R. Hari Ramesh is rudely woken up in the middle of the night by the piercing ring of his cellphone. The caller is in panic. Speaking in accented English, he says “Doc, there is an emergency at home. My mom is not answering my calls. I am worried!” Dr. Hari checks on the old lady who lives in Chennai with a fulltime helper and reports to her anxious NRI son: “She is fine. She was sleeping too soundly to hear the phone. The helper is on a day's leave.”
Dr. Hari is not upset by the false alarm. Like many others, this NRI has paid him a retainer to keep a watch on his parent in Chennai. The service includes carrying out a variety of medical check-ups and also attending to emergencies. The general physician and geriatrician has built a unique medical practice, catering to ‘NRI parents' around Adyar and Thiruvanmiyur by entering into annual medical contracts.
For a fixed sum of $ 1000 per annum, Dr. Hari and his team will regularly visit senior citizens signed on the programme and conduct a series of tests (including ECG, blood sugar, blood pressure), supervise the intake of prescribed drugs (if necessary) and conduct master health check-ups. The package includes a 24-hour doctor-on-call and ambulance service, and the online relay of the health status of these patients to their NRI children.
The health package was born out of the concerns frequently voiced by NRI children of Dr. Hari's patients. The doctor sensed a demand for it around 12 years ago. While he has been accepting requests for a 24/7 care of such senior citizens for many years now, it is only recently that it evolved into a comprehensive medical service scheme, which he calls ‘Home Health Care'. While his medical programme remains committed to its original goal of serving aged parents of NRIs, it also caters to other seniors. “We also offer packages tailored for the slightly different needs faced by senior citizens whose children are with them.”
Dr. Hari admits that he is not building on an original concept. He traces his work to what is well-entrenched in Indian society: the idea of the family physician.
“What we do basically is go to the patient and take care of him/her, but we have added newer dimensions to this familiar concept to address the complications of modern life, one of which is aged parents living alone. It is only going to get more complicated in the future. In 2020, the biggest socio-medico-economic problem in India is not going to be HIV-AIDS or tuberculosis or any other condition. It's going to be old age. As a result of medical advancements, life expectancy in India keeps going up. When people live longer, they tend to develop degenerative conditions that make them dependant on others.”
Dr. Hari is convinced that preventive or prophylactic pre-paid care of the aged is the model of the future. Given its rich potential, he persists with it despite encountering certain problems while practising it. “Often, the opposition to this model comes from the patients themselves. The majority of seniors don't warm up to the idea of being visited by a doctor when they are not in any form of distress. The service often serves the goal of preventive care, which is lost on most seniors.”
The NRI children have, however, extended rock-solid support to Dr. Hari. One of them, Raghu Ram, wants the doctor to take this service to the other parts of the city and is willing to work with him towards this end. The plan involves introducing this service in other localities, including Mylapore, T. Nagar, Kodambakkam, Nungambakkam, Velachery and Anna Nagar. “From Anna Nagar to Adyar” is how Dr. Hari refers to this initiative. Among the features planned to be added to the care of the aged are home monitoring gadgets — including geo-fencing aids and warning relay instruments — and advanced electronic medical records.
Dr. Hari is also indirectly spreading this model beyond Chennai. “Doctors in Mumbai and Delhi have contacted me and inquired about this model and I have only been too glad to help them adopt it. It's not good to keep a good thing confined to a city.”
Children – primarily NRIS– pay an annual amount for the medical care of their parents
*A pre-set list of medical check-ups are carried out for these seniors
*The team attends to medical emergencies of these seniors
*Children are regularly updated about the health status of their aged parents
