October 29, 2009

Five facts about medical tourism

Medical tourism is booming as health care costs in developed countries spiral upward.

Here are five facts about the industry:

* Some 648,000 Americans will seek medical treatment abroad this year, and that number will grow by 35 percent over each of the next 3 years, according to the Deloitte Center for Health Solutions. Other researchers, such as Josef Woodman, author of Patients Beyond Borders, put the number of outbound U.S. patients at 240,000 per year.

* U.S. health providers are predicted to lose as much as $67.7 billion in revenue in 2010 because of medical tourism, Deloitte says, adding that consumers can save as much as 90 percent. Mexico is the No. 1 destination for U.S. medical tourists, while Costa Rica and Panama are also big markets.

* Asia is home to the industry's biggest names, including Dusit Medical Services, Bumrungrad and Bangkok Chain in Thailand; Parkway Holdings and Raffles Medical in Singapore; and Apollo Hospitals in India.

* U.S. insurers Wellpoint and Health Net have recently launched medical tourism pilot programs.

* The second annual congress of the Medical Tourism Association is convening in Los Angeles this week, featuring an estimated 2,000 representatives from major insurers, international hospitals, and agents who book medical trips.

Link: Original Article

Medical records sent for computerisation to India up for sale

In a development that is certain to lead to a hardening of stance on the outsourcing industry by the western world, investigations conducted by a British TV channel have come up with the stunning revelation that confidential medical records sent to India for computerisation are being offered for sale, triggering heightened concerns about breach of data security here.

The revelation has forced police of the two countries to join hands to launch an official investigation into the data pilferage of the records stored by the Indian BPOs. If found true, the allegations could hit the flourishing BPO sector in India hard, fuelling doubts about their integrity and efficiency.

There is already a substantial public opinion building in the western world about the viability of outsourcing jobs to the developing countries, primarily India. In the run-up to the presidential election in the US, Barack Obama had advocated lifting of tax breaks to the American companies who ship jobs abroad.
The health records-for-sale investigation is scheduled to be broadcast on ITV on its Tonight programme on Monday.

Sall Anne Poole, head of investigations at the Information Commissioner’s Office (ICO), confirmed that an official probe had been launched to get to the bottom of things. “We are very concerned that private patients’ medical records are on sale in India. The ICO will establish the full facts and will then decide what action, if any, needs to be taken. Medical records are sensitive personal information and must be held securely,” she said.

The modus-operandi employed to procure the records was simple. Chris Rogers, the programme’s presenter, contacted two Indian salesmen through an internet chat room, and posed as a marketing executive keen on buying medical records to sell insurance and medicines.

Rogers bought 116 files with detailed medical records of British patients , from the two salesmen, whom the programme named as Jayesh Bagchandnani and Kunal Gargatti, the Daily Mail, a prominent British tabloid, reported on Sunday.

Bagchandnani reportedly said they came from staff at an Indian ‘transcription’ centre where medical records are computerised. Bagchandnani told Rogers: “We can do really good business with these leads. These leads will give you diagnose, entire diagnose of all the India’s top 10 BPO customers, what the customer is facing. There are 17 teams or you can say team managers. The floor managers, they are working as freelancers for me and I am telling them to pull the data for me. They work for me.”

Researchers for the programme then met Gargatti, in Mumbai. “You have the doctor’s name, doctor’s address, doctor’s phone number. Each and every thing here. I have 30,000 files to give you today, right now. I’ve around 140 diseases here. You just tell me which disease you’re looking out for — I can give you anything ,” he told them.

The files procured were of patients of London Clinic, one of Britain’s top private hospitals. Several hospitals in the National Health Service have also outsourced their transcription to India, sparking concern over data safety following the latest investigation.

The London Clinic said it dealt with its own files internally and did not send them to private companies. But it advised a group of consultants

to use a specialist Buckingham-based IT company, DGL Information Technologies UK, with which the clinic has a contract, to help turn paper records into computerised files.

DGL itself did not handle the records but recommended that the doctors use a document-scanning service provided by a company it has a contract with, Scanning And Data Solutions, which operates from Hertfordshire.

But Scanning And Data Solutions then sub-contracted further work on the files to a company in Pune. Scanning And Data Solutions admitted it had sent thousands of medical records to India over the past two years and said it ‘had no reason to disbelieve’ that it had scanned the records obtained by ITV in India.

It has now suspended its operations there and requested that its partners delete all the information they hold. It has told both Hertfordshire Police and the Indian police of the theft.


The revelation has forced police of the two countries to launch an investigation into the data pilferage of the records stored by the Indian BPOs ‘We are concerned that private patients’ medical records are on sale in India.

The ICO will establish the full facts and will then decide what action, if any, needs to be taken. Medical records are sensitive personal information and must be held securely,’ Poole said There is a substantial public opinion building in the western world against outsourcing

Link: Original Article

More medical colleges coming

Companies registered under the Company Act will now be allowed to open medical colleges on campuses spread over 10 acres in metros instead of the 25 acres needed earlier.
Health Minister Ghulam Nabi Azad has given his nod to an overhaul of medical education that will include rationalising land use for setting up colleges, introducing new course, increasing post-graduate seats by 30 per cent to create more specialists and super specialists.

There are 300 medical colleges in the country — which can be run only by the government, trusts and societies — and they produce 23,000 doctors each year.

Amendments to the Medical Colleges Regulations (1999) will allow medical colleges to be run in high-rises built on 10 acre-plots in metros and grade-A cities. “Since land availability is a problem, we’ve shifted to the concept of total built area required for essential infrastructure including the college, hostels, hospitals, libraries, etc,” said Dr Ketan Desai, president, Medical Council of India.

This means Indraprastha Apollo Hospitals, for example, can open a college on its 15-acre campus in Delhi, if it so desires.

“The amendments were needed as there’s an acute shortage of doctors and we need at least 50,000 medical graduates each year,” said cardiac surgeon and Global Health chairman Dr Naresh Trehan.

Link: Original Article

October 17, 2009

National Council for Human Resources in Health: Your Opinion is imortant!

To overcome the acute shortage and uneven distribution of human resources in public health delivery system, the Ministry of Health & Family Welfare aims at overhauling the current regulatory framework. Toward this end, it is proposed to set up a National Council for Human Resources in Health as an overarching regulatory body to achieve the objective of enhancing the supply of skilled personnel in the health sector.Task Force and the draft bill are available at ministry of health website: http://www.mohfw.nic.in/nchrc-health.htm

The general public is invited to go through the report of the Task Force and the draft bill and send their comments / observations on the suggested provisions at debasish.panda@nic.in, csharat@ias.nic.in and rshankar50@hotmail.com or to Dr. Sharat Chauhan, Director ( Medical Education), Ministry of Health & Family Welfare, Room No. 305, wing-D, Nirman Bhawan, New Delhi. The last date is over, but send in your opinions anyway!

October 09, 2009

2009 Nobel Prize in Medicine for work on Telomeres

Three U.S.-based scientists have won the 2009 Nobel prize for medicine for their discovery into how chromosomes are copied and protected. The work casts important light on cancer and the aging process.

Elizabeth Blackburn from the University of California, San Francisco, Jack Szostak from Harvard Medical School and Carol Greider from Johns Hopkins University all share this year's Nobel prize for medicine.

Nobel Committee member Rune Toftgard from Sweden's Karolinska Institute says the three took the top honor for their work in the 1980s that revealed how chromosomes, the rod-like structures that carry DNA, protect themselves from degrading when cells divide.

"They have been awarded the prize for the discovery of telomeres and the enzyme telomerase and how it protects the chromosomes," said Toftgard.

Telomeres are structures at the ends of chromosomes often compared to the plastic tips at the end of shoelaces that keep the laces from unraveling.

The enzyme that builds telomeres is called telomerase.

Professor Toftgard says the function of telomeres is absolutely crucial in understanding how genetic material is copied and preserved.

"All genes are encoded by DNA, and the DNA is present in the chromosomes in the cell nucleus and telomeres, they are the ends of the chromosomes and they have an important function to protect the chromosomes and maintain the integrity of the chromosomes," added Toftgard.

Their research has shed new light on disease mechanisms and has spawned the development of potential new therapies.

For instance, some research suggests that cancer cells use the enzyme telomerase to sustain their uncontrolled growth. Some in the scientific community are studying whether drugs that block the enzyme can fight the disease.

Elizabeth Backburn says she was awakened at 2 in the morning with the news of the award. She says prizes are always a nice thing and it is lovely to share it with Carol Greider and Jack Szostak.

The three will also share the $1.4 million that comes with the prestigious award.

Link: Original Article

Pakistan wants to replicate India’s health insurance

The Indo-Pak dialogue may not be moving anywhere at this stage, but it’s a different story when it comes to social schemes for the poor. Pakistan, sources said, has expressed an interest in replicating India’s health insurance scheme for the poor.

The Rashtriya Swasthya Bima Yojana, an insurance cover for BPL families implemented by the Centre, state and insurance companies, has caught the attention of Islamabad, which is keen on studying the scheme that at present covers BPL families in 18 states across India.

Through the World Bank, Indian and Pakistani officials recently had a video conference between Delhi and Islamabad to discuss the project. Pakistan’s health services has even expressed an interest in sending a delegation to India to study the scheme which covers 64 lakh people in India and is targeted at the unorganised sector. “Pakistan has shown a lot of interest,’’ sources said.

Though the Indian government has refused to resume the Indo-Pak composite dialogue process and restricted the bilateral dialogue to the issue of terror, Indian officials have also continued to stress that India bears no grudge against the people of Pakistan and that the effort is to get the Pakistani government to deliver on its anti-terror commitments.

Nevertheless, the discussion on the insurance scheme has been channeled through the World Bank which has also been closely involved in the scheme. But international interest in the health insurance programme is growing too. It’s not just Pakistan that is interested in the scheme. Bangladesh, sources said, is also keen on studying the health insurance programme, which provides biometric smart cards to BPL families so that they have access to healthcare across the country at both private and public hospitals. Dhaka already has pilot projects on micro insurance for the rural poor but is still interested in the Indian project, which is implemented on a large scale and is slowly being rolled out across the country.

At present, the scheme covers 18 states with many more to join in the coming months. The scheme also showcases India’s IT prowess, which continues to attract international attention, with ten separate software applications used to deliver the smart card and insurance cover to BPL families. The scheme is basically aimed at migrant workers who have the facility to access healthcare in any of the 18 states that has implemented the project.

According to government figures, around 94% of the total workforce is in the unorganised sector.

Around 1,500 private and public hospitals that have been empaneled to provide healthcare for the poor and 8 to 9 insurance companies are taking part in the scheme. The government’s plan right now is to extend the scheme for BPL workers and their families all over the country by 2012/13. “It’s the biggest rural IT scheme,’’ said an official. Since it started, the government has found that nearly 1.2 lakh people have used the smart cards to access health care.

Link: Original Article

October 05, 2009

Drug firms offer transport to docs for Delhi council polls

Pharmaceutical companies gifting pens, calendars, clocks and so on to doctors has become old hat. Panacea Biotech has come up with a unique new initiative where its medical representatives (MRs) in Delhi offer to arrange transportation for doctors who want to cast their vote in the Delhi Medical Council (DMC) Elections scheduled to be held on Sunday.

There have also been allegations that the MRs have been canvassing for one of the two factions fighting the DMC elections. Panacea joint MD Rajesh Jain, however, denied any company involvement in the elections. "From the company, there has been no move to offer transport or get involved in the elections. On an individual basis if some doctors have asked for transport, we might have obliged," he said.

However, several doctors insist that they have been canvassed by Panacea's MRs. Former secretary of Delhi Medical Association Dr Sarvesh Kumar insisted that he was given a pamphlet of the faction called Faith by a Panacea Biotech MR who sought votes for the group and offered transportation to the voting venue in Pusa Institute. "I told them to desist from such unethical canvassing and refused their offer of transportation, saying that I could afford my own transport," said Dr Kumar.

However, a Panacea executive said: "We are not interested in campaigning for any faction. We are merely providing a support service to doctors by offering to arrange for transportation to take doctors to the voting venue, irrespective of which camp or faction he or she might belong to."

An MR of the company confirmed that they have been covering doctors who figure on a list given to them by the senior management. "We are approaching doctors with whom we have a good relationship, that is, doctors who have been regularly prescribing our products. It is just a support service to make it convenient for them to vote. We have no stake in the elections," said the MR.

Several resident doctors, too, have been approached. "They gave me a pamphlet of the Faith group, canvassed on their behalf and said that they could arrange to pick me up from my residence and take me to the Pusa Institute to cast my vote," said a resident doctor working in Bhagwan Mahavir Hospital, Pitampura.

Such offers of transportation or canvassing go against the code of ethics of the Indian Drug Manufacturers Association (IDMA), of which Panacea Biotech is a member. "I agree it is against the code, but we can't do anything about it. The fact is, IDMA has no power to intervene, discipline or enforce the code," said an IDMA office bearer about Panacea's new initiative.

On the other hand, a senior faculty member of Maulana Azad Medical College (MAMC) said it was not at all surprising that doctors would accept such offers of transport as the venue, deep inside Pusa complex, is difficult to access for most doctors compared to the venue for the last election held five years back, which was the more centrally located MAMC campus.

Link: Original Article

Doctors take management lessons for better pay

More doctors and healthcare professionals are joining management schools, turned away by the limited number of seats for a post-graduate course in medicine and the prospects of a better pay package after graduating from a B-school.

Doctors who have successfully completed an MBA course get job offers with packages of anywhere between Rs 12 lakh and Rs 18 lakh per annum. While 'normal' MBA students get Rs 8-18 lakh per annum. At IMT Ghaziabad, there was one doctor last year. Now, there are two, even as companies like Ranbaxy and Dr Reddy's come for campus recruitments.

The trend is only increasing due to the boom in the healthcare and pharmaceutical industry. The Indian pharmaceutical market (IPM), which was valued at Rs 55,500 crore last year, grew 8.9 per cent in July and 18.3 per cent in June, according to ORG IMS, which tracks sales of drugs in India.

Consider this: In the class of 2010 at the Indian School of Business, Hyderabad, there are 13 students with a background in medical studies — up from 10 in 2008 and substantially up from six in 2007.

“Hospitals have to develop their value propositions and deliver results to ensure a loyal clientele. Hence, the need to professionalise the services being offered. All this calls for a highly professional management team. Doctors with a management background are ideally suited to manage this responsibility. They can understand all sides of the equation — from the doctor's viewpoint, from the patients' viewpoint and from the management's viewpoint. This is why they are in high demand and the reason why many talented doctors are joining premier B-schools,” explains V K Menon, senior director (career advancement services, admissions and financial aid), ISB.

The healthcare club at the ISB has 70 members who conduct a healthcare conclave, wherein they invite leaders from the healthcare industry and hold sessions on various current issues related to medicine, healthcare and pharmaceuticals.

At the Indian Institute of Management, Kozhikode (IIM-K), there are three students with a background in medical studies who have enrolled in the Post-Graduate Programme. Last year, there was only one such student.

"With more medical as well as other varied graduates venturing into business education, the resultant heterogeneity will generate a richer learning experience due to the incoming diverse perspectives," says a student from IIM-K.

The case is similar with Delhi’s Faculty of Management Studies (FMS), where there are four doctors in the 2011 batch — up from two last year.

"After MBBS, the number of post-graduate seats is less. Moreover, the healthcare sector is growing and has a lot of scope for management," added Shreekar Sudarshan, joint secretary (media relations), FMS.

Concurs Professor A M Sherry, chairman, Joint Admission Committee, Institute of Management Technology (IMT): “We have BDS and MBBS students here. The reason for this trend is limited seats in post-graduation in medicine. Besides, after getting an MBA degree, the student is sure of a placement and a salary that is higher than a normal MBA.”

Link: Original Article



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