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HOSPITAL management is a very important and popular academic course in many universities abroad, especially the US which is a forerunner in its sophisticated approach to education. For a long time, it was thought that starting and running a hospital was no different from managing any other kind of institution. You brought a few public figures to serve as directors on the board, mobilised the needed financial resources as equity and loan, invested in infrastructure and equipment, appointed the professional and ancillary personnel, fixed the scales of fees to give the expected rate of return — and you were all set.

Many well-meaning promoters have been misled by these standard preliminaries into regarding a hospital too to be like all other mundane business propositions. This explains the poor shape, in terms of bottom line, quality and service, of many corporate hospitals. It is a strange paradox viewed against the fact that with the burgeoning of the population, the number of patients too is exploding. A good number of hospitals have eminent medical luminaries at the helm or on the board. Apparently, the belief that a technical person at the helm of a technical outfit will necessarily do a good job of managing does not hold good in their case.

In truth, a hospital is far more complex and difficult to manage than other organisations. The reason is that it is intimately concerned with the most precious and personal pursuit of a human being: Good health, without which there can be no happiness and life itself may not be worth living. Entering a hospital means all the difference between suffering and well-being, pain and pleasure, and life and death.

How many of those running hospitals understand this? In the US, because of the respect for human life, the first and the highest priority is the condition of the patient to which all other considerations, including payment of the charges in emergency cases, are subordinated. You go to any big hospital in India. You straightaway bump into front office bureaucracy which is as wooden and insensitive as any other bureaucracy and treats you as a commodity, not even a customer. Patients are pushed around with little sign of sympathy or kindness.

Check the following as true or false: You never get to see the doctor exactly at the time given. For the hospital, you are an idler and a vagrant with no commitments of your own. Consultant doctors are often so unpunctual that you may have to wait for an hour or more before they turn up. The manners of the doctor are unsmiling, brusque and blunt. When he prescribes a procedure, test or medicine, you have just to lump it. There is little effort on his part to put you wise on the reasons, possibilities and prognosis. Rarely are the side effects and contra-indications of the drug explained. Dealing with patients has become mechanical, with no thought for their doubts and anxieties, and those of their relations. There is no salvation unless India's hospitals become human institutions.

B. S. Raghavan

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