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Monday, September 28, 2009

Chasing Immortality


Immortality 1Immortality seems to be staring the human race in the face. If one was to believe the ‘futurist’ (never knew what this meant till recently) Mr. Ray Kurzweil, mankind will find a permanent solution to the scourge of dying and that too, not in too distant a future. Mr. Kurzweil believes that by 2029, that is in just 20 more years, man will conquer the final frontier in medicine and will be able to continue to live forever.

Ray Kurzweil has been a thinker, author and entrepreneur. He has done pioneering work in developing optical character reading technology as well as developed a text to speech synthesizer way back in the 1960’s and 1970’s. Of late he has been researching and writing on Artificial Intelligence and how life as we know it is on the verge of extinction, thanks to what Kurzweil calls ‘The Law of Accelerating Returns’. Kurzweil believes that we are on the verge of a technology explosion, which will grow human knowledge exponentially by a billion times in the next 25 years or so.

Armed with this kind of knowledge and technology, mankind will be able to reverse aging, turn the clock back permanently and maybe bring the dead back to life using their DNA. In fact Kurzweil is on record stating that one of his goals is to ‘resurrect’ (or shall we say reboot) his late father using some of his DNA. All this it seems will be made possible by rejuvenating body organs using the ‘nanobots’, very small nano sized robots , which will be able to identify and destroy disease causing micro organisms, tumour cells and aging cells, thereby curing and restoring humans to good health.

While, this may seem completely futuristic and the figment of somebody’s very fertile imagination, the truth is that many scientists today believe that the day is not very far, when nano particles will be in use in medicine, destroying tumours, opening blood vessels, rebuilding necrotic tissue and healing horrendous injuries. This leads us to the inevitable question- Is the ultimate goal of all the advances in medicine ‘immortality’ or is it to prolong and enhance the quality of life to a reasonable degree?

At a more philosophical level we must ask ourselves, whether man should even endeavour to live forever. In our quest for a longer and healthier life are we really going overboard by chasing immortality? Resurrecting the dead? Does any of this make sense? And where does God fit in this scheme of things? Are we aiming to be Him?

These are questions that need to be pondered by people with intellect much higher than mine. All that I can say that while man mulls over the possibility of attaining immortality in the next few decades, he must be very very careful. Disturbing the inherent equilibrium of the cycle of life and death is fraught with unknown risks and dangers. Playing God is very dicey (apologies to a certain Mr. Albert Einstein) and honestly life would hardly be as much fun if we knew it would never end.

Pic courtesy http://www.flickr.com/photos/duncan

Thursday, September 10, 2009

The Dilemma of Single Speciality Hospitals


DoctorA recent cover story in Business World highlights the growing influence of Single Speciality Hospitals (SSH) in India. I read the story carefully. First and foremost, I was delighted to see a cover on healthcare in Business World. It is not often that the business of healthcare gets prominence in a widely circulated and highly respected business weekly. That, BW decided to do this story is a testimony to the growing importance of the private healthcare sector, which is something to cheer about.

SSH’s make good business sense at least in some specialities. The investment required is low compared to a large Multi Speciality Hospital (MSH), funds can be accessed through PE firms and financial institutions, the hospital can be set up quickly and if one ropes in a well known medical luminary of that particular field, it is not too difficult to fill up the beds. Once the operations stabilise, one can consider franchising or expanding by setting up super specialised centres in large multi speciality hospitals. Specialities like Ophthalmology, Dentistry, Obs and Gynaecology (remember the neighbourhood mother and child centre) have always had Single Speciality Hospitals and clinics. The trend is now towards large SSH for Oncology, Urology and even Day Care Surgeries.

These hospitals are presently being set up by eminent doctors, who are partly putting in their own money and getting PE funds and financial institutions to invest in their ventures. Thus these SSH’s are hugely dependent on the goodwill and equity of the owner-doctor. Also one is not sure, how capable these hospitals are of attracting the best medical talent and thus providing high standards of care to patients. Typically, in a doctor owned SSH set up, it is rare to find other doctors of similar or higher capabilities than the owner. The fear of always being eclipsed by the owner-doctor drives other talented doctors to MSHs, where the canvas is bigger and the environment less claustrophobic.

From a consumers perspective SSH’s are a huge dilemma.

My father, now in his seventies suffers from an enlarged prostate. This is a problem that most elderly men are likely to have. Like most people he is terrified of surgery and has been on medication for the last few years. However, we know that surgery can only be postponed for a while and sooner than later he will have to go under the knife. Now should I choose a RG Stone Clinic, which is a well known SSH for Urology, or do we go to the multi speciality Max Hospital. While RG Stone may have better and more advanced equipment for the treatment of his condition (some fancy lasers), I am not sure they are equipped to handle complications, which may happen. The last thing one would want to deal with is an emergency requiring shifting him to a larger hospital after the surgery.

Also, I am not sure about the credentials of the doctors in RG Stone clinic. On the other hand MSHs like Max and Fortis and Apollo are well established brand names, have systems and processes (Apollo is JCI accredited and the others are in the process of accrediatation) and some of the most well known surgeons in the city are associated with these hospitals. From a cost perspective RG Stone might be cheaper, but if the patient is fully covered by health insurance (as my father is), expenses are the least of ones concerns.

Thus, in a situation like this, I will be inclined to go to the bigger MSH and I would reckon most of you will do the same.

And here is than the lesson for the SSH’s. They need to establish themselves as a far superior option in their chosen speciality. They need to invest in the brand, move away from the perception of being owner-doctor driven centres, hire the best talent by offering a great work environment and competitive salaries and establish systems and care protocols comparable to the best in the business.

SSH’s must convince me, the consumer, that they really are super experts, before I can seriously consider entrusting them with my care.