The small nursing homes/clinic in your neighborhood, the friendly places which are the first point of contact in any emergency are working under a lot of constraints, thanks to the government policies and to the changing doctor-patient relationship.
One of the main reasons for this is the competition put up by the bigger multi-specialty hospitals which provide all kinds of services from blood tests to routine check-ups. Competition sounds death knell for smaller hospitals which already have the minimal charges.
Compounding it are the government policies which puts various conditions for getting the insurance panels, like the mandatory NABH certification requirement for various government health panels, which for a small clinic is impossible to get as it needs huge investment. The minimum standard guidelines are again putting a lot of pressure on the doctors who are unable to meet those with the current rates.
“Smaller nursing homes provide primary care and cost effective treatment and the government should encourage entrepreneurs. There are no incentives for the medical industry and unable to cope up, smaller facilities are shutting down. This is more common in bigger cities where corporate hospitals have more presence, but it's impact can also be seen in smaller towns as well, where the growing trend is to go for multispeciality."
Unable to grapple with the rising costs and increasing competition from their much bigger counterparts, smaller hospitals are either folding up or are investing huge to scale up their facilities.
Moreover, because of the increasing assaults on the doctors and increase in number of medico legal cases, even young doctors are preferring to work in a corporate hospital instead of opening their own clinic. The big hospitals have the resources to manage these headache for the doctors, who in turn want a peaceful work environment and a basic job security, which they get in these corporates.
But in all this change, people are forgetting that India has got one of the cheapest healthcare rates in the world and that is just because of these husband wife clinics who provide a nice treatment with minimal rates. Quality guidelines should be emphasized in the treatment but the infrastructure requirements and their cost-outcome analysis must be done because unnecessary interference with these primary caretakers will only send the cost and health access into further turmoil.
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