Dr. Mahadev Bhide
Incharge of Thane Helath-Care Hospital

Tell us about yourself?
My father, Dr S M Bhide had his general practice on Station road thane and I attended St John High school. We belong to the few thousand original residents of Thane and have seen the town become a city and getting bigger and better each year! I did my HSC from Thane College, and had a great time studying in a place where teachers knew not only the students but their families as well, so small was Thane then. Medical education was in Sion hospital where I did my MD in Obstetrics and Gynaecology in 1990. After that I went to London where I did my MRCOG and then worked for around 10 years in the government hospitals. I have spent around 3 years doing clinical research in assisted conception (test tube baby) at the Barts and Royal London Hospital.

From 1996, we started a medical training group called Y B Education Systems Ltd which has become the leading group for training doctors in the UK. We train more than 2500 doctors each year and the work is now managed by our faculty in London. I visit them a few times in the year to help in the teaching etc, that allows me to stay in touch with the latest in the field.

Tell us about Thane Health-Care Hospital?
Throughout my training times, my father who is now 75 used to remind me about his dream of starting a hospital which would be ableto help patients with all their problems under one roof and for that we rebuilt the Thane Healthcare building so that it could look and serve well as a hospital.

The building constuction lasted for more than 2 years and for the last 5 months we are working full-fledged. The hospital has all medical care under one roof and the total area over 4 storeys is more than 11000 feet. From routine surgery to open heart surgery, neuro (brain) surgery, to kidney stones, to deliveries and caesarean section, cancer surgery and all specialities are available in THC.

Our opthalmologists offer the latest in phaco surgery with intra-ocular lens implants and we have plastic surgeons as well. Most of all we have a well equipped cardiac and medical intensive care unit with a total capacity of 4 ventilators and this is manned 24 hours a day by specialised intensivists. We have dialysis facilities as well. We have C-arm (image intensifier, useful for special orthopaedic operations as well as permanent heart pacing) and Xrays (portable and fixed) as well as a pathological lab means the patient does not have to go elsewhere for tests. Our medical consultants and cardiologists as well as renal physicians can look after all medical problems and because they are all together, there is facility for immediate consultation and work together.

What makes THC special?
Our USP is everything under one roof. Our main strength is the well staffed intensive care unit which has full time intensivists, one of whom is an MD in medicine and the other is an anaesthetist. This means that the consultants who admit the patients in our hospital will have peace of mind and patients have the best of care. All our staff-nurses are qualified nurses so patients realise that they are been looked after by professionals. More than anything else, the fact that we are a dedicated place, means the premises are clean and uncluttered by other commercial establishments.

As we are doctors ourselves, the hospital looks well thought off. Simple yet pleasing to the eye. E.g we have 2 big theatres, one for doing special surgeries such as knee joint replacement, plastic surgery and brain surgery etc whilst the other surgeries such as appendix, caesareans, laparoscopi cholecystectomies etc which are less clean operations. This is purely done to keep the first theatre totally free from infection. This means we have to use extra space for the surgical theatres, however, this allows us to keep our theatres clean for special uses.

It is always small things that make the treatment experience better, e.g. at THC, our 2 lifts means the patient and relatives for ICCU as well as dialysis dont have to climb up the stairs. Whilst such a small thing would be in the mind of other treatment centres as well, the fact that we built the hospital with nothing else in mind, these things were possible. Our generator can take care of all ICCU and theatre equipment including A/C's and lifts and Xray machines, so in case of a power failure, the surgeon wont feel the pinch and the patient does not get less quality care.

Has health-care changed over the last decade? In what way?
Health care in the western world has changed a lot and mainly because of the insurance companies dictating the type of care that a patient could have. However in India the main change has been accountability and transparency that the patients expect. Currently it is common to blame the consumer courts for increased litigation in the medical field however, in many ways I think the threat has improved the quality of care patients expect and doctors provide. Having worked in the UK for long, I can appreciate the reasonable and understanding nature of Indian patients.

The main change I think is that quality has become more accessible to the masses. 25 years ago, there was only one or two surgeons in south Bombay doing total hip replacement, now there are atleast a handful in Thane alone doing total knee replacement. THC has Dr Milind Sawant who worked in the UK for 8 odd years and has done several successful cases in THC. IVF (test tube baby treatment) was once only in south bombay, today Thane has 2 places and we at THC will be doing it early 2002.

The other thing is the doctor patient relationship, this has greatly altered. In my fathers times, doctors were demigods and their eccentricities were tolerated or even appreciated. "Our doctor hardly speaks to patients, he does not like being asked questions" has all changed and now patients like to participate more in their treatment. Doctors now like to invite patient questions and are themselves patient about answering those queries. We at the THC are instituting patient information sessions to encourage this process

Has the patient perception changed about the medical practice ?
As I was saying earlier, the old demigod image of the doctor is gone. That doctors are professionals and medicine is a way they make their living is now accepted and doctors too are not too hypocritical about their medical practice as their means of livelihood. Patients now expect a professional performance from their doctors and will not take shoddy treatment or tolerate mistakes. Having said this, if you have a good rapport with your patients, you still get good respect from your patients and you can enjoy your work as well.

What have you done as a responsible member of the society?
We have claimed to be a professional outfit and in THC we have nurtured a thought that good quality is not optional but entirely a basic need. Good doctors need good backup facilities to make their treatment more bearable and all that has been achieved at no extra cost to the patient, this in some ways has been a responsible behaviour as a doctor. However more conventionally, we have been conducting health-awareness camps which is an ongoing service for senior citizens. 7 tests (ECG, Xray, full blood count, cholesterol, glucose, cataract check, surgeons check and ENT check) all done for only Rs200 makes this a very good thing for senior citizens. We are now planning to start a cancer screening programme which will include scanning for prostrate, gut cancer, lung cancer, oral cancer as well as female cancer (cervix and breast) all for a fraction of the market price will make people more interested in these tests. We have been offering cataracts at half the market price for senior citizens as an ongoing offer.

Our philosophy is that we have been lucky in having medical training and the chance of having a dedicated place for a hospital. We are keen on extending our service to as many people as possible, at a reasonable cost.

As a doctor what dilemma do you face and how have you answered those questions ?
Medicine and ethical dilemmas are inseparable, but I could perhaps mention one of my biggest area of moral confusion. Abortion or medical termination of pregnancy for "social reasons". As a trained gynaecologist, I have done quite a few of these and each time I thought I was helping either a woman in distress or the population control policy of the nation. However now that I am firmly in middle age with my own child, I have a different perspective to termination of pregnancy. I think that is not the right thing to do. On the other hand, I can see that our society is will accept termination of pregnancy but not an unwed mother! As a society we have still not solved this issue and I am aware that my stance does not solve the poor girl's problem. I really wish there was a simple good answer. What is definite that we should not be judgemental and critical of such patients. They should be supported and counselled not critisised or embarrassed.

To address this, I am very keen on promoting contraception in the population and will be happy to answer any queries free of cost either on the web or in person. Supporting sex education is not the same as supporting "free love" or promiscuity. However, I sincerely hope that there is a bigger and more open discussion on this matter.

What is the role of IT in a hospital practice?
IT is coming of age and it means that the patient care will improve hugely. E.g. Xrays and ECG's and all reports and doctors notes can be archieved and when a patient comes even years later, the reports are accecible to us in minutes. At THC we are in the process of fine tuning this arrangement. We also are keen to use patient information information in a multi-media setup so that patients can participate in their own care in a far better way. Our website www.thanehealthcare.com is being developed for these purposes as well.

Are you satisfied in your job ? What are your future plans for yourself and THC?
I work reasonably hard, and I am greatly satisfied with my job and activities. I work with my family and friends and what better way to spend your time! My biggest success has been getting a great team for THC and all of them make it tick well and easily. THC has great plans for improving our services, making more treatments available for more patients as a reasonable price. We have a cardiac catheterisation lab in mind as well as state of the art cardiac ambulance for citizens of Thane. Our IVF unit (test tube baby treatment) should start soon and in future we have a neonatal intensive care in mind. Hopefully we have 6-12 months to get all this going.

Message for the younger generataion?
Enjoy what you do and you wont have to "work" another day. Doing quality work is crucial, money is a byproduct, it will come your way, you dont have to chase it. Spend time away from your society and peer pressure, so that you can return to it stronger, more sure about yourself and your ideas and make your surroundings a little better.

And last message is dont ask for too many messages from middle aged people, they dont know when to stop!

As told to Thaneweb.com