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Sunday, September 7, 2014
Monday, August 11, 2014
This apathy has been historically global. Hospital administrators were looked upon with a degree of disdain. Most of the hospital superintendents in my medical school days (more than four decades ago) had gravitated to that position after a prolonged clinical career when it was presumed that they had acquired all the skills necessary to function effectively as administrators. The need for specialized training was completely unappreciated. In fairness some of them did demonstrate efficiency but for most it was a welcome sabbatical from years of clinical overload.
Quality Management In Hospitals (2nd Edition)
Author: S K Joshi
Paperback: 464 pages (Rs 595)
Publisher: Jaypee Brothers (2014)
Sunday, August 10, 2014
For the residents of West Bengal, the long wait for All India Institute of Medical Sciences (AIIMS) is over as the Narendra Modi-led NDA government has okayed the proposal of setting up of AIIMS in the state.
While informing about the decision over establishment of AIIMS, union health minister Harsh Vardhan on Friday said that the centre has approved the setting up of two AIIMS one each in Uttar Pradesh and West Bengal under Phase-II of Pradhan Mantri Swasthya Surksha Yojna (PMSSY). The scheme aims at correcting the imbalances in availability of affordable tertiary level healthcare and to augment facilities for quality medical education in the under-served states.
The minister further informed the Lok Sabha that AIIMS in Raebareli is under construction, while AIIMS in West Bengal would be set up at Kalyani, about 80 km from Kolkata.
To expedite the setting up of AIIMS, the health ministry has requested the chief ministers of different states to identify three or four suitable locations for the establishment of new AIIMS. ‘Approximately 200 acres of land at a location is required for establishment of one AIIMS-type super-speciality hospital-cum-teaching institution.
The location should have road connectivity, availability of water and electricity,’ a health official said, adding that the state government has to undertake to provide, free of cost land and other required infrastructure such as suitable road connection, sufficient water supply, electricity connection of required load and regulatory clearances for the purpose.
The six new institutions modelled on AIIMS under the Phase-I of PMSSY are located in Bhopal (Madhya Pradesh), Bhubaneshwar (Odisha), Jodhpur (Rajasthan), Patna (Bihar), Raipur (Chhattisgarh) and Rishikesh (Uttarakhand). All these news AIIMS will also have medical and nursing colleges. The Atal Bihari Vajpayee-led NDA government had announced in 2004 the setting up of new hospitals on the lines of AIIMS in New Delhi under the PMSSY.
Under attack over delay in completion of all six AIIMS, health minister Harsh Vardhan had asked all AIIMS directors to complete the institutes within six months, so that PM Narendra Modi can dedicate it to the country on 25 December.
‘Six new AIIMS were the dream of ex-PM Atal Bihari Vajpayee and the foundation stone was laid during his tenure. We want all of them to be inaugurated on his birthday on 25 December,’ Vardhan had said.
Friday, August 8, 2014
Wednesday, July 2, 2014
How do you learn to give injections? Join a nursing school, become a compounder or enrol for MBBS. But, if you ask the Sabharwals, a Delhi-based family of 140 doctors, chances are that they would hand you a banana stem instead. “Our grandfather Dr Bodhraj Sabharwal was so obsessed with making us doctors that, when we were young, he used to make us inject banana stems to teach how to administer injections,” says Dr Vijay Sabharwal, owner of Shree Jeewan Hospital, one of the five hospitals owned by the family in Delhi.
The 63-year-old eye surgeon does not believe in the method. Even without it, his 11-year-old granddaughter Diya has grown adept at giving injections. For the last five generations, every single member of the family has become a doctor. And Diya, too, has no other goal. The World Health Organisation says there is one doctor for 1,700 people in India. If you go by that estimate, the Sabharwals take care of 2,38,000 Indians.
The family entered the profession 95 years ago. Stirred by a speech of Mahatma Gandhi, Vijay's great-grandfather Lala Jeewanmal Sabharwal decided to become a doctor and serve the nation. A station master at Jakhal railway station in Gujrat district (now in Pakistan), he saw people suffering for lack of medical facilities. So he thought the best way to alleviate misery was by making all his children doctors. “He insisted that his four sons study medicine,” says Vijay.
His eldest son, Bodhraj, became a surgeon in 1919. His brothers Rajinder Nath, Trilok Nath and Mohinder Nath followed suit. In 1922, Jeewanlal quit his government job, sold all his property and wife Malan Devi's jewellery to open a hospital in Jalalpur Jattan in Gujrat district, in Khyber Pakhtunkhwa of present-day Pakistan. After the partition of India, the family moved to Delhi and opened five hospitals¯all named after their great-grandfather¯under the Jeewan Trust.
Bodhraj set up a hospital on Rohtak Road, which is now run by his son Ved Prakash's eldest son Vijay. Bodhraj's other two sons, Vinay and Vikesh, have their own hospitals nearby. Rajinder Nath established a hospital at Jeewan Nagar, which was taken over by his sons Ravinder, Davinder and Satinder¯all doctors. It is now run by Ravinder's son, Dr Arvinder. Satinder's son Dr Venu and Davinder's sons Dr Shailender and Dr Vitender have now opened a hospital adjacent to the original one.
The hospital set up by Trilok Nath at Rohtak Road was taken over by his son Dr Omprakash, whose son Dr Sandeep now heads it. Mohinder Nath set up a hospital at Pusa Road, which is now headed by his son Dr Vivek, who has four daughters¯all of them doctors. As the fourth generation Sabharwals hone their management skills, the third generation runs the family hospitals.
Call it the family's devotion for the profession, Dr Bodhraj even trained his wife Leelawanti, a homemaker, as his surgery assistant and anaesthetist. Leelawanti also used to cook for patients.
Vijay says when her mother, Sarla, a gynaecologist, came to their home after marriage, she was first taken to the hospital reception. As luck would have it, just before the new bahu could be welcomed, an emergency delivery case came. “My grandfather insisted that Sarla attend to the patient first and then perform the rituals. So, my mother performed the first delivery of her life here in this hospital,” he says.
Before his death, Bodhraj directed that every family member must study medicine and get married to a doctor. “You can find sons-in-law and daughters-in-law of several castes, states and communities in our family, because being a doctor is the only criterion to get married into our family,” says Dr Suman, Vijay's wife, who takes care of the gynaecology department with her daughter-in-law, Dr Ramneek, a Sikh.
Of course, there have been rebels in the family. But, perhaps because of the desire of the rebels to fit into the family or the encouragement they received from other members, “things never went out of hand,” says Vijay. For instance, one of the sons in the family recently married a biochemist. But, after two years, the daughter-in-law herself decided to study medicine.
“Your family and peers have such high expectations from you that, at times, it gets difficult to manage,” says Dr Ashish, the eldest son of Vijay. Though he respects the family's mission to serve patients, he is willing to let his two daughters take up any profession of their choice. “Their happiness matters most to me,” he says.
Thanks in part to luck and to the spurt in the number of private medical colleges, no Sabharwal has ever failed to get a medical degree. “So far, no one has ever flunked. When there are so many medical professionals to guide you at home, the exam result has to be good,” says Suman. The family believes that the members are “naturally tuned” to become doctors, but it does not stop them from taking coaching classes.
While the thought of visiting an operation theatre leaves most of us sweating, children of the Sabharwal family do their homework in the operation theatre. They are named keeping in mind the roll call in medical colleges, so that the teacher is not tired by the time their name comes in the attendance register. They also enjoy the benefit of being ahead of their classmates in knowledge of subjects like anatomy. “The biggest advantage is that in case of an emergency, a pool of doctors is just a phone call away. And they don't even charge for it,” says Vijay.
Suman recalls a particularly hectic day in the hospital. Twelve hours after giving birth to her younger son Akash, she was resting in the hospital when an emergency delivery case came early in the morning. “There was no gynaecologist in the hospital. So I attended to the patient, and then returned to my bed,” she says, laughing.
The benefit of marrying into such a family is that you have seniors to consult on critical matters, says Ramneek. Besides, as all women in the family are working doctors, it is easier to balance work and life. “Not everyone is lucky to have a mom-in-law who not only understands the pressures of your profession, but also helps you grow as a professional,” she says.
The fourth generation of the family is not keen to push the family tradition on the next generation, but the young Sabharwals are nevertheless determined to emulate their elders. Ask Ashish's three-year-old daughter her name, and she lisps “Dr Naina”. Bodhraj, perhaps, is smiling in heaven.