Dr. John provided us with an excellent summary of the ills of the specialization/hospitalization system in his article here. A summary of what he said is: Provide good primary care, not flashy (digital) solutions and tertiary care complexes.
There is no doubt that primary care needs to be the foundation of good healthcare however, it needs to be said that that there’s an unsolvable manpower problem with the traditional approach to healthcare, and primary care in particular.
1. We’re producing world class doctors, but not even close enough in numbers to meet the needs of our country, even if they were somehow distributed rationally in primary care.
2. We need to think beyond the doctor, as she is only a small part of the system. Utilizing nurses, health aides and even patients and patient communities themselves in delivering healthcare is essential. There are ample examples from various parts of the world that demonstrate the effectiveness of this approach
3. Even if we were to restructure healthcare delivery to utilize every link in the chain, from patient to super-specialist, there’s still a significant manpower crunch, as even a cursory examination of the NHS primary care system will inform us.
4. The App mania has indeed taken the focus away from improving access to improving comfort, but the two are not mutually exclusive, neither does it mean that that’s all digital health can do.
5. The manpower problem, along with the knowledge problem, which is a discussion for another time, can be significantly reduced by investing in relevant technologies. This again has been well demonstrated.
6. Technology can only provide solutions to problems it is trying to solve. The overwhelming mandate of the digital health market is “make life easier”, not, “make healthcare accessible”. This lies at the core of why all this big talk in digital health often does not translate into improved healthcare immediately.
7. In the end, it comes down to incentives, neither corporate healthcare in India, nor the larger public/govt health system in India is investing in creating such solutions, or providing incentives or environment to technologists to work in this field.
Till this shift happens, we’ll keep pining for solutions that no one’s working on.
This post was originally posted on LinkedIn