With this year’s International Day of Older Persons (Oct 1) almost around the corner, we decided to do an in depth analysis of this opportunity. ‘Why should one invest in geriatric care?’ asks our cover story (pages 11-15) and goes on to highlight the pioneer players in geriatric care in the country as well as the roadblocks.
A long term solution would be to start right at the beginning, by giving geriatrics its due in medical curricula. As of today, only one medical college in the country, Madras Medical College, offers a full-time geriatric MD programme while Indira Gandhi National Open University (IGNOU) offers a one-year part-time Post-Graduate Diploma in Geriatric Medicine.
KPMG International recently released a new global report, ‘An uncertain age: Reimagining long term care in the 21st century’ and again, India does not feature as we do not have an organised approach to elderly care. Amit Mookim – Partner and Head of Healthcare, KPMG in India makes an important point when he says that the Indian system of care is not patient centric and is still a reactive rather pro-active approach – with emphasis on treatment rather than management. (read more on page 25)
We also need to recognise that senior care extends beyond the hospital and in fact, home care for the elderly is the thrust of such initiatives globally. Also, medical/clinical care is only one facet; meeting the psychological needs of this segment of the population calls for special skill sets. And thankfully, we already have a few efforts like Epoch. Another story in this issue, ‘Sunset years of solitude’, (pages 70-71) shadows an Epoch elderly care specialist as she helps a senior citizen go ‘social’ with Facebook as well as taking him down memory lane.
If geriatric care is all about appreciating and acknowledging the right of our elders to healthcare and a place in our society, we carry forward this theme to the In Imaging section as well. The lead story, ‘Old is gold: Aye or nay?’ (pages 49-50) debates the pros and cons of the refurbished equipment market. Overcoming the mind block of re-using medical equipment took time, but today players like Sanrad are meeting the growing demand for diagnostic imaging services from India’s rapidly urbanising smaller metros. Sanrad’s founder, Ratish Nair reels off the names of towns in rural Maharashtra and other states where his machines allow doctors and radiologists to have a decent practice even as they accommodate the numerous requests from family, friends and NGOs for ‘free’ tests.
In fact, their success has convinced the big brand players, who used to initially look down on refurbished equipment, to go down the same path. Today, original equipment manufacturers (OEMs) have dedicated divisions for their own refurbished machines and have realised that at this price point a whole new market opens up to them.
Even though corporate hospitals still don’t trust or admit to using refurbished medical equipment, it is only a matter of time before this mental block is demolished. Using refurbished medical equipment is by no means a ‘third world’ strategy to balance cost with reliability and credibility. It is a recorded fact that the trend of refurbishing medical equipment started from Japan, where hospitals don’t buy but lease such medical equipment and therefore need to buy afresh when each three-year lease period expires. Nair of Sanrad says that 40 per cent of such refurbished machines from Japan’s hospitals find their way to medical facilities in the US, and this number is only going increase as Obamacare forces further cost cutting.
This is one price war where the patient wins as both sets of players keep each other on their toes. A recent IMS Health study, ‘Understanding Healthcare Access in India: What is the Current State?’, once again underlined the urban-rural skew in healthcare. Urban residents, who make up 28 per cent of India’s population, have access to a lion’s share (66 per cent) of the country’s available hospital beds, while the remaining 72 per cent who live in rural areas have access to just one-third of the beds. Thanks to refurbished radiological equipment, we can be assured that more of these areas will at least have better access to diagnostic imaging services. Old it seems, is truly gold, both when it comes to medical equipment, as well as our senior citizens.
Viveka Roychowdhury
Editor