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Interview: ‘Patient is the Boss in healthcare industry’ — Sunil Saggar

Sunil Saggar is currently the chief executive officer at Jaipur Golden Hospital in New Delhi. He is a Qualified Hospital Administrator and has also done his Masters in Hospital Management and Human Resource Management. Besides, he is also Six Sigma (Green Belt) trained and certified Hospital Industry professional with more than 36 years of versatile experience in management cadre across various hospitals including St Stephen’s Hospital, Gandhi Eye Hospital, Narinder Mohan Hospital, Moolchand Medicity, and Rajiv Gandhi Cancer Hospital. He is also a member of various professional bodies and work groups.

Sunil Saggar
Sunil Saggar

In an exclusive interview with India Medical Times, Sunil Saggar spoke about the new trends, evolution and quality care in the healthcare industry of India.

What are the new initiatives taken at the Jaipur Golden Hospital under your leadership?

Healthcare delivery is the delivery which is the most desirable and wanting at the time of the meet. Jaipur Golden Hospital is purely a charitable hospital institution. We are a unique hospital where the patients who are under the BPL (Below Poverty Line) category are taken care of as any private patient would have taken care of. Jaipur Golden Hospital is a complete hospital, which provides all services from A to Z. This is a unique hospital where general/free OPDs are at prime time i.e. morning 9am to 11am. We make sure it is attended by senior consultants and not by senior residents or junior consultants. This is a place where stress is made on choosing your own thing – whether you want to come to general OPD or private OPD – nobody forces you. This is again a unique hospital where under the category of BPL — we have 10% beds free, 20% OPDs free — we provide all the services free because if you see my tagline, WE CARE WITH CARE, that is the point we are making. At Jaipur Golden Hospital we do organ transplant, kidney transplant, cardiac surgery, almost everything and our results are best under the world standards. Whatever we do is not as per the requirement of law but as per the conscious call, which is given i.e. ‘we are here to serve and care with care’.

What are the initiatives taken at this hospital under your leadership?

We create leaders. In our office, there are no calls for managers to how to do things. Because leadership starts from the very beginning – right from the ‘In Gate’ to the ‘Out Gate’.

What a healthcare CEO can and should do to reform the healthcare system?

A healthcare CEO ideally should do what he would expect to be done when he has gone to another hospital (as a patient), for example: service with smile, non-commercial principals, and ethical practices.

What is the advantage of having a professional CEO rather than a senior clinical officer at the helm of affairs?

Having a professional administrative head of the organisation is an advantage especially if he is laced with experience and expertise; it is a completion of the whole thing. The professional CEO, who knows the administrative processes, looks at all the things from the administrative angle, understands the financial, administrative, legal and other things. So that’s the advantage of it. Otherwise if you look at any other person where one side is missing – the delivery of the results will also get affected largely due to this.

What are the strengths of Jaipur Golden Hospital?

The strength is service with smile, ethical practices and taking care of patients as if you are taking care of yourself.

How quality care accreditation is important for a hospital?

Most important aspect of delivering services is ensuring the quality delivered. Quality is not that quality which I understand is management driven qualities. We keep on taking feedbacks from the patients. We keep on raising the expectations of the patients who come to receive a service and then deliver according to that.

What should be done to improve doctor-patient relationship in the changing times?

Ethical services. What is the ABC of a doctor? A is availability, B is behaviour and C is competence. The moment a patient wants a service from a doctor, if a doctor is available it basically serves the purpose. Then his behaviour – he should have time to listen to his patients, he should use his fingers as a physician who understands things, not ordering unnecessary investigations or diagnosis. We at Jaipur Golden Hospital through our team ensure that unnecessary investigations are not done, unnecessary diagnosis are not done, unnecessary references are not made. Doctors should have time to listen to patients. That’s why we make sure our senior consultants provide services to poor patients.

What are some of the major challenges before the Indian healthcare system?

First major challenge is corrupt medical practices, which somehow the industry players are trying to introduce. Second challenge is the referral practices. Third, it is a high investment intensive activity wherein if you do not want to invest in technology, you won’t be giving quality services; and even if we are investing in that the return on it becomes very difficult, because of some corrupt players, some of the players which actually want to have the things done on cut practices or other things. That will kill a genuine organisation – the patient will get diverted for some vested interests.

How to control corruption in healthcare and who will do that?

First of all, if someone wants to set the system right, he or she would have to correct himself or herself first. It’s a moral value. The law, whatsoever you make, it may not work very effectively. Why we have entered this profession? Why we started an organisation? Why there is healthcare delivery service? We have to set our own standards — those standards which are acceptable to the society as well as acceptable to me if I am the service taker.

You have spent more than 36 years in this field, so you have seen the system deteriorated? What are the factors that led to this change?

Over a period of time values have lost their value.

Could you please explain this?

You go to a doctor who is in his 70s or 80s, and you will find that his approach to seeing a patient and a youngster’s approach to seeing a patient is very different. That explains everything. Experience matters. Unless we have taken the history of a patient, unless we have examined the patient, unless we have applied our mind to that, unless we are sure what requires to be done, if we start treating the patient without knowing enough of his history and how much the history is taken that will decide the type of result, the outcome of the treatment. Youngsters have no time and that has eroded their values.

Where do you think the Indian healthcare system is heading?

Strong revolutions are required otherwise we will go down the drain. It is getting eroded and it is eroding fast.

Please explain what kind of revolutions should be there.

The government has taken certain initiatives but those initiatives are again implemented at some level. There might be a revolution but there is no revolution to regulate those people who are chosen for the revolution. That’s the crisis. If you want, you can corrupt the system. Do whatever you want, all the systems are in place, but people still find loopholes – look at pharma industry, diagnostic industry or whatever is there. So, what is important here – it is to regulate ourselves. If everybody corrects himself then the job is done!

Anything you would like to add?

We should treat patients as the boss. Who is the boss in this industry? It is the patient. If the patient decides to spend his time elsewhere, no institution would exist. So, patients basically give us an opportunity to serve. And if we do not provide that service, he will go away.

by Rajesh Barnwal

7 Comments

  1. kajamohideen kajamohideen Monday, October 12, 2015

    ‘Patient is the Boss in healthcare industry’
    Sunil sir I first thank you for giving me this opportunity. As many people say I too accept that Patient is boss in our field.
    In certain field in the present situation where some time this ‘Quote’ has some practical difficulties. Patient are today getting awareness on the healthcare industries from different medias, which creates a lost of wrong perception by the patient and attenders during certain times i.e. during discharge or on the final settlement. Even the media’s some time does not explore the exact incident happened. In those cases this patient becomes a boss and collapse the exact situation.
    sir Please don’t take this as if I am against this quote, but this is my view as a healthcare administrator facing these problem certain time. Otherwise Always “Patient Is the boss in Healthcare Industry”

  2. Kalpna Gulati Kalpna Gulati Friday, October 9, 2015

    A very well written article. And for the youngsters…well the values are our own…whether we succumb to corrupt practices or keep ourselves clear to our conscience is our choice. And this is not only just for the medical field but any of the other fields too. The impact that these values have on medical field is though manifold as it involves human lives!!

    Great going Mr. Saggar!! Very few people in the health industry hold these values and ethical character.

  3. An ardent follower An ardent follower Wednesday, October 7, 2015

    I can just say that the patients need organizations like yours with people like you sitting at the helm to manage the affairs. Rest all becomes incidental and is a by-product. Having personally seen and felt it, I understand what it feels if you have a medicine expert willing to listen to you, spare some time to diagnose the things properly,advice care impartially and then follow it up with regular checks. While it is definitely good for the patient, it works wonders for the confidence of the attendants and provides them the necessary comfort that someone is there to take care of the patient with as much passion and dedication as the attendant would have asked for. This community is getting rarer by the day, which should be a cause of concern for all of us.

  4. Raja Dutta Raja Dutta Wednesday, October 7, 2015

    i congratulate you on this nice interview delivered. I fully agree with you in all the issues discussed in the interview & agree with your remark. Yes patient is our boss he decides what he wants & because of him healthcare org is exist. We are here to serve his well being. Rightly mentioned about professional administrator as CEO not the clinician who only know half of the dealing issues that is not enough. When as CEO you are handling any case then one myst see holistic approach of ethical, financial, legal & compassion. Maximum time clinician turned CEO only deals the clinical aspect with lot of weight without realising financial burden & legal. They take decision like half baked cake. Hence more & more senior clinician opting for MBA

  5. S K Kochhar S K Kochhar Wednesday, October 7, 2015

    The thoughts are rational and thought provoking
    New generation doctor may be angry but they are compelled to swim with systems otherwise they will sink and stink

    Patient is boss then the need is to teach and correct the system to recognise the rational expectations of the patients

  6. Dr GD Sharma Dr GD Sharma Tuesday, October 6, 2015

    The article and reply are both true . The article shows the effect of deterioration and the reply is the cause by a young medic correctly.None bright today wants to join teaching as half the seats r reserved
    and salary of an Asstt Prof adhoc post Mch is 70000 in Delhi. The corporate sector lures by a bait bigger than a medic can chew , hence remains under stress to generate more money by any means . It’s sensible to take a realistic MG , to perform well ethically and retain job too.
    The few left as last Mughals of ethical practice should come forward to help learning of next generation. Looking at a young surgeon , u can always tell the qualities of his teachers as young medics r by far the mirror image of their mentor.

  7. Youngster. Youngster. Tuesday, October 6, 2015

    Quote:
    “You go to a doctor who is in his 70s or 80s, and you will find that his approach to seeing a patient and a youngster’s approach to seeing a patient is very different. That explains everything. Experience matters. Unless we have taken the history of a patient, unless we have examined the patient, unless we have applied our mind to that, unless we are sure what requires to be done, if we start treating the patient without knowing enough of his history and how much the history is taken that will decide the type of result, the outcome of the treatment.
    Youngsters have no time and that has eroded their values”.

    Respected Sir,

    Many thanks for sharing your wisdom.

    Pardon me for disagreeing on one point though: That youngsters have no time and that has eroded their values, etc.

    As a youngster, may I dare to defend a few doctors of my generation:

    Youngsters have no time because their teachers failed to instil values.

    Youngsters rush on to tests because that’s what their teachers and seniors taught them, and that is what they have seen their elders do.

    Youngsters have no time because they are pressure from employers to generate cash, or get out.

    Youngsters today are eroded because they are made to believe that only making an obscene amount of money, hook or by crook, will make them “successful”.

    Proof? Hardly anyone among the top rankers wants to get into Internal Medicine as 1st choice today. Psychiatry? Bah! Though 10-20 percent population is mentally ill, 1-2 % being schizophernics. The need is huge, but then why are there so few interested? Family Medicine is another specialty which already pretty much follows what you have suggested as ideal, is well established in most countries with cost-effective care, but which hardly anyone knows about in our own India- thanks to the vested interests you have hinted on.

    Radiology is the top choice of today’s doctors. Little touch needed, little interaction with patients needed, little involvement needed, but rake in huge money from testing and glamour. That itself speaks of the “values” among our young doctors. They are not born with these values, but they learn from the “system” and their teachers.

    Youngsters today are eroding because they are a chip off the old block.

    Youngsters today are eroding in values because 75% of them who are practicing doctors today are doing so by getting medical seats on the “strength” of caste, or money power. Merit has got only 25% presence in today’s medical admissions. With doctors who have never known the value of hard work being doles out seats these ways, what “values” would one expect?

    Sorry Sir, The generation of elders is responsible for the unfortunate names that the medical profession is given today. A few among them started the trend of greed, selling of medical seats, selling the profession, etc in the 90’s that you mentioned. Majority of the your generation weren’t foresighted enough to see where it was heading to.
    They are guilty of being silent onlookers when the trend started in those decades.

    Kindly spare the youngsters from the sins of their professional forefathers.

    The good news is, there are still a good percentage of youngsters who are doing their job, with sincere attitude, selflessly. They work with a proper approach to history, examination, and the ABC’s you have suggested. There are youngsters who stick as much as possible to values, even opt for Internal Medicine or Psychiatry over radiology or the increasingly “powerful” MBAs in hospital administration. Unfortunately they will never be heard of. Neither the mainstream media nor even India Medical Times will be interested in them for one simple reason- they are not “corporate” enough.

    Sir, we need more leaders of your stature to take us youngsters back to the 80’s in terms of attitude. We really do. Most of us have just started practicing. Many of us are willing to learn, and bring back the good old days of trust back to the medical profession.

    Hope we see better days ahead. Lets work together.

    Thanks and regards,
    With due respect sir,
    An unfortuntate youngster doctor.

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