju Centre for Information Technology and the Networked Economy (SRITNE)
July 01, 2006
Inauguration of the Srini Raju Centre for Information Technology and the Networked Economy (SRITNE)
01-Jul-2006
KNOW MOREInstitution of the Thomas Schmidheiny Chair on Family Business and Wealth Management
December 14, 2006
Institution of the Thomas Schmidheiny Chair on Family Business and Wealth Management
14-Dec-2006
KNOW MOREFirst Global Social Venture Competition commences
December 01, 2004
First Global Social Venture Competition commences
01-Dec-2004
KNOW MOREInauguration of the Centre of Analytical Finance (CAF)
August 01, 2004
Inauguration of the Centre of Analytical Finance (CAF)
01-Aug-2004
KNOW MOREPresident S R Nathan of Singapore visited the ISB
January 02, 2002
President -Elect A P J Kalam presided over the First Graduation Day
June 24, 2002
President -Elect A P J Kalam presided over the First Graduation Day
24-Jun-2002
KNOW MOREInauguration of the first Centre of Excellence:Wadhwani Centre for Entrepreneurship Development (WCED)
December 20, 2001
Inauguration of the first Centre of Excellence:Wadhwani Centre for Entrepreneurship Development (WCED)
20-Dec-2001
KNOW MOREInauguration of the Centre for Executive Education(CEE)
November 20, 2001
Inauguration of the Centre for Executive Education(CEE)
20-Nov-2001
KNOW MOREFirst class of Post Graduate Programme in Management started on campus with 128 students
July 01, 2001
First class of Post Graduate Programme in Management started on campus with 128 students
01-Jul-2001
KNOW MOREDr Pramath Sinha appointed as the ISB's Founding Dean
June 30, 2001
Dr Pramath Sinha appointed as the ISB's Founding Dean
30-Jun-2001
KNOW MOREFirst student Exchange Programme commenced
September 01, 2001
First student Exchange Programme commenced
01-Sep-2001
KNOW MOREISB Inauguration by the former Prime Minister of India, A B Vajpayee
December 02, 2001
ISB Inauguration by the former Prime Minister of India, A B Vajpayee
02-Dec-2001
KNOW MOREFirst international Governing Board meeting held in New York
October 13, 1998
First international Governing Board meeting held in New York
13-Oct-1998
KNOW MOREMoU signed with the Government of Andhra Pradesh for the setting up of ISB in Hyderabad
September 19, 1998
MoU signed with the Government of Andhra Pradesh for the setting up of ISB in Hyderabad
19-Sep-1998
KNOW MOREAssociation with The Wharton School and The Kellogg School of Management
November 19, 1997
Association with The Wharton School and The Kellogg School of Management
19-Nov-1997
KNOW MORE