Economics Of Surgery In India

Developing countries like India might not keep public health as one of the top priority, such as in the US. Be it cataract, obstructed labor, symptomatic hernia or anything else -it adds a significant burden of ill-health on the rest of the population.

Despite the lack of health care facilities in India as compared to the developed nation, India still continues to one of the most preferred nations for 'medical surgeries'. The medical tourism in India is known to be growing at an exponential rate. It is expected to be around $7-8 billion dollars till 2020 (according to a survey by Confederation of Indian Industries conducted in October 2015).

The primary reason that India attracts so much medical travel value is because it is extremely cost-effective and high-quality service industry.

BW Businessworld spoke to Dr. Ganesh Shivnani, senior consultant and chairman, department cardiac surgery Ganga Ram Hospital, New Delhi. Dr. Shivnani (55) has made an unusual record in LIMCA Book of Records for performing most successful Bypass Surgeries. He completed 446 consecutive coronary bypass surgeries without any casualities (from Feb 18, 2013 to Feb 15, 2015). For the last two decades he is leading a successful medical practitioner with 5000 bypass surgeries to his credit. Besides this, he has also shown his up-to-mark proficiency in Valve Repairs and Replacements.

Though Dr. Shivanani works in a very tight schedule throughout the day and takes up to four surgeries on a given week-day, he found time to interact with us. An extremely down to earth person, with a genuine smile he welcomes me to his office.

Excerpts from the interview:-

Sir, please share your journey behind featuring in the LIMCA book of world records?
It came as pleasant surprise to me that the number of coronary bypass surgeries I had completed, qualified as unusual entry in the book of world records. I actually, never thought on those lines. I was happy doing my duty as a doctor but my colleagues pressed me to register. So, all the credit goes to them. Later, however I realized how much good it can do to the society.

What is your take on the challenges of faced by practicing surgeons these days?
Nowadays, in the field of cardiology and cardiac surgery, I witness a lot of change. In my 20 years long career, I have seen aged patients (60+ age) coming for a bypass surgery, but now even much younger patients have serious heart complaints. The age factor poses a very complex kind of a challenge for doctors. The reason behind it may be anything ranging from lifestyle, eating habits or stress but it challenges a doctor to sustain the life of a patient beyond 5-10 years or more.

The second one is just an emerging trend in our field, which came up 5-10 years ago. Earlier, people from the cardiology branch would only assess a patient's case and tell what kind of surgery would be required. However, these days, cardiologists have become specialists and can even perform stunt or valve surgeries. Clinically speaking, cardiac surgeons now handle only left-over work.

Doc, what do you think about standards of medical studies in India?
On a personal note, I think it is getting better and better. Indian doctors are actually considered the best minds, globally. There is not dispute about that. Further, I feel NEET exam notification passed by the government this year, has enhanced the quality bar further up. Now at least the private institutes offering medicine seats on donation, shall not be able to let in undeserved candidates. It was a much desired legislation.

Have you come across any interesting concept or discovery in the field of surgery that you would want to share?
I would like mention the low cost surgeries concept, brought in by Devi Shetty in India and the US. It is known as Narayan Hrudayala, which initiated a concept of micro-health insurance scheme. They mostly take in young doctors; even I would want to contribute in their hospitals if I get a chance.

Their concept is unique and so is their clientele. Since, the difference in the cost of performing a surgery is huge in the US and India, people will prefer the latter anyhow. If the cost of a particular surgery is Rs. 35 lakhs there, here it is just 1/10th, nearly Rs. 3.5 lakhs.

Doc, is there a risk factor involved in cardiac surgeries that people should know about?
Yes, I would say organ transplantation is a tedious process in India. People should know the amount of legalities involved that pushes the time of surgery behind. The government is trying to ease the process of organ transplantation since many years but I feel there is a major need for organ donation banks and the awareness to help the cause. Sometimes, even a single patient's organs can save as many as five lives.

Sir, your words of advice for medical aspirants who want to become surgeons in the future.
Keep in mind 3 A's that would help you to lead a successful life in this profession. Even I have inherited it. These are: Availability, Affability and Ability. These 3 pillars aren't only the makings of an excellent doctor, but an excellent entrepreneur and an excellent human being. As people first would want to talk to you and then see that you are flexible or not then finally, there will be a test of your capabilities.

Thanks doc! It was so insightful talking to you. (Signs- off)
(Smiling) The pleasure is mind.