Eman Ahmed, RIP

201710ehm01The sad news of the demise of  Egyptian national Eman Ahmed took me back to my editorial column of June 2017. (Hope vs hype: http://www.expressbpd.com/healthcare/editorial/hope-vs-hype/386201/)

Once referred to as the world’s heaviest woman, Eman has now finally passed away into medical archives. And, might I say, into the annals of medical ethics. The last few months of her life were both painful and controversial.

She was and will be the subject of debate, and hopefully, introspection in the medical fraternity in India as well as globally. Bariatric surgeons in particular will tend to measure each future similar case against her case, the treatment given and the outcomes.

More than anything, it revives the debate on outcomes versus available resources. While each individual deserves the right to live as healthy a life as possible, in a resource-scarce situation, how can we justify the spend on one patient? Maybe Eman’s doctors, both here at Mumbai’s Saifee Hospital as well as at her final stop, Abu Dhabi’s Burjeel Hospital, were driven by both humanitarian concern to heal a patient as well as the urge to set a precedent which could serve more patients in the future.

Either way, let’s us hope that Eman will not have died in vain and the practice of bariatric surgery will be more circumspect and humane. Let us also hope that there is more self-monitoring among the medical fraternity and at the healthcare facility management level, to curb the impulse to make medical history or worse, news headlines, by pushing the envelope, even when it may not have long term benefits for the patient.

The controversy over Eman’s departure from Mumbai made the government take steps to prevent such incidents. It was reported that on May 22, the Ministry of Tourism asked the National Medical & Wellness Tourism Promotion Board to draft the Medical & Wellness Tourism Policy for India. The board was due to submit the draft policy to the government in three months, after discussing the framework with various stakeholders and industry associations. However, we are yet to see any sign of this going forward. It would indeed be sad that we fail to learn from past missteps.

The Eman case was merely one of many instances where the healthcare sector failed to protect its reputation. The case damaged the image of the sector (doctors and hospital administration alike) and the public came to see them, once again, as profiteering, publicity seeking entities working not for, but against the patient. Be it pricing of medical devices, surgeon fees, or the Gorakhpur tragedy, the profession and sector have taken and will continue to take hits unless there is introspection and a will to change. The ability to manage risk perception was in fact one of the key points of debate during a panel discussion at Healthcare Senate, held over September 7-9.

Now in its second edition, Healthcare Senate touched on many issues which are impacting our sector.  With panel discussions on the urgent need to curb antimicrobial resistance (AMR), ensuring cost efficiency in capital intensive departments like imaging and radiology labs, the need to put people first, and the finer nuances of revenue cycle transformation in healthcare organisations, the conclave once again became a meeting place for the finest minds in India’s healthcare sector.

Picking up some of the key takeaways from the sessions, I think it is interesting that the medical fraternity is now actively looking for support from outside their circles. For instance, the panelists felt that increasing public awareness on AMR, through media and harnessing CSR spends, was crucial to tackle the menace of drug resistance.

On the talent front, there is a realisation that unless there is long term investment in skill updation, creating credibility and making sure that there are clear career paths, we will lose our best human resources. And on the need to plug the revenue leaks, many hospitals would do well to look to a new age tool, fintech, which could be the game changer on this front. Do read our October issue for a detailed report on Healthcare Senate.

Viveka Roychowdhury