Medical care redefined

Published : Sep 10, 2004 00:00 IST

Offering world-class medical care at affordable costs, Bangalore's multi- and super-speciality hospitals attract more and more domestic and overseas patients.

WITH a growing number of multi-speciality and super-speciality hospitals and a large reservoir of doctors, Bangalore is becoming a serious competitor for cities like Mumbai, Chennai and even Delhi as a destination for domestic and overseas patients seeking world-class medical care. Given the top-notch facilities and care offered by these hospitals, it is not surprising that overseas patients, especially from the West and West Asia, make a beeline for Bangalore. (The cost of medical care in Bangalore is a fraction of what they incur in their respective countries.) This fact prompted a suggestion in the State legislature recently that Karnataka should actively promote `health tourism'.

Among the best of Bangalore's multi-speciality, super-speciality hospitals offering complete care is the 250-bed Sagar Apollo hospital, promoted by the Sagar Group. According to Dr. D. Premachandra Sagar, chief executive officer, Sagar Apollo Hospital, the hospital's aim is to offer patients world-class facilities, diagnosis, treatment, convalescence and comfort in an ambience that is totally unlike a hospital.

The hospital has six presidential suites (each equipped with an intensive care unit, a kitchen, a pantry and a waiting room, and costing Rs.7,500 a day), 10 day-care beds, seven operating theatres with two of them in a state of readiness round the clock), 32 general ward beds (each costing Rs.400 a day), 78 semi-private beds (Rs.900), 20 private rooms (Rs.1,750), 20 deluxe rooms (Rs.2,500), a critical care unit (with 60 beds), top-rung diagnostic services, six dialysis machines (Rs.1,000 a session), a dedicated neuro ICU, corporate empanelment, annual health screening programmes, a telemedicine facility, blood bank and a state-of-the-art Cath lab where angiographies, stenting, fixing of pacemakers, device closures and other cardiac-related procedures are done. The hospital also runs Spine Service, a centre run by a team of neurosurgeons and orthopaedic spine surgeons that offers complete spine care and spine trauma care, congenital deformity correction for scoliosis, kyphosis, microdiscectomy for cervical and lumbar disc prolapse, and so on.

The hospital's orthopaedic department has also been successfully performing primary joint replacement surgeries of the hip, knee and shoulder. It hopes to widen its ambit by including surgeries for the elbow, wrist and fingers.

According to Air Commodore (Retd.) K.P. Das, Medical Director, Sagar Apollo, the hospital has to its credit many firsts in India: it was the first to install a spinal cord stimulation device for cardiac cases; start a surgical workshop on facial nerves, conduct a laparoscopic radical prostatectomy, start a fibroid clinic and launch birthing suites. The birthing suite involves a 72-hour package costing Rs.29,999 (for normal deliveries) and allows a pregnant woman to stay in the same room through labour, delivery and recovery. The suite along with its adjoining lounge for the person accompanying the mother-to-be is equipped with all the facilities of a comfortable modern home and is designed to offer the best of both worlds - the comfort of a home and the medical security of a modern hospital. Sagar Apollo Hospital was also the first to conduct a bone marrow transplant in Karnataka.

With around 200 consultants available at the hospital, patients have a wide choice to choose from. The hospital's 27 consultation suites (seven of which are dedicated to neurology, gastroenteritis and diabetology cases, and two for cardiac cases) are visited by around 100 patients every day. Besides the consultants, the hospital has 50 resident doctors. According to Prof. Ramamurthy Bingi, a consultant cardiologist, the hospital conducts around 12 coronary artery bypass surgeries every month. The patient charge is around Rs.95,000 for the general ward and Rs.1.35 lakhs for a semi-private room.

The hospital only conducts related renal transplantation. Each patient needs to be first cleared by the eight-member In-House Ethics Committee chaired by a retired judge. So far five transplants have been performed. The hospital has four nephrologists and four urologists. Sagar Apollo is equipped to conduct cadaver transplants and it recently entered into an agreement with the Foundation for Organ Retrieval and Transplant Education, the pioneer organisation for cadaver transplants in Karnataka.

The Sagar Group, which owns and manages 30 hospitals across the country, is planning to build three more hospitals in Bangalore and open representative clinics in other parts of the country.

THE M.S. Ramaiah Memorial Hospital (MSRMH) is a Rs.100-crore, multi-speciality, state-of-the-art, one-stop centre for all medical disorders. Total health care solutions from cardiology to urology are offered under one roof. The 5,00,000 square feet, 350-bed swanky new hospital will soon also be a postgraduate teaching and research centre. While the 750-bed M.S. Ramaiah Hospital built in 1985 continues to serve the underprivileged, MSRMH is meant for the patient who "doesn't mind paying a little extra for excellent medical facilities and an ambience that is akin to 5-star comfort". MSRMH is the brainchild of M.R. Jayaram, the chairman of the Gokula Education Foundation, which runs the hospital.

A bed in the general ward (six/eight beds in all) costs Rs.450 a day (all inclusive), a bed in the four-bed general ward costs Rs.675, a semi private room (two beds) costs Rs.900, a private room Rs.1,350 and a deluxe room Rs.2,100. The hospital currently has an occupancy rate of over 80 per cent.

According to Dr. Naresh Shetty, medical director, MSRMH, the infrastructure at the hospital is of international standards and is capable of handling any kind of medical emergency, including disaster management. The hospital's 24-hour emergency, trauma and critical care wing, connected by wireless and hotline services, has state-of-the-art ventilatory and monitoring equipment, a comprehensive pre-anaesthesia clinic, a pain clinic and palliative care services. The hospital is equipped with eight operating theatres, which, according to B.R. Prabhakara, chief executive, Gokula Education Foundation, are rated as among the best in the world by leading surgeons in the United States.

The hospital has over 200 full-time doctors available on call 24 hours a day, eight dialysis machines, a blood bank that also undertakes manual plasmapheresis procedures, a blood component separating centre (that offers packed red blood cells, platelets, cryoprecipitate, saline washed red cells and fresh frozen plasma), a diagnostic imaging and interventional radiology centre that offers multi slice CT scanning, computed radiology, ultra sonography and colour doppler, magnetic resonance imaging (MRI), mammography and a specialised referral testing laboratory that currently offers around 1,500 tests.

The departments in the hospital complement one another in offering services that are thorough and specialised. There are dedicated clinics for general cardiology, adult cardiology, paediatric cardiology, pacemaker and cardiac arrhythmia and hypertension. Among the cardio vascular interventions performed at the hospital are balloon angioplasty, stenting and valvuloplasty. Among the non-invasive procedures are electrocardiogram (ECG), stress ECG, transesophageal echo, vascular profiler, event recorder and ambulatory blood pressure monitoring. MSRMH offers surgeries such as coronary artery bypass graft, valve replacement, valve repair, re-do cardiac and arrhythmia.

In a bid to fasten the recuperation of patients who have undergone cardiac surgeries, the hospital has constructed an impressive roof-top garden - complete with steps and paths to walk on, greenery and cascading water. In-hospital cardiac care patients will be encouraged to spend time and walk in the roof garden, the first of its kind in India.

The hospital's Department of Gastroenterology offers emergency endoscopy around the clock, while the Department of Clinical Immunology has specialised clinics for arthritis, vasculitis and connective tissue diseases and immuno-deficiencies. MSRMH also prides itself about its Centre for Nephro-Urology, which, besides dialysis, offers renal transplantation, paediatric nephrology and reconstructive urology, Neurosciences Centre (both neurology and neurosurgery) and its Cancer Institute. The Cancer Institute offers radiation, medical, surgical and gynaecological oncology.

The Karnataka government has on more than one occasion reserved a room in the 215-bed, multi- and super-speciality Mallya Hospital, managed by Chaparral Health Services Ltd, whenever the President or the Prime Minister visits Bangalore. For Commodore (retd.) Indru Wadhwani, president, Mallya Hospital, there can be no bigger recognition than this of the hospital's commitment to quality services. Says Wadhwani: "Our policy is to achieve continuous improvement in providing quality patient care using state-of-the-art technologies and rendering service with a human touch."

Opened in June 1991, Mallya Hospital is the first hospital in India to be awarded the ISO-9002 certification. In June 2003, it was upgraded to ISO 9001:2000. Says Wadhwani: "To make a good hospital which believes in quality patient care you need three elements. First, the best consultants, and we have them. The hospital has 170 consultants. Secondly, you need state-of-the-art equipment, which we have installed. And thirdly, committed and motivated employees who take care of patients all the time and with a smile. I think my 800 employees do that."

According to Wadhwani, Mallya Hospital has almost all major medical specialities - advanced oncology, neurology, orthopaedics, neurosurgery, ENT, nephrology, cardiology, dentistry, ophthalmology and so on. The hospital is equipped with state-of-the-art dialysis machines, a high-speed CT scanner, a C-arm, mammography and ultrasound machines, an Echo machine, an advanced catheterisation lab, intravascular ultrasound machine, a 1.5 Tesla Symphony high-energy MRI scanner, a modern intensive care cardiac unit (ICCU), an exclusive medical intensive care unit and seven operating theatres. The hospital recently added two operating theatres, which have stainless steel panelling, sophisticated lights and vertical lamina flow to ensure the highest standards of infection control. The hospital recently equipped its Renal Care Centre with advanced dialysis machines. The hospital's ICCU has also been expanded from eight to 14 beds.

It has conducted several successful coronary bypass, open and closed heart, spinal, tumour, orthopaedic, plastic and craniotomy surgeries, double valve replacements and renal transplants. And though it is known to be a corporate hospital - given the large number of clients from that sector - Mallya Hospital, according to Wadhwani, has the largest number of general ward beds (38) for a hospital of its size. Says Wadhwani: "This is yet another indication of our commitment to the socio-economically weaker sections of society. We also conduct a number of free basic health camps. And our general ward package for a bypass surgery costs Rs.90,000."

In a bid to further improve its services, Mallya Hospital is acquiring an Innova 2000S Cathlab, an Infinia with Hawkeye gamma camera (for use in nuclear medicine and advanced imaging for cardiac checks) and a C-Arm Flexiview 8800 series (for use in radiology and orthopaedics). The hospital's blood bank is planning to expand its services by including blood component facilities.

It may not quite qualify as a super-speciality hospital but the 421-bed Dr B.R. Ambedkar Medical College and Hospital offers a service that few in the private sector can match. Doctors in its outpatient departments see, free of charge, as many as 500 patients every day, most of whom are from below the poverty line families and slums. Most of these patients visit the hospital to get treatment for respiratory infections, gastroenteritis and skin allergies, and for minor surgeries.

The teaching hospital has as many as 318 doctors (including 43 professors). It offers services in all specialities ranging from general medicine and surgery, dermatology, orthopaedics and paediatrics to gynaecology. Most minor surgeries are done without fees. Even for major surgeries, the costs are minimal: a laparoscopy costs Rs.1,250, orthoscopy Rs.1,000, a joint replacement surgery Rs.1,200, and endoscopy Rs.250. There are no charges for a tubectomy.

Says Dr G. Mohan, principal of the college: "We only charge for the drugs and anaesthesia. For an appendectomy, we charge Rs.250. In our maternity ward, we do not charge any delivery charges."

Adds Dr. S. Manmohan, the hospital's medical superintendent: "Even in our diagnostic laboratory we do not charge for biochemistry and micro-pathological tests. And we do around 300 investigations every day. Our X-ray charges are only Rs.60."

The hospital has a full-fledged blood bank. It conducted a number of surveys on the incidence of hypertension, diabetes, cancer, and cataract among people living in the vicinity. It hopes to start cardiac and neuroscience centres in the near future.

Praxair Healthcare Services, a division of the $6 billion multinational company, Praxir, has established itself as a name to reckon with in health care circles. Fifty per cent of its business comprises production and supply of oxygen, nitrogen and carbon dioxide, calibrated gases, gas mixtures and nitrous oxide to leading hospitals. Its other popular services are pipeline distribution and waste water treatment systems in hospitals. It recently opened an ozonated laundry system, which, according to Asit Gangopadhyay, senior vice-president and Head of On-Site Business Development, Praxair Healthcare Services, is being used by almost all the leading hospitals in Bangalore. It currently washes around 3,000 kg of linen every day. This is expected to go up to 7,000 kg a day by the end of the year.

Praxair Healthcare Services has opened its Home Respiratory Centres at Bangalore, Chennai and Mumbai. Patients with chronic obstructive pulmonary diseases like asthma can call the centre and get relief at their doorstep. The company has also launched sleep therapy equipment for patients with obstructive sleep apnoea.

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