Why Kenyans Prefer Indian Medical Treatment
Earlier this year I had the opportunity to accompany a close relative for treatment at a well-regarded hospital in Chennai, India. The hospital is part of a chain of hospitals across India and Asia that specialize in providing low cost yet high quality medical services to its customers who consist of both local and international patients.
Apollo Hospitals was started in 1983 by its visionary Chairman Dr. Prathap C. Reddy as a 150-bed hospital. Today, it is part of India’s success story in emerging as a major hub in global healthcare. The group has 5,888 owned and 2.388 managed beds across 36 owned and 14 managed hospitals across Asia. My fascination with the group’s performance simply arose after bearing witness to fast, efficient service delivery at their Chennai hospital having spent many a night at local Kenyan hospitals waiting to be attended to and wondering if this is what my destiny as a human being awaiting medical attention was deigned to be.
I think we all know that nothing is certain in life except for death and taxes. In view of the fact that it is human nature to try and delay and in most parts avoid the two as much as possible, you can see why both hospitals and tax consultancies are big business. The accompanying table demonstrates the financial success that is the Apollo Hospitals business. Healthy double digit EBITDA margin yields speak to good cost controls that do not destroy the quality of service and the remarkable cash positions provide good working capital buffers that keep the costs of running the business within control.
My personal experience demonstrated to me that it is possible to have good quality medical care at fairly reasonable costs. Of course, it goes without saying that the Indian medical industry has the benefit of sheer numbers which underpin the high volume low value business model. I’ll give them that. But the efficiency of document and information movement has nothing to do with providing low cost medical care rather it’s a service delivery mechanism that ensures very little time is wasted by patients in seeking medical attention.
Here is an illustration: we had set up appointments with about five specialists at different times within 48 hours. At the International Patient Centre, the clerks opened a patient file with all the patient data that we could produce. A blue physical file was produced with a bar code appended to the cover. We were never allowed to touch that file, and it mysteriously appeared at every single appointment we went to because the hospital’s system showed where the next appointment would be and where the patient file should thus be headed. At one appointment, the file had not yet appeared (thank God for small inefficiencies) and the doctor’s receptionist just took the patient’s badge (which everyone gets at the point of signing up) that had the bar code printed above the patient’s name. She scanned the bar code and the system showed her exactly where the file was (under a stack of a million other files at our last appointment) and it was retrieved and brought before we had even entered the doctor’s office. The small glitch allowed me to see their document movement system at work. Once the receptionist had identified the file’s location, she made a call to that office barked a few admonitions in rapid fire Tamil and a small, ferret like minion appeared within minutes, file in hand.
All the doctors’ fees are the princely sum of 500 Indian Rupees equivalent to Kes 750/-, regardless of whether that doctor is the absolute top dog in his or her field of specialization. This is noteworthy as I was in Chennai six years ago in 2006 and the fee was exactly the same amount of rupees then! The result is that one gets attended to by the very best in the field of medicine that one is seeking attention for without worrying about the cost of paying for that experience. It also bears noting that where one is admitted into the hospital, one is cared for by a team of specialists [typically a senior and a junior doctor] No one doctor can treat you alone and it makes for excellent health care as the team collectively decided on the best course of action after vigorous debate and discussion.
I daresay it will be a long time before our private medical services will attain the economies of scale that their Indian counterparts enjoy which allow them to drive volume and keep the prices low. But the local medical industry does have the capacity to improve efficiencies in their service delivery. Those improvements lead to a lower cost of production and should translate into lower prices for medical services. Increasing the volume of treated patients by reducing the time taken from start to finish of a hospital visit would be a good start. This helps to build confidence in patients (customers) that going to hospital to seek medical attention sure beats hunkering down on the sofa and wishing the sickness away.
On a lighter note, every time I entered the Chennai hospital, I would be met by a hospital orderly, face was covered with a mask, and whose sole purpose was to slather antibacterial spray on anyone entering the hospital (before we placed our bags through a security screening machine). This fellow took his job very seriously, until about 1 p.m. when he took his lunch break. At this point, no one would man the bacteria-security point until he returned from his break. I gathered Indian bacteria goes on lunch break too.