“Indian healthcare sector faces crisis of skilled medical professionals”

Dr N K Pandey, Chairman & Managing Director, Asian Institute of Medical Sciences, Faridabad shared his views on the current healthcare scenario

With a career spanning decades, Dr Narendra Kumar Pandey has a vast and varied experience servicing the healthcare sector. Dr Pandey who is the visionary behind the Asian Institute of Medical Sciences, is an honorary recipient of Padma Shri Award for his outstanding contribution in the field.  He has also been awarded with Dr. B.C Roy National Award, the highest award in medicine instituted by the Government of India for his pioneering work in Video Assisted Thoracoscopic Surgery (VATS) and Chest Surgery.  Dr Pandey is the Ex-President of Association of Surgeons of India (ASI) and is currently a Trustee of the International College of Surgeons – Indian Section.
In an exclusive interaction, Dr N K Pandey, Chairman & Managing Director, Asian Institute of Medical Sciences, Faridabad shared his views on the current healthcare scenario, adoption of latest technologies, growth drivers, future outlook and much more.

BV LogoYour views on the current healthcare infrastructure in India? Any major changes over the last decade?
The last decade has witnessed significant strides in the Indian healthcare industry owing to the emerging technologies. The industry is one of the country’s largest sectors in terms of employment and revenue generation. The country has significantly improved its people’s health outcomes according to the World Health Organization. Life expectancy is considered as one of the most used and an important indicator for human development. The life expectancy for India in 2022 standing at 70.19 years saw a 0.33 percent increase from 2021. It has increased considerably over the past decade due to better availability of diagnosis, treatment, medicines and evolving technology. Additionally, significant enhancements in infant and child mortality along with maternal mortality has led to the longevity in the country.
Schemes like National Health Mission (NHM) and National Rural Health Mission (NRHM), Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK) have made a remarkable difference.  Pradhan Mantri Surakshit Matrutva Abhiyan (PMSMA) focuses on the provision of good antenatal care and identification and management of high-risk pregnancies. Last decade witnessed the launch of a centrally-sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) which is the largest government funded health insurance scheme in the world.
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Does India have enough skilled medical professionals? What would be the best strategy to improve doctor/nurses: patient ratio?
The Indian healthcare sector is facing a crisis of skilled medical professionals. The country has over one million modern medicine doctors for treating its population of over 1.3 billion. While recent statistics do show some improvement in the doctor-to-patient ratio or the skilled-healthcare-workers ratio to population, still there remains an issue of lack of access to timely healthcare. The government on its part is working on concerned areas to increase the number of skilled professionals in the healthcare space. By 2024, it aims to reach a ratio of one doctor for every 1,000 people. The country would need 2.07 million more doctors by 2030 to achieve a 1:1,000 ratio.  Currently, our country has 1.7 nurses per 1,000 people as against the World Health Organization (WHO) norm of 3 nurses per 1000. Also, mid-level providers need to be trained to practice medicine in order to bolster primary care. In addition, public-private-partnership is needed to meet the gap in the human resources.
The government is working in all possible ways to increase the number of skilled healthcare professionals. For this, it has given a nod to converting district hospitals into medical Colleges, setting up government medical Colleges to be attached to existing district or referral hospitals. This exercise will improve tertiary care in the government sector, increase the availability of qualified healthcare professionals, promote affordable medical education among others.
“Indian hospital industry is growing at a CAGR of 16-17% and is expected to reach $132 bn by 2023.”
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Key public health challenges that deserve immediate attention? Your expectations from the policymakers?
The union government has already launched a very good health scheme- Ayushman Bharat- that provides Rs 5 lakh insurance cover to the poor making healthcare affordable and accessible to them. Realistic pricing, however, needs to be brought into effect, which will make healthcare sustainable for institutions like us who focus on quality, hire the best of doctors, nurses, and technicians, and have better equipment. We have to find a means for some graded system so that hospitals welcome Ayushman, and where hospitals of all scales can operate irrespective of their geographies.
We expect the government to define and lend support to private hospitals by offering subsidies which will reduce cost of creation and will encourage delivery to come in. The government has given the mechanism of Ayushman as an accessibility card for which it has to partner with institutions like us also to create those venues for affordable treatment.
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Which are the major initiatives of AIMS for catering to the needs of patients in Delhi NCR and other regions? 
The Asian Institute of Medical Sciences in Faridabad is an affirmation of our strength and commitment to bring quality healthcare services to the people of Delhi NCR. This hospital caters to the people in the best of its capacity by providing quality healthcare services. We could recognize the challenges confronting the healthcare sector in India so we decided to make quality healthcare affordable and accessible in other parts of the country and specifically, in smaller towns and cities. The first hospital to come up in this noble pursuit was the Asian Vivekananda Hospital in Moradabad. This hospital made the best of efforts to fill in the gaps existing in the medical infrastructure in that region.
The next project which we took up was to reach out to the people of Bihar and Jharkhand where Healthcare facilities were negligible, with this motive Asian Super Speciality Hospital is made in Dhanbad. Here the healthcare condition was so poor that, in case of heart attack there was no cardiac care centre in the radius of 100km and another project that we started is a Super Speciality Healthcare centre in Patna. Further, we have also acquired a hospital in Noida where we intend to develop and commission this new facility as a centre of excellence for 5 super specialities i.e., oncology, urology, nephrology, neuro and cardiac surgeries.
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AIMS has recently adopted the latest robotic surgical technology. Why is it important and how cost effective is it currently?
Next-generation advanced robotic surgery offers enhanced accuracy with less tissue trauma, minimal blood loss, lesser chance of getting infection and less complication, better mobility and improved early functional recovery besides a shorter hospital stay for the patient after surgery. Though traditional procedures available for cancer, weight loss, and transplant surgery offer good outcomes, the next-generation advanced surgical robot is minimally invasive and gives accurate 3D visualization that makes all the difference. Advanced robotic technology aims, and hopes that these procedures will enhance accuracy and lessen the chance of infection and consequently further improve surgical outcome.
“We expect government to define and lend support to private hospitals by offering subsidies.
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In what ways has the hospital adopted digital technologies during its daily operations? Any specific examples?
In this current era of digitalization, Asian has adopted advanced technologies to benefit the patients in more improved clinical operations and extended it to operational and financial benefits across the continuum of care. The adopted technologies are not limited only to bed side entries, utilization of cloud and Artificial Intelligence. One of the key technologies adopted by Asian is capturing patient movements and clearances on Mobile application be it financial clearance, nursing activities, bed booking, discharge or patient file availability. To share a specific example, patient discharge is done by the doctor from a mobile application, where a doctor can see complete patient information, and finalize their discharge summaries in no time.
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How do you look at the future of the Indian hospital industry?
The Indian hospital industry is growing at a CAGR of 16-17% and is expected to reach $132 bn by 2023 from $61.8 bn in 2017. Accounting for 80% of the total healthcare market, the hospital industry in India is witnessing a huge investor demand from both global as well as domestic investors. This growth is driven by multiple factors including increasing healthcare awareness, rising income levels, ageing population, growing penetration of health insurance, growing burden of the non-communicable diseases and government’s increasing focus on providing universal healthcare. Along with these drivers, availability of skilled workforce and advanced technologies and low healthcare costs are driving India’s unique value proposition in the healthcare market.
The long-term market outlook for Indian hospitals is stable and the annual revenues are likely to grow robustly over the next few years on account of increasing domestic demand for healthcare and medical tourism as well.  Additionally, big healthcare players are now looking at expansion in Tier-2 and Tier-3 cities which is swiftly changing the healthcare landscape in these cities.

**This interview was first published in the February 2023 edition of the BioVoice eMagazine.