A Different View Of Healthcare

Pune-based Symbiosis Centre of Health Care's introduction of on-campus healthcare facilities and now a department of health sciences has culminated in the ambitious Medicity project, reports Nayantara Som

SDHS, Pune: A trendsetter in healthcare education

When a doctor says "We do not want people to deteriorate into patients, but rather prevent them from falling prey to any diseases," you might well be taken aback. However, after a tête-à-tête with the faculty, it will dawn on you that the Symbiosis Centre of Health Care (SCHC), Pune believes in providing healthcare facilities with a new vision. This is perhaps the primary reason for the Centre shifting the spotlight from curative to preventive and promotive healthcare.

Dr Rajiv Yeravdekar, Director and Head, SCHC, points out, "Although the healthcare industry in the country in the past few years has undergone a tremendous metamorphosis, there is more emphasis on curative healthcare. There are very few centres which promote preventive and promotive healthcare."

Inspiration From Oman

Rome was not built in a day. Neither was SCHC. The idea germinated in 1996 when Dr Rajiv Yeravdekar and his wife, Dr Vidya were in Oman working with the Ministry of Health. There, they observed that great importance was accorded to on-campus school health checkups. Dr Yeravdekar reminisces, "Specific doctors under the government were assigned to schools in the relatively interior parts of Oman to conduct on-campus health checkups. If a student missed taking an immunisation injection, the hospital would send him reminders at regular intervals. This was the commitment that spurred us-that the government was truly bothered about the welfare of the people when it comes to public health." True, Oman had a different population and scenario, but the crux of the idea was that healthcare at the level of academics is an avenue that the Indian government ought to include in its priority list.

When the Yeravdekars returned to India in 1996, they realised that people were focusing on curative healthcare and precious little was done at the preventive level. Coincidentally, at that time, around 15-20 of their colleagues shared the same passion for doing something with a social commitment. However, initially they were reluctant to address a larger community. Since a large portion of the city's population consisted of outstation students, they zeroed in on educational institutions. These consultants with a common mission and vision got together and started doing annual health checkups, at a nominal remuneration.

Screening Students

Although Dr SB Mujumdar, the Founder President of Symbiosis was his father-in-law, Dr Yeravdekar had to make a presentation to the management convincing them of on-campus health checkups, a concept alien until then. Having been accepted by the Board of Directors of Symbiosis, the endeavour began by way of an annual health checkup. Students were screened by a consultant with a post-graduate degree, expertise and experience. They were checked by five consultants: paediatrician/physician, ENT specialist, ophthalmologist, dentist and pathologist. They also had to undergo an ultrasonography. This practice is continued even today. The Symbiosis family is medically insured up to Rs 1,00,000 through a tie-up with the National Insurance Company. Symbiosis was the first institute to initiate a cashless medical insurance scheme, in 2001. A detailed health file of each student is maintained. Everyday, around 25 students undergo the health checkup both in the morning and in the afternoon, according to the academic schedule.

What was the outcome? Students were detected with an array of problems. There were students with borderline blood pressure, diabetes, refractive errors, dental problems and allergy disorders.

Spreading The Service

Initially, such services and facilities were available only to the students and the staff members of the Symbiosis family, but over the years these facilities have also been extended to various sections of the society.

In a span of eight years, the SCHC has conducted blood donation camps, adolescent education programmes in schools, campaigns on sex awareness education, campaigns on childhood obesity problems and lectures on various issues related to occupational health and safety.

An additional facet of the SCHC is the thrust on promotive healthcare. The idea behind the concept is that only a healthy mind can lead to a sound academic life performance. Hence, every campus of Symbiosis has a Fitness Club complete with a gymnasium, aerobics studio, a yogashala and a swimming pool.

Lateral Expansion

Over the past eight years, Dr Yeravdekar and his team of consultants and specialists realised that this service sector component of the SCHC needed to be supplemented with academics related to the healthcare sector, in order to keep pace with the changing healthcare scenario.

With a view to providing innovative, need-based programmes, the Symbiosis Department of Health Sciences was set up under the aegis of the Symbiosis International Educational Centre Deemed University, (SIECDU). The idea was to offer academic programmes directed at the untapped, hitherto neglected sectors of the healthcare industry.

It also was observed that in most hospitals, a doctor in addition to treating patients, is also expected to handle the administrative functions. Experts at the helm then harboured the idea of creating a set of professionals who would be formally trained to handle these functions and would ultimately constitute the core of the hospital management. This in turn would culminate in the union of management with healthcare.

Dr Yeravdekar adds, "Symbiosis believes that a doctor's core competency is to treat the patients for which he has been trained, evaluated and certified. The auxiliary part of managing the hospital, like waste management, labour laws, equipment management, billing, finance and accounts, insurance, legal issues, handling of medical equipment must be handled by professionals who are formally trained for the purpose." This led to the inception of a formal training programme: Post Graduate Diploma in Hospital and Healthcare Management (PGDHHM).

So, what section of the people were they targeting? Replies Dr Yeravdekar, "Hospital and healthcare managers. But they are not the only targeted section. People conventionally think of healthcare sector as hospitals, nursing homes and diagnostic centres. But it is much beyond that. It also includes pharmaceuticals, insurance, IT and NGOs. By setting up the department, the PGDHHM programme in particular, aims to train people who can handle all these sectors of healthcare."

Colonel Uday Krishna Vidwans, Programme Director, Hospital and Healthcare Management Programme points out, "Our modules include fundamentals, Information Technology, research methodology and principles of management. All this will equip the students to ably handle various healthcare organisations. A full fledged two-year MBA in hospital and healthcare management is to be launched from June 2007."

Another sector that was considered by SDHS was the training of technologists rather than technicians. With hospitals now turning into super specialities and state-of-the-art facilities coming up all over the country, technology is coming up at a brisk rate. Unfortunately, very few institutes in the country provide training in technology. Typically, in a hospital, a ward boy after some years of experience becomes the X-Ray technician or a lab technician. But when the world is looking at India as the next medical destination, machines need to be manned by technologists who have received sophisticated and professional training.

The department thus offers a three-year BSc degree programme in Medical Technology. In the first year, students are taught the basics of pre clinical and para clinical subjects. In the second year, the candidate chooses one out of the eight technological specialities from cardiac, perfusion, imaging sciences, dialysis, respiratory care, clinical lab, anaesthesia and operation theatre technology. In the final year, the students are posted for practical experience to various tertiary care hospitals.

Dr Prakash Bhave, Course Director, Imaging Sciences points out, "We have initiated tie-ups with universities from Florida and Healthcare Personal Association, UK because our course must offer excellence and quality." Dr Sammita Jadhav, Head, Medical Lab Technology, points out, "The advantage of the course is that students also have internships in various prestigious hospitals. The response of both the industry and the students has been positive."

Another interesting course is the Post-Graduate Diploma in Fitness Management (PGDFM). According to Ninad Pathak, Programme Director, PGDFM, "The fitness industry is the seventh largest industry in the world and in India the industry is flourishing like never before." However, today there is an appalling lack of certified trainers and instructors. There is an urgent need in the country to launch a formal academic training programme, which is essentially different from the usual physical training programmes imparted in schools and colleges.

The department thus offers post-graduate diploma in fitness management meant to train managers and a diploma in fitness training meant for individuals aspiring to be instructors. The fitness management section has a lot of ambitious ventures on the cards like the introduction of the BSc degree in sports sciences and the initiating of a fitness forum, a common body to address the various difficulties of the fitness industry and to ensure standardisation.

Equipping Professionals

The pioneers of the department also realised that doctors usually were poor communicators, lacked the skills to maintain records and document their findings, were ignorant about insurance policies, ignorant about police procedures in case of a complaint etc. In light of the prevalent medico legal scenario and given the time constraints of the practicing doctors, Symbiosis launched a distance education programme: Post Graduate Diploma in Medico Legal Systems under the Chairmanship of Advocate Ram Jethmalani.

And why the idea to diversify in training students for paramedical and allied healthcare services? Why did they opt out from venturing into a medical college?

Dr Prasad Rajhans, Consultant EMS and Emergency Medicine, SDHS opines, "When we initially thought of a programme in Emergency Medical Services, we received very encouraging support from Dr SB Mujumdar, the Chancellor of Symbiosis International Education Centre Deemed University who strongly believed that we should start a need-based education and not a greed-based education and that such a programme was needed to be introduced in the education system."

Dr Rajhans further opines, "If EMS programmes have failed in the past it was only because there was no formal academic training programme. If one had has to create a movement for EMS one has to create students." The post-graduate Diploma in Emergency Medical Services (PGDEMS) is affiliated to the Los Angeles Paramedical School, and the curriculum and the modules are designed as per the standards of the Department of Transportation (DOT), USA. Offshoot developments of the EMS programme include the Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Paediatric Advanced Life Support (PALS) programmes of The American Heart Association (AHA) and the Advanced Trauma Course of the International Trauma Life Support Organisation, USA. The SDHS enjoys an International Training Organisation (ITO) status of the AHA. It is also a recognised "Chapter" of the ITLS. Hence these weekend programmes offered by Symbiosis are valid internationally.

Clockwise:1. Dr Rajiv Yeravdekar, Director and Head, SCHC; 2. Blood test being taken; 3. The Gymnasium located within the Fitness Club; 4. Col U K Vidwans conducting a class on hospital and healthcare management

What Lies Ahead

The Department has several plans up its sleeve. In the next three years, the department is aiming for an understanding with foreign universities which run such programmes for formal accreditation and subsequently to develop a student exchange programme. Dr Yeravdekar explains, "My student might be doing the first two years here in Pune and the next six months in a university abroad."

The idea is that at the end of three years, the student will be absorbed by any hospital not only in Pune and the country but globally. Symbiosis has already tied up with Higher Colleges of Technology (HCT), Abu Dhabi, UAE. Talks are being initiated with prestigious universities like the University of Leeds, UK and the University of Oakland, US. More importantly, the department is looking at accreditation agencies abroad because there is no apex body which supervises and regulates paramedical and technology education in India.

Importantly, around 300 acres of land had been purchased in the outskirts of Pune to set up the 'Medicity' project, which will have a hospital teaching institute, nursing college, a national paramedical training school, centre for alternative and complimentary medicine and programmes in clinical research. This, however, is still in its preliminary stage. It appears there is no looking back for the SDHS. Its interests multiply by the day. With myriad options available and an emphasis on quality education, students can definitely arm themselves to face the fierce competition and corporatisation of the healthcare industry. SDHS is here to give medical education a new look and meaning in India.

nayantara@expresshealthcaremgmt.com