Wednesday May 22, 2019

Why patients are not put first in Indian hospitals

By Dr Aniruddha Malpani
New Delhi: Despite most Indian hospitals claiming that serving the patient is their only priority, the reality is quite different.
Most patients in government-run hospitals are treated very shabbily – and their family members are treated much worse.
Why do hospitals continue putting patients last?
I think there are two reasons for this.
One, of course, is the fact that the hospital authorities can get away with it. They’ve done this for many years, and they feel that it’s not a problem which they need to address.  The number of hospital beds are far fewer than the number of patients, and since they have enough bed-occupancy (and, therefore, enough profitability), they see no need to change what they’re doing.
Their primary focus today is in incentivising doctors ( and other middle-men) to make sure that their beds are full, rather than trying to delight patients. This is a short-sighted approach which will come back to haunt them later.
Times are changing, especially in large cities, where lots of corporate hospitals have empty beds and are no longer profitable. At some point, when they find that their balance sheets are in the red, they will hopefully get their act together.
I think the second reason is that whatever initiatives they’ve tried in order to put patients first haven’t worked very well. Part of this is because they’ve been very half- hearted interventions – for  example, holding a conference;  or adding a few videos on their website.
However, the problem is that no one in senior management has taken ownership of trying to delight patients.  Each hospital should have a chief patient officer, whose job is to make sure that everyone in the hospital remembers that the only reason the hospital exists is to help patients to get better. He needs to champion the cause of the patient if we want things to improve. Ideally, this should be the Chairman of the Board, who can inspire change by taking rounds daily.
Dr Aniruddha Malpani is the Medical Director at Malpani Infertility Clinic
the article first published at

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New Sleeping Pill Can Help Patients Wake up in Response to Threat

However, more studies on humans are needed to confirm DORA safety and efficacy, they noted

Pills (representational Image), Pixabay

Japanese scientists have shown that a new class of sleeping pill that preserves the ability to wake in response to a threat, unlike the commonly prescribed drugs that muffles a sleeping brain’s “intruder alert”.

Even during sleep the brain continuously processes sensory information, waking us if it detects a threat. But the most widely prescribed class of sleeping pills, known as benzodiazepines, makes us less likely to rouse in response to sensory input.

The findings showed that millions prescribed on these sleeping pills would sleep through a fire alarm as someone vacuuming next to their bed.

 However, the new class of drugs called dual orexin receptor antagonists (DORAs) more selectively targeted the brain’s sleep or wake pathways, which gives them safety advantages over benzodiazepines, said researchers from the Kagoshima University.

These include a reduced “hangover effect”, with DORAs less likely to affect driving ability the day after use.

“Benzodiazepines stimulate the widespread brain receptor GABA-A, which makes us sleepy but also suppresses off-target brain areas – including the ‘gatekeeper’ that decides which sensory inputs to process,” explained author Tomoyuki Kuwaki, Professor at the varsity.

Contraception, Men
New sleeping pill can help patients wake up in response to threat.

In the study, published in Frontiers in Behavioral Neuroscience journal, mice that were given the new experimental hypnotic drug DORA-22 wake as quickly when threatened as drug-free sleepers — and then fall back asleep as quickly as ones given standard sleeping pills, once the threat is gone.

While DORA-22 allows mice to wake to a threat, it still helps them sleep.

Thus, the selectivity of DORAs could make them a safer alternative during sleep as well — by allowing the brain’s sensory gatekeeper to stay vigilant to threats, the researchers said.

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However, more studies on humans are needed to confirm DORA safety and efficacy, they noted.

“Although it remains to be seen whether DORAs have the same properties when used in humans, our study provides important and promising insight into the safety of these hypnotics,” Kuwaki said. (IANS)