The Mecca Of Medicare

STATE-of-the-art medicare and corporate hospitals are fast becoming an integral part of the Indian healthcare landscape. And as major metros compete with each other to become the country's leading health centres, it is Hyderabad which seems to be leading the way with a mix of superspeciality and single-speciality hospitals, well-reputed doctors as well as competitive prices.

Hyderabad has for decades been considered an important medical centre, with Indian presidents from S. Radhakrishnan to V.V. Giri having their medical check-ups at the Osmania General Hospital. Over time, smaller nursing homes have sprung up, taking advantage of the lacunae left by government hospitals. But it was not until the mid-'80s, when the Nizam's Institute of Medical Sciences (NIMS) became an autonomous institution and Apollo Hospital was set up here, that medical care in the city grabbed national attention. This set off a chain reaction, and today Hyderabad boasts of the largest number of hospitals in the private sector in the country. 

"Every city in India is becoming a self-sufficient medical centre, but if Hyderabad seems to be growing faster than the rest, it's because at a certain stage, with government hospitals not being able to provide the requisite infrastructure, we were lagging behind," says Dr B. Somaraju, a cardiologist at Mediciti who headed the team of doctors at NIMS in 1985 that performed the country's first angioplasty. Today, he and his team routinely perform coronary angioplasties, mitral valvuloplasties (procedures for removing artery blockages), intercoronary stent implants, rotablators, establishing Mediciti as the foremost centre for cardiac care in the country. Mediciti was set up by Dr P. Sudhakar Reddy, a professor of cardiology at the University of Pittsburg, with funds raised from fellow doctors in the US. (After Gujarati doctors, Andhraites form a large proportion of Indian doctors in the US.)

 "We perform nearly 22 angioplasties in a day. The Mediciti cathlab is one of the busiest in the country," says Dr Sunil Kapoor, a senior cardiologist who specialises in the use of rotablators, an advanced method of removing artery blockages .

In fact, while many hospitals like Mediciti, Apollo and the L.V. Prasad Eye Institute (LVPEI)have been established by Andhraite doctors from the US keen to return home, others have been set up by doctors with entrepreneurial intentions. "The trend now has shifted from government to private hospitals, from smaller nursing homes to superspeciality hospitals and from curative to preventive medicine," says Dr C. Dayakar Reddy, an anaesthetist who heads the successful CDR group of hospitals that has diversified into allied fields like a school for hospital administration.

Happily, these superspeciality hospitals are doing their bit to reverse the brain drain, inspiring Indian doctors abroad to return home. "The best facilities are now available in India. For me it was a commitment to come back to the nursing home that was started by my father," says Dr Ramesh Ramayya, who runs Pramila Kidney Hospital and who has notched up a reputation for treatment of urological problems by laser, keyhole and laproscopic surgery. He performed the country's first nephrectomy (removal of kidneys) in 1993. He is also the first person in India to have performed the first ureteroscopic extraction of stones in the urethra, and one of the first to use lasers for prostate surgery.

Little wonder then that Hyderabad is emerging as a leading medical care centre. In fact, the city is considered way above other metros in areas like cardiology, urology, nephrology and ophthalmology; its hospitals offer young doctors challenging opportunities. Says Sangeeta Reddy, managing director, Apollo: "We can prevent young doctors from going abroad."

 Besides superspeciality hospitals like Apollo, CDR, Mediciti, Medwin and Kamineni, there are single speciality hospitals like Dr Ram Bhoopal's Satya Kidney Centre (where one of the country's top nephrologists, Dr S. Sahariah, performs kidney trans-plants), Dr Ramesh Ramayya's Pramila Kidney Hospital, Dr Mamta Deendayal's Infertility Institute and Research Centre (where 2,500 childless couples have already been treated and two babies delivered by the IVF method) and Dr Y. Chiranjeev Reddy's Amrutha Diabetic Centre. Recently, Reddy has also set up the Amrutha Holiday Hospital, the country's first health spa where diabetics, hypertensives and those suffering stress-related problems recoup in idyllic surroundings. Nearly 500 diabetics have stayed here and almost all have gone back on a reduced dosage of insulin.

And so, while not long ago Hyderabad residents would go abroad for angioplasties or bypass surgeries, today they are being referred back by doctors abroad to hospitals like Mediciti for cardiac complications and the LVPEI for ophthalmological problems. LVPEI, set up by Dr Gullapalli N. Rao (associate professor of ophthalmology at the University of Rochester where he was director of the Corneal Research Bank) achieved a breakthrough when one of its doctors, Dr Taraprasad Das, performed the world's first transplant using tissues from a human foetus to restore five per cent vision to a blind man.

Hyderabad is also emerging as an important centre of training. Dr D. Nageshwar Reddy, an endoscopic gastroenterology specialist and visiting professor at the Boston Medical University and the Harvard Medical School in the US, not only has patients coming from India and abroad with gall bladder or intestinal problems, but even doctors from well-known hospitals across the world visiting him for training in diagnostic and therapeutic endoscopy. "Our training programme is booked for the next two years. Doctors coming from abroad see cases in three or four months which they would not see in 10 years," says Reddy 

And the medicare boom seems nowhere near an end. Because of rising real estate costs in the metros, Hyderabad has emerged as a viable option for setting up new hospitals and expanding existing ones. For instance, while Delhi and Madras both house Apollo's prestigious hospitals, it is only in Hyderabad, notes Sangeeta Reddy, that there's an opportunity for expansion because of the 30 acres of land Apollo Hyderabad is built on. Besides, it is the cheapest in terms of medical services offered. Even otherwise the cost of medical care in hyderabad is less than half of what it is in Bombay or Delhi, and less than a tenth of the cost abroad. For instance, bypass surgeries at Mediciti cost Rs 1 lakh, angiography Rs 8,000-9,000, a lithotripsy between Rs 7,000 and Rs 15,000, and a simple cataract operation Rs 2,700-Rs 10,000.

Confirming this, Uma Nath, administrator, LVPEI, says that recently a group of Swiss citizens on a tour of India came to them for cataract operations because not only is such surgery cheaper here, but the institute compares with the best in Europe; it is already the best in South-east Asia.

But the euphoria, cautions Sangeeta Reddy, may be shortlived. For, to sustain the services Hyderabad has to offer, the state needs to set up a regulatory body to ensure certain standards and ethics in medicare. Failing which, the prognosis could be dangerous.