Monday, June 24, 2013

A centre for excellence in Cancer Care

Dear All,

This is the third and concluding piece of my three part article series titled `C` invades my home`which has appeared in the latest issue of Madras Musings (16th-30th June,2013). Here I have described in detail my family`s experience with one of the finest hospitals in Chennai, for Cancer treatment. Generally well-to-do people consider it ‘infra-dig’ to avail of this hospital’s facilities and avoid it because it does not have a ‘snob’ value. Such people are not aware that it is already rated by the World Health Organisation (WHO) as a top ranking institute in Cancer Care.

At the inaugural function to celebrate the Diamond jubilee of the Institue the Chief Minister of Tamilnadu mentioned that she has recommended that the Union Government confer the status of a 'Centre of Excellence' to the Cancer Institute, Adyar,. Personally I feel the recommendation is fully justified based on my family`s experience with the Institute where my wife was treated for cancer.

I, however, pray God to keep you and your near and dear ones always healthy so that you don`t need to visit any hospital for any kind of treatment.


It was on 4th June 2012 that we got the shocking news; that my wife was suffering from cancer and subsequent tests proved that it was cancer of colon which had already metastasised to the liver and lungs.

It was an inoperable case. Unfortunately we discovered the disease very late - all the doctors who saw the test reports opined that cure was not possible. But still we had to give her some treatment to see if we could contain the disease so that she could live longer than what was predicted..

The choice for treatment was between a top five star speciality hospital and the Cancer Institute. We were in a dilemma. My family had already undergone a bad experience of dealing with this particular star hospital for a simple tonsilitis procedure required for my granddaughter. Though the hospital boasts of some of the finest doctors, because it is a corporate hospital with high investment in latest equipment, the systems have to ensure maximum utilisation of the equipment and profit for the hospital.

On the other hand Cancer Institute Adyar, though a centre of excellence in Cancer treatment, run by Women`s India Association (WIA), is a not-for-profit NGO and has the image of a typical government hospital. It caters largely to poor patients from across the country, who are given the expensive treatment, totally free of cost! So there was some hesitation on our part to go to the Cancer Institute.

A senior doctor from a five star hospital whom we consulted informally helped us make up our mind.
He said, "If you are prejudiced against the five star hospital because of your bad experience, I would recommend you go to the Cancer Institute, Adyar, because they are one of the best in the country".
So the decision was made, my wife would be taken to the Cancer Institute for treatment not because it was less expensive but because we were assured that the hospital is totally dedicated to providing top rate diagnostic facilities and focussed treatment for all types of cancer, irrespective of whether the patient is poor or rich. Our experience with the Institute laid to rest all our early apprehensions.

The hospital has two wings. The main building is where thousands of poor patients are provided free consultation and treatment by the panel of highly qualified Oncologists. There is another wing called Maduram Narayanan (M &N ) Block where patients paying for the services are given appointments to meet the consultant doctors This wing has an air conditioned reception area where patients wait patiently for their appointments with the doctors. The same building also houses well appointed and well maintained non AC and AC rooms for patients who come for treatment, be it for investigations, chemotherapy or for post-operative care. Rooms are reasonably priced unlike the rates of rooms in the five star hospitals which are higher than even the rates in some of the five star hotels today..

A team of top medical Oncologists provide consultation to all the paying patients. If you are particular about meeting the same doctor for reassurance, you can do so by scheduling an appointment on that specific day of the week when that particular doctor is available. All the doctors are down to earth, practical and are friendly. No patient or attendant is allowed to throw his weight around using his/ her position or power. At no stage do you get the feeling that you are being exploited. Besides this, as it is a speciality hospital totally devoted to cancer, only relevant tests are conducted. Thorough investigation is conducted to locate the root of the Cancer before the doctors commence treatment. There is no question of your being admitted to the hospital for observation and having every single specialist in the hospital check on the patient, recommending unnecessary tests, the cost of which gets added to your bill

The Cancer Institute has the best of Diagnostic testing facilities in the country which are available for both paying and nonpaying patients. Testing facilities are common for both types. This is the only place
where paying patients have to rub shoulders with non paying patients and where I saw some discrimination – paying patients get a priority over non paying patients, if there is a long queue for a particular test.
All the doctors at the testing centres are kind, sympathetic and try to make the patients feel comfortable though the patient is undergoing a painful procedure. Similarly the nurses and ayas are equally friendly and kind.

Two other areas where I found the hospital distinctly different from the exploitative five star hospitals are in their methods of treatment and financial dealings.. All the tests we had conducted on my wife conclusively proved that her disease was not curable. It was only a question of time. Three of the consultant doctors told us that though special and highly priced injections are now available they would not recommend them because the effort would be futile. At best her life span could be extended by a couple of months but with all the pain and misery related to the disease. So they decided to give her only palliative treatment which would keep her comfortable with much less side effects associated with aggressive treatment.

In a similar situation involving a relative, the doctors at the five star hospital started on the expensive injection from the word ‘go’. The patient did not live long and the last few days of his life he spent in the ICU of the hospital resulting in the family having to pay a huge bill before the body could be removed from the hospital.

The second area is the payment system – this is where the five star hospitals make you feel miserable. Not only do you have to pay a sizeable advance to such hospitals before any kind of tests are conducted but you have to keep topping up the balance constantly to ensure that the tests and treatment are conducted without interruption. On the other hand at Cancer Institute, apart from paying consultant fee for the first time there is no further consultant fees. If the patient has to be admitted to the hospital either for tests or treatment you get an order from the consulting doctor, that you produce at the Cash Centre and pay the necessary fees in advance and in cash. If the amount is more than Rs.5000, you have to pay the amount at the Andhra Bank counter located within the campus and obtain a receipt. Credit cards or cheques are not accepted but there is an ATM machine in the premises for emergency cash withdrawals. If it is a continuous process running for a couple of days then the cash department makes a note of the doctor’s diagnostic prescriptions to your account but provides you a final bill only at the time of discharge. There is no question of treatment and tests stopped for want of a balance in your account.

Considering the large number of patients handled by the hospital and apparent pressures on the administrative staff, I found the established systems and procedures work very well and every single patient is attended to every day. There was a method in the madness. There was hope and a positive attitude among the hundreds of patients and their attendants waiting in the reception area.

Inspite of the huge turnout of poorer patients visiting the facilities, I found the hospital being maintained well. The entire sprawling campus is clean and even the Wards meant for free patients are neat and tidy. The typical disinfectant smell you get in any hospital was surprisingly missing.

My wife had to be admitted to the hospital seven times during the six month period she was undergoing Chemotherapy. Except for the first time when there was a feeling of nervousness and trepidation, on every subsequent occasion it was like a picnic for two or three days. The atmosphere was so informal and nice that inspite of the pain and suffering, her stay in the hospital was comfortable.

Though my wife passed away on the seventh month from the date of being diagnosed with terminal cancer, my family and I would like to thank the Team of dedicated doctors at the Institute and the staff, ably led by the Magsaysay Award winning Chairperson of the Institute, Dr.Shantha, for doing their best under the circumstances. Never, ever, making us regret for having gone to the Cancer Institute instead of the five star hospital. The family, however, was hoping that a miracle will save my wife. It was not to be. She left this world surrounded by her near and dear ones. Her time had come.

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