August 16, 2014
This morning we decided to separate in a few different directions so that we could maximize the number of people we spoke to, as our final few days in Hyderabad are approaching. Erin and Jay went off with Raju to search for more GPs around the area whilst Maddie, Anant, and Kesavan went to Osmania General Hospital (OGH) to watch a procedure and speak with patients, doctors, and students.
Erin and Jay tried their luck following up with a few of the GPs the group had met on Thursday and attempted to search for a few of their own. Unfortunately, most of the GP offices did not open up until 9:30 or 10am. Luckily Raju, who saw how much trouble they were having, suggested that they go talk to one of his friends that he knew had previously had a cardiac surgery. Suprisingly, Raju's friends welcomed us into his home and willingly spoke with us about his medical history and knowledge about insurance and cardiac issues. The two of them then made their way back to one of the GP houses they had found on Thursday. When the the doctor came to the door he immediately seemed taken aback that they were asking to speak with him. He quickly shooed them away from the house, but not before telling them to go visit Dr. Salman at his clinic down the road. After some help from people on the street, Erin and Jay made their way to Dr. Salman's office. Inside the office they found a busy waiting room with about 12 chairs, a consult room, and a pharmacy room. Dr. Salman was busy attending to his patients, so they patiently took seats in the waiting room. Jay used this opportunity to speak with a number of the patients about their conditions, how they got to the clinic, why they were there, and what their normal pathway was while Erin did her best to pick up on the few words that are the same in English and Hindi. When it was finally their turn to go into the consult room, Dr. Salman was more than happy to share his thoughts on the Indian medical system and provided some helpful insights into the role of general practioners in the care pathway.
Following the talk with Dr. Salman, Erin, Jay and Shruthi headed to Global Hospital to speak with Dr. Naveen, a neurologist. Becuase of the lack of awareness and knowledge surrounding bradycardia and arrhythmias in India, a number of patients who faint from cardiogenic syncopes end up at a neurologist office instead of a cardiologist. Although Global Hospital is a private hospital and one of the most prestigious and structured hospitals we have seen in India, Dr. Naveen acknowledged that this can still be an issue and shed some light onto his thoughts regarding patient awareness and healthcare in India.
Meanwhile at Osmania, Maddie, Anant and Kesavan were kindly accommodated again by Dr Imamuddin, who invited them to watch a pacemaker revision procedure and talk to the patient afterwards. During the procedure they spoke to Martin, a technician who had been practising for 33 years, who provided some valuable insights on how age is a strong influencing factor on the adoption of implantable devices. He also explained why some patients abscond from treatment at OGH at the last minute. The majority of patients who come to this government hospital are below the poverty line, which means that under the Aarogyasri Insurance scheme for Andhra Pradesh, they are also eligible for treatment at corporate private hospitals, which are required to allocate 30% of their beds to the scheme. When these patients are given a definite recommendation for a medical device at OGH, they are sometimes found to be swayed by the advertising provided by corporate hospitals and will go to these institutions for treatment instead due to perceived superiority in facilities and care. The reality is, the OGH cath lab is just as adequate as some of the other private facilities. This was an interesting perspective to hear, as it uncovered some underlying insights about the power of money in societies such as India where there are significant discrepancies in knowledge and resources.
After speaking to a few patients and their families, plus pharmaceutical representatives in the outpatient center, Anant, Kesavan and Maddie had gathered a substantial amount of information on the experiences and concerns patients have, as well as the decision processes GPs go through in distinguishing bradycardia from hypertension and diabetes (now the two most prevalent medical conditions in India). They moved on next to a meeting with a medical student about her experiences working in the OGH system. Her personal insights spoke very strongly to the team and will be shared in a subsequent post.
After a long and information-packed day for everyone, the team regrouped in the afternoon to discuss what they learned and to plan out the next few days.
This morning we decided to separate in a few different directions so that we could maximize the number of people we spoke to, as our final few days in Hyderabad are approaching. Erin and Jay went off with Raju to search for more GPs around the area whilst Maddie, Anant, and Kesavan went to Osmania General Hospital (OGH) to watch a procedure and speak with patients, doctors, and students.
Erin and Jay tried their luck following up with a few of the GPs the group had met on Thursday and attempted to search for a few of their own. Unfortunately, most of the GP offices did not open up until 9:30 or 10am. Luckily Raju, who saw how much trouble they were having, suggested that they go talk to one of his friends that he knew had previously had a cardiac surgery. Suprisingly, Raju's friends welcomed us into his home and willingly spoke with us about his medical history and knowledge about insurance and cardiac issues. The two of them then made their way back to one of the GP houses they had found on Thursday. When the the doctor came to the door he immediately seemed taken aback that they were asking to speak with him. He quickly shooed them away from the house, but not before telling them to go visit Dr. Salman at his clinic down the road. After some help from people on the street, Erin and Jay made their way to Dr. Salman's office. Inside the office they found a busy waiting room with about 12 chairs, a consult room, and a pharmacy room. Dr. Salman was busy attending to his patients, so they patiently took seats in the waiting room. Jay used this opportunity to speak with a number of the patients about their conditions, how they got to the clinic, why they were there, and what their normal pathway was while Erin did her best to pick up on the few words that are the same in English and Hindi. When it was finally their turn to go into the consult room, Dr. Salman was more than happy to share his thoughts on the Indian medical system and provided some helpful insights into the role of general practioners in the care pathway.
Following the talk with Dr. Salman, Erin, Jay and Shruthi headed to Global Hospital to speak with Dr. Naveen, a neurologist. Becuase of the lack of awareness and knowledge surrounding bradycardia and arrhythmias in India, a number of patients who faint from cardiogenic syncopes end up at a neurologist office instead of a cardiologist. Although Global Hospital is a private hospital and one of the most prestigious and structured hospitals we have seen in India, Dr. Naveen acknowledged that this can still be an issue and shed some light onto his thoughts regarding patient awareness and healthcare in India.
Meanwhile at Osmania, Maddie, Anant and Kesavan were kindly accommodated again by Dr Imamuddin, who invited them to watch a pacemaker revision procedure and talk to the patient afterwards. During the procedure they spoke to Martin, a technician who had been practising for 33 years, who provided some valuable insights on how age is a strong influencing factor on the adoption of implantable devices. He also explained why some patients abscond from treatment at OGH at the last minute. The majority of patients who come to this government hospital are below the poverty line, which means that under the Aarogyasri Insurance scheme for Andhra Pradesh, they are also eligible for treatment at corporate private hospitals, which are required to allocate 30% of their beds to the scheme. When these patients are given a definite recommendation for a medical device at OGH, they are sometimes found to be swayed by the advertising provided by corporate hospitals and will go to these institutions for treatment instead due to perceived superiority in facilities and care. The reality is, the OGH cath lab is just as adequate as some of the other private facilities. This was an interesting perspective to hear, as it uncovered some underlying insights about the power of money in societies such as India where there are significant discrepancies in knowledge and resources.
After speaking to a few patients and their families, plus pharmaceutical representatives in the outpatient center, Anant, Kesavan and Maddie had gathered a substantial amount of information on the experiences and concerns patients have, as well as the decision processes GPs go through in distinguishing bradycardia from hypertension and diabetes (now the two most prevalent medical conditions in India). They moved on next to a meeting with a medical student about her experiences working in the OGH system. Her personal insights spoke very strongly to the team and will be shared in a subsequent post.
After a long and information-packed day for everyone, the team regrouped in the afternoon to discuss what they learned and to plan out the next few days.
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