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(This thread was posted by Dr. Shahad Ansari via email)

As soon as a trauma patient reaches the emergency room, along with the routine protocols of patient care, one of the responsibilities of the emergency physician is to evaluate the "Affordability" of the patient if he could bear the treatment expenses at the corporate hospital. This is not west for sure, mind you India is developing.

How often a person is actually ready or financially stable to decide if he can undergo the treatment at any tertiary trauma center during that time of anxiety? Given the confusion of medico-legal aspects which are indispensable part of not all but majority of the accidents. We know the answers...dont we.

The point of consideration is, how to make the entire emergency treatment cost effective, affordable and less complicated for a common man in terms of money and legal issues keeping in view that average Indian barely manages to earn hand to mouth per month.

In my opinion I feel we should make an audit into these cases wherein how many patients are referred to government hospitals (even against the wish) due to lack of finances or any other significant issues. And no points for guessing what happens when the same patient reaches any government hospital whilst we are supported by the facts, figures and notions that the best trauma centers are the corporate hospitals.

I am here to raise a question and with a very limited knowledge I can say that the major difference in the emergency care in India lies in couple of facts

A. Make the emergency investigations like CT scans, ECGs, Ultrasounds, X-Rays etc half/free of cost so that emergency physicians can at least elucidate the condition of the patient to the concerned people which would help them decide if they can bear the rest of the treatment expenses. I am aware that majority of my colleagues would not agree to this but we need a line between primary investigations and definitive management.

B. Mandatory health insurance for earning community and free cover for non earning communities like paediatric and geriatric age groups.

C. And last but not the least, to furnish government hospitals upto the standards where they could provide best treatment modalities absolutely free of cost so that patient develops confidence in the government institutions.

I am sure that the competitive approach would serve best in the interest of a common indian.


Dr.Shahab Ansari
Senior Resident,
Emergency Department,
Apollo Hospitals,
Hyderabad