From nursing homes to corporate hospitals, how private healthcare has managed Covid-19

Private medical practitioners and their nursing homes form the backbone of primary and secondary healthcare in rural and urban India. But unlike large hospital chains, which are more resilient in terms of finances, resources and clout, Covid-19 has put many private healthcare providers in a difficult situation. Viswanath Pilla brings out the chalk and charcoal difference in these two private-sector segments through the story of a tiny clinic in Tamil Nadu’s Dindigul town

JC Sekar, 63, a general physician, has been running Sobha Clinic, a typical rural primary care nursing home, for over three decades in a Vadamadurai village, 17 km from the historic town of Dindigul in Tamil Nadu.

The nursing home is equipped with a lab and x-ray, and also provides inpatient services with 20 beds attached. The nursing home employs 20 people, of whom 16 are nursing assistants and the rest non-clinical staff.  Sekar even maintains computerized records of his patients.

The nursing home is popular in that area and handles a heavy load of outpatients. Sekar says he works for more than 12 hours attending patients and often has to skip lunch.

The popularity of his clinic stems from quality care and the personal touch with patients that Sekar has become known for over the years. Another major reason is affordability; Sekar charges just Rs 50 per outpatient consultation.

Private primary care providers struggle 

Private medical practitioners such as Sekar and their nursing homes form the backbone of primary and secondary healthcare in rural and urban India.

According to the National Health Policy (2017) report, only 1 in 5 Indians in rural India uses outpatient services at government health facilities due to the perception of substandard care, non-availability of essential services and drugs, and absenteeism.

But unlike their larger peers, who are more resilient in terms of finances, resources and clout, Covid-19 has put many private nursing homes in a difficult situation. Sekar says he had to shut down his clinic for 10 days beginning March 23, when the government announced the lockdown. The district collector later permitted nursing homes to open, on condition they take safety measures.

Sekar says he decided to open his clinic when many of his younger peers in the district were not ready to do so fearing infection.  Primary care providers are known to be at much higher risk of getting infected by Covid-19 as they are the first ones to see patients.

Opening the clinic wasn’t easy. Sekar had to put in place a series of measures to protect staff from getting infected. He ensured that the staff had sufficient protective gear such as PPEs, face masks, and sanitizers all of which were scarce during the initial months of the pandemic. He shifted his outpatient consultation outdoors and even got a temporary pandal erected so that patients didn’t have to suffer in the heat. The staff worked in two groups, spelling each other every two weeks. The nursing home also had to forgo inpatient services during that period.

Despite all these measures, there was a lingering fear and the staff had to be motivated. “I have ensured everyone, and assured them I will take care of them if they fall sick,” Sekar explained.

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