Hospitals and Train Stations

From guards manning multiple entry points, greedy auto drivers at the entrance, turnstile access on the ground floor, sea of humanity conversing in different languages (Telugu, Tamil, Hindi, Bengali, etc.) to food carts rolling in for purchase, there seemed no difference between Apollo Hospitals and the Central Railway Station. 

The last time I was at Apollo was probably 5 years ago, despite multiple specialty hospitals mushrooming in the city this place continues to be a beehive attracting patients from across India. From consultations, admissions, insurance, to pharmacy there is a method to madness and on every visit I discover something unique in the medical business.

During my last visit to Apollo, I noticed some radiologists working without lead jackets and discovered many worked beyond the stipulated hours thereby exposing themselves to excessive radiation. Is it a supply demand issue or is it the quota or target system that is operational across most corporate hospitals, where everyone on the payroll carries a monthly target? Why would someone in the medical field who understands radiation risk over expose themselves?

The innovation in the medical field continues to surprise me and what was earlier a hospitalization procedure is now a day procedure. Nevertheless, hospitals and insurance companies continue behave like snake and mongoose going after each other’s throat.

I was at the hospital a day prior to get an admission note from the doctor and his secretary suggested that I explore the insurance route and sent me to the insurance desk. At the insurance desk, a hospital staff handed me a bunch of forms to be filled out and explained that the procedure will cost Rs 36,000 with insurance and Rs 25,000 if I opted to pay out of my pocket. This explains to me why the insurance companies and hospital behave like snake and mongoose.

Like a boomerang, I was back at the doctor’s office to get the insurance paper signed off. After an hour, the doctor surfaced and convinced me that the insurance route might be a difficult as the preliminary test results showed nothing irregular establishing the need for further medical investigation. He convinced me that I must opt to pay from my pocket and take it up with the insurance company in case they discovered something unusual.

While I was working on the admission note with his secretary, the doctor suddenly popped out of his room and offered to do the procedure for Rs 14,000 after 6 pm that evening and said I could go back home the same night and rest in my bed. Was this concession given due to my appearance or financial inability to afford the procedure? I was clean shaven, well dressed and didn’t put up a poor face looking for discounts or someone to fund the procedure and was surprised by his proposition.

I realized this may be the new normal in corporate-run hospitals where hospitalization procedures have turned into day/night procedures to reduce their battles with insurance companies and effectively managing patient load and beds. And they have effective bed utilization strategy and dynamic pricing aimed at maximizing revenue.

Life is an economic activity and for hospitals irrespective of whether you are dead or alive, the terms are strictly commercial. Unlike the radiologists, who ignore their health, I wasn’t ready to make a compromise on my health. I settled to pay out my pocket and even offered to stay overnight. While our airlines, railways and cab aggregators like Ola and Uber are on dynamic pricing, our hospitals may soon go that way.

Despite its uncanny resemblance to the Central Station, Apollo Hospitals are being run in a corporate way. And today, I realized Uberization of medical care is not far away!