Tuesday, May 30, 2017

Winds of change - 14

(This is the fourteenth part of a short story which is entirely a work of fiction.)

Manav worked until late that night and got all the numbers and the survey questions ready by the next morning.

Dr. Som and he discussed the numbers, made a few tweaks here and there. They decided to run the numbers by Vasudha. Dr. Som sent the file to Vasudha who said they looked good and that they should roll it out as soon as possible.

Dr. Som and Manav felt they should explain the move to the doctors in the department and get their thoughts as well. So, they had a meeting with the doctors where they went over each of the points. They took pains to assuage any concerns the doctors might have on any of the aspects of the plan. The doctors seemed to be on board. However, by the end of the day, doctors in the other departments got to know of this. Some of the senior doctors went to speak to Vasudha. The main concern they had was that having different rules for different departments was not the right thing to do. They were wondering how inter-departmental referrals would work? For example, if they referred patients to the nephrology department, would they get their referral fee? Vasudha said that would not be the case. Anything pertaining to the nephrology department would now work as per the rules of the pilot. The doctors were against such a partial implementation. Vasudha convinced them to give the pilot three months of time.

Dr. Som and Manav decided that the plan would be rolled out on the first of the following month, about two weeks away. This would give enough time for the other departments to gear up for implementation. They put up notices on the board informing the patients about the changed tariff. They made it very clear that this was for a period of three months only. The patients were pleasantly surprised. For the first time, they had seen prices actually go down for services at a hospital, even if only temporarily.

The pilot began with little fanfare. Not much change was seen on the ground. Things went on like before. Dr. Som and Manav reasoned that the real impact was in the patient satisfaction survey numbers which would indicate if the number of patients would eventually increase or not. Dr. Som and Manav did some informal feedback gathering as well. There was a generally positive feedback on the new prices. Doctors were also happy because their earnings from the hospital remained intact.

Dr. Som and Manav conducted a weekly review of all the numbers including those related to patient satisfaction. For the first few weeks, there was no change at all in any of the numbers. At the  beginning of the second month however, hospital revenues from the department began going down. The profit from the department also dipped. Dr. Som and Manav were worried. They tried to analyse the reasons behind this. Manav dug deeper and found that the new patients added for dialysis had dropped. He also noticed that the revenues from investigations from the department had also dropped.  He discussed his findings with Dr. Som. He told Dr. Som that it was likely that other doctors in the department were referring cases elsewhere. That way they would get their fixed income from Narayana Hospital and get a referral on these cases from other places.

Dr. Som called a meeting of the doctors of the department. He discussed the findings with them. Each of them sounded surprised. They assured Dr. Som that none of the cases were going outside. They thought this could be a temporary thing and that things would pick up once other patients got to know. Dr. Som and Manav agreed.

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