Clutching a radiological scan image to his chest, 28-year-old Narang wanders into the Red Rose Restaurant, a landmark of Hyderabad’s Punjagutta area. He takes a look at the ₹60 vegetarian meal before eventually stepping out. The scan, from the Gauhati Medical College and Hospital (GMCH) in his home State, Assam, is that of his 35-year-old sister-in-law Shilpa, who has been diagnosed with gallstones.
Shilpa was referred by her family doctor to the GMCH, which, in turn, referred her to the ESIC Medical College and Hospital in Hyderabad. Her husband, a government servant, was unable to take leave from work, thanks to the flash floods in that State. So he sent his brother Narang, a private company employee, to Hyderabad to make enquiries as well as arrangements for the treatment.
After embarking on a 47-hour 2,400-km train journey, Narang found that ESIC had now directed them to the Nizam’s Institute of Medical Sciences in Punjagutta, nearly 6 km away.
Frustrated with the healthcare maze, Narang turned to the nearby Asian Institute of Gastroenterology (AIG) Hospital in Somajiguda to explore alternatives and understand the associated costs.
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“When I was running out of options, my friends and family back home suggested that I visit AIG as many people from Kolkata and the northeast come to this hospital for treatment,” he says. The estimated cost for Shilpa’s treatment at AIG would amount to approximately ₹1.5 lakh, he found out. Despite the financial strain, he expressed determination to arrange funds and relocate his sister-in-law for necessary medical care.
Narang’s ordeal is not an isolated case, but emblematic of a common trend with individuals from the eastern parts of the country flocking to Hyderabad, a preferred destination for those seeking quality healthcare. The city’s private and corporate hospitals have been consistently drawing patients from various parts of the country for their reputation of excellence in medical care, with state-of-the-art facilities and a cadre of highly skilled medical professionals.
While such healthcare standards have been a beacon of hope for lakhs, they are also putting a strain on the existing facilities. The result of this influx is evident in the increasing waiting time at the private hospitals.
A waiting game
A visit to four private medical facilities revealed a disheartening reality — patients with chronic conditions, along with their attendants, often find themselves waiting for hours on end before they can even hope to see a doctor. This is in stark contrast to the popular perception that private hospitals offer respite from long queues and longer waiting periods for consultation and tests, something that is usually associated with government-run healthcare institutions. This is true even in case of patients who secure appointments days or weeks in advance.
A case in point is Parineeti, who regularly goes for check-ups at a multi-speciality hospital in Gachibowli, an affluent IT neighbourhood in west Hyderabad. She diligently secures appointments a month in advance due to the hospital’s strict policy against walk-ins. However, a prolonged waiting time for consultation is a regular affair.
“Upon arrival and file submission, I am informed of a two to three-hour wait despite a pre-scheduled appointment. I usually schedule my appointments around 12.30 p.m. and make it a point to arrive 15 to 20 minutes early. But I often end up waiting for at least 3 hours to see the doctor,” she says.
Parineeti recounts a similar ordeal involving her mother-in-law, who endured a five-hour wait despite having a scheduled appointment at the same hospital. If a patient arrives without prior appointment, the staff simply tells them that the doctor is unavailable at that moment, she shares.
This recurring situation is not unique to this particular hospital, but is reflective of a broader issue in leading private hospitals across the city. Patients, despite paying substantial consultation fees and diligently booking appointments well in advance, find themselves enduring extended wait times before finally getting to consult with their doctors.
Staff call the shots
On a sunny Tuesday afternoon at a prominent hospital in twin city Secunderabad, the outpatient wards saw an overwhelming flow of people seeking medical attention. While this surge highlights the community’s trust in the hospital’s services, a notable concern revolves around the extensive waiting times.
In the outpatient waiting hall, a recurring scenario unfolds, with patients frequently approaching the staff desk to enquire about their turn. “Often the staff members say that the doctor has not come in yet or that the other patients inside the doctor’s chambers are taking longer than usual. That is their common response,” says a patient requesting anonymity.
The waiting area that day witnessed individuals dozing off on chairs with others seeking refuge in the nearby coffee shop nestled between the OP ward, and a queue forming at the free phone charging station as patients awaited their turn.
Amrutha, who visited a corporate hospital in the plush Jubilee Hills area of Hyderabad, says, “Everytime I walk in, I complain to the doctor about the long wait, after which he calls his staff in and directs them to give limited appointments per day. A wait time of 30 to 45 minutes is still manageable, but what do you do if it extends beyond an hour or two? It is frustrating, no less.”
She also points out that the hospital staff often ‘fit in’ people without appointments due to personal connections, causing inconvenience to others.
A staff member of a private hospital notes that many patients who are getting treated by the same doctor for years share a rapport. “Those patients bypass the appointment system altogether. Instead, they directly contact the doctor, requesting consultation. When this happens, the doctor checks their schedule and upon finding it partially vacant, invites them to the hospital. However, by the time these individuals arrive, the doctor’s appointment sheet fixed by his staff is already fully booked. Therefore, the staff is compelled to make accommodations for them, as the patients claim to have communicated directly with the doctor,” the staff member explains, seeking anonymity.
Doctor delays
The waiting period extends beyond just the consultation with the doctor, encompassing delays in tests and procedures as well. During a recent visit to a hospital on Minister’s Road for an endoscopy and colonoscopy, Syed Moinuddin underwent a similarly harrowing time. He was instructed to arrive between 10 and 10.30 a.m. to be able to meet the doctor. He turned up on time and promptly underwent pre-procedure preparations.
However, despite his punctuality, Moinuddin found himself waiting until 1.40 p.m. before being ushered into the procedure room. The delay persisted even after he went inside, with the commencement of the procedure being postponed due to the delay in the doctor’s arrival.
“Such situations, where individuals are subjected to prolonged waiting periods despite prior preparations, can adversely impact their well-being,” a patient’s attender remarks.
Moinuddin’s father, who has faced a similar situation for years, says patients are summoned much before the doctor reaches the hospital. “After waiting for hours, we see the doctor entering his room right in front of us,” he rues.
This scenario apart, there’s another aspect to consider when patients reach the hospital even slightly late. Nithin, a resident of Malkajgiri, a suburb of Hyderabad, frequently visits a popular children’s hospital in Secunderabad for his three-year-old son’s periodic check-up. His usual practice involves booking an appointment online through the hospital website, usually between 11 a.m. and 5 p.m. based on the doctor’s availability.
Nithin and his wife, both IT employees, must coordinate their schedules to ensure they can take their child to the hospital. “Since I need to take my child regularly to the hospital, I typically schedule appointments early in the day. This way, we can return to work promptly after the checkup. But there have been instances where we arrived early and had to wait for an extended period of time. On the contrary, if we are slightly delayed by 10 to 15 minutes, the staff informs us that they have moved on to the next patient, requiring us to wait until all patients are attended to before our turn comes again,” he shares.
Preference for private hospitals
In spite of various considerations, the average middle-class individual often opts for private hospitals.
According to a government hospital doctor, if one needs to consult a cardiologist at a State-run facility, the process can be time-consuming due to a shortage of doctors. In contrast, private hospitals offer the convenience of pre-scheduled appointments, allowing patients to plan their visits according to their own timelines.
“Upon arrival at the hospital, the wait time significantly differs between private and government facilities. In private hospitals, individuals may experience longer waiting periods because paying patients are often willing to wait to receive the best possible care,” the doctor says, adding that the distinguishing factor between the two lies in the diagnostic testing process.
“Following a cardiologist’s consultation, if a 2D Echo test is recommended, government hospitals provide another date for the test. But private hospitals, while possibly requiring some waiting, may offer the advantage of conducting the test on the same day as the consultation, providing a quicker turnaround,” he explains.
A doctor, who runs a private hospital in Jangaon district of Telangana, shares that in the realm of healthcare, the duration of patient waiting time often hinges on the specialty a doctor belongs to. General physicians or those focused solely on non-surgical aspects of patient care typically have shorter waiting times. On the contrary, patients seeking a surgeon may experience delay, particularly if surgical procedures are on the agenda.
Seniority matters
However, the dynamics shift when a senior doctor delegates patient care to a junior. In such instances, patients may express reluctance, preferring direct interaction with the experienced practitioner. This phenomenon contrasts with healthcare practices in developed nations, where adherence to appointment schedules takes precedence over the specific doctor attending to a patient.
A distinct challenge in India is the prevailing perception akin to a ‘demigod’ status assigned to doctors, transcending the nature of the medical issue. Even for ailments like diabetes, there is a cultural inclination to seek consultation with specialists, such as nephrologists.
The crux of the matter lies in the prevailing mindset, which, until altered, will continue to influence patient behaviour and doctor-patient interactions. “Each corporate hospital has certain VIP and VVIP slots which are not given to general public. It is these slots that the doctor, staff and other senior management people to allow their own contacts to have seamless consultation,” says a patient’s attender who has an insight into the functioning of multiple hospitals.
Another doctor presents a hypothetical scenario illustrating that even if a highly qualified doctor, for instance a gold medallist from prestigious institutions like PGI Chandigarh or AIIMS New Delhi, were to establish a clinic adjacent to a corporate hospital, patient preference might still lean towards the corporate setup.
“It is important for doctors to assert their busy schedules, and suggest that patients may need to consult with junior doctors in their absence. Patients should also be encouraged to recognise the proficiency of the entire medical team working under a senior doctor,” a doctor working at a private hospital says.
As per the Telangana Hospitals and Nursing Homes Association (THANA), the twin cities predominantly hosts multi-speciality hospitals. In the category of 250 beds, there are approximately 2,150 hospitals in the twin cities of Hyderabad and Secunderabad. Moreover, alongside these, there are super-speciality hospitals with capacities of up to 1,000 beds, while some smaller hospitals have as few as 10 or 20 beds. For instance, Apollo Hospitals’ Jubilee Hills branch has over 1,000 beds, while its Hyderguda branch has about 150 beds. On an average, it can be considered that each hospital accommodates around 150 beds. “Additionally, it can be noted the presence of private medical colleges with a minimum of 500 beds in the region” said THANA president-elect Dr. Rakesh.
“Each corporate hospital has certain VIP and VVIP slots which are not given to general public. It is these slots that the doctor, staff and other senior management people to allow their own contacts to have seamless consultation”A patient’s attender
“Upon arrival and file submission, I am informed of a two to three-hour wait despite a pre-scheduled appointment”Parineetia patient
