As per CGHS requirements, I have to take my FIL to a Govt. Hospital every month for consultation.

Over a period of time, I have come to accept this as de-facto and no longer question CGHS officials about why consultation by Doctor’s at private hospitals (hospitals that are empaneled by CGHS) is not accepted when it comes to prescribing medicines.

While my FIL was at Kolkata, we would take him to S.S.K.M. hospital and to be honest, we had no faith in the ability of doctor’s at that hospital to administer customized care to my critically ill FIL. We had an army of Private doctors who would recommend tests and medicines and we had to use all our ingenuity to persuade the doctor at the Govt. hospital to prescribe what the private doctor had recommended.

This however is not the case back at home. At Hyderabad, we visit the Nizam’s Institute of Medical Sciences (NIMS) and consult with Dr. K. V. Dakshinamurthy; who IMHO is an excellent doctor and a gentleman to boot. He has been very sympathetic and never fails to advice and reassure us w.r.t. the well-being of our patient.

A new issue that we are facing at NIMS is the A.P. Goverment’s Arogyasree scheme that entitles millions of poor citizens of the State of A.P. to avail expensive medical treatment at Govt. Hospitals at the states cost. This has increased the influx of patients at the Govt. hospitals by a quantum leap leaving the generally meager resources at these hospitals stretched to a limit. This has dramatically increased the wait time for CGHS beneficiaries who only want a prescription of medicines but now must compete with the thousands of patients wishing to avail free medical procedures.

This highlights following three lacunae which should be addressed by CGHS:

  1. For Out-Patient Referral, CGHS may do away with the requirement that patient’s must first arrive at the CGHS Clinic, obtain the CMO’s permission and only then visit the Govt. hospital (within 15 days of the permission). First of all, there is really no need for the CMO to see the patient purely for verification issues; since the patient will be examined and verified by the Govt. Hospital anyway. If not acceptable, perhaps CGHS should instead permit exceptions where the patient is verified by the CMO to be physically handicapped or too ill to travel repeatedly.

    Secondly, the patient should be able to visit the Govt. Hospital as many times as they want without repeatedly obtaining out-patient referall form. W.r.t. medical prescription, in nay case CGHS Clinics accept only fresh prescriptions generated approximately within 1 month of each other; no frequently.

    Thirdly, for patients who are disabled or suffer from critical illness, visiting CGHS Clinic on one day and visiting the Govt. Hospital on yet another day simply exerts enormous strain on them and their family and this is something that is utterly callous on CGHS part. I have encountered at first hand at CGHS where patient suffering from Spinal injury was asked to arrive at the CGHS hospital; even if it meant he would arrive in an ambulance and be carried in a stretcher; thus possibly provoking injuries. Ambulance service in India is neither free nor efficient. If patient is expected to spend an upwards of Rs. 1000/- just to obtain ‘Out-Patient Referral Permission’, it will be considered inhumane by one-and-all.

  2. CGHS may allow doctors who belong to Private Hospitals that have been empaneled by CGHS to diagnose patients and recommend medicines and procedures.Many CGHS patients can and will pay the Private Doctor’s fee quite merrily if it means getting treated efficiently and effectively. In the city of Hyderbad, most hospitals only charge about Rs. 50 – 200/- for Doctor’s visit and this is easily affordable by many. Even the evening clinics at Govt. Hospitals are pseudo-private clinics, where for a increased fee; relatively well-to-do patients are able to access the Doctor quicker.

    Only in city like Kolkata do Doctors charge 800 – 2500/- per consultation and thus the only option for many is the practically free Govt. Doctor. Allowing CGHS patients to obtain consultation from private doctors will greatly reduce the load on Govt. Hospitals, many a heart-burn and generally earn brownie points for CGHS.

    The poor medical scene in Kolkata is something so horrible, that it is beyond the scope of this article and I will quite possibly write another article about it some day.

  3. Govt. Hospitals may be allowed (funded) by the State Govt. to set-up additional infrastructure to cope with the rush generated by their populist measure and implement other facilities so that millions of patients who are beneficiery of systems like CGHS are not inconvenienced.

  4. CGHS must establish an effective and rapid communication system between itself and treating doctors so that basic information like ‘Medicines that are approved by CGHS’ are available to the doctor’s at their fingertips. This will allow the doctors (govt. of private) to only recommend those medicines that are pre-approved by CGHS Store for purchase and distribution. This will also save a lot of time and effort for patient parties who at times have to return to the Govt. Hospital (and face the entire rigmarole) just to get the prescription corrected.The system will also be used by Doctors to effectively notify CGHS of newer and more cost effective medicines that maybe approved from time to time or drugs that have been proven dangerous and must be removed from CGHS list.

These are but a few suggestions which I feel CGHS should implement if it wishes to be categorized as customer centric organisation. Readers of this article are invited to pen their two cents.