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‘Need to Inform the Patients Transparently’ – Abhishek Bhartia, Director, Sitaram Bhartia Institute of Science & Research

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Abhishek Bhartia,Director of Sitaram Bhartia Institute of Science and Research,

Abhishek Bhartia,
Director of Sitaram Bhartia Institute of Science and Research,

‘Need to Inform the Patients Transparently’ says Abhishek Bhartia, Director of Sitaram Bhartia Institute of Science and Research, a nonprofit hospital, that has carved a niche in women’s health. In conversation with Shahid Akhter of ENN, he focuses on the changing scenario in birthing.

When was the Sitaram Bhartia Institute of Science and Research founded and what it its legacy?
Sitaram Bhartia Institute of Science and Research (SBISR) was founded in 1979. It took off under the aegis of its first director, Dr N Gopinath, a renowned cardiologist noted for his expertise in heart bypass surgery. The institute conducted one of the largest community based studies of coronary artery disease in India. It  then took up a large study of blood pressure in Indian school children. Similar studies yielded valuable information on the risk factors for cardiovascular disease in our country. SBISR was established with a spirit of serving society through research and the motivation was to establish excellence  in healthcare delivery, research and education. With the passage of time, we have evolved into an organization that combines medical research with excellence in patient care.

When did you shift to patient care and what was the outcome?
Our research continues to focuses on collecting health related information, translating evidence-based guidelines in clinical practice, developing cost-effective interventions for improving care, investigating factors influencing disease development, and analyzing medical literature for developing clinical guidelines. In 1995, we decided to broaden our range of activities and thought  of providing a sustainable base for research. The ground work was laid by eminent physicians and surgeons from All India Institute of  Medical Sciences. Professors J S Guleria (Padma Shree), the late M M S Ahuja, R Tandon, I K Dhawan, and V L Bhargava were among the early faculty members to join. Today they serve as outstanding care providers and role models for the next generation of doctors.

Sitaram HospitalWhat clinical specialities and services Sitaram Bhartia offer?
Our specialities are spread across from anaesthesiology to urology, with special focus on obstetrics and gynaecology. We offer radiology and diagnostics, laboratory tests, pharmacy and preventive health check-ups.

Sitaram Bhartia is noted for women’s health. Tell us more on the services in this speciality?
We care and support women in every phase of life, from adolescence to menopause. True, Sitaram Bhartia is a leading centre for women’s health. The patients admitted here rate Sitaram Bhartia high on desirable outcomes and quality of care. In obstetrics, our comprehensive birthing program spans a duration of nine months. It lays emphasis on education and empowerment as key elements for a fulfilling journey to motherhood. An inter-disciplinary team consisting of obstetricians, women’s health educators, physiotherapists, nutritionists, paediatricians and nursing staff deliver the comprehensive program. When it comes to labour, delivery and post-delivery care, Sitaram Bhartia offers a safe and satisfying birthing experience. The patient is comfortable with physical and emotional support that reduces the need for medical intervention and improves infant outcomes. The mother is given lactation counselling, and informed about post discharge care after the delivery.

What are your views on the surge in caesarean rates?
Cesarean section is a major surgery and like all surgeries, it carries risk. Recently, the American College of Obstetricians and Gynecologists issued a statement that “pregnant women  plan for vaginal birth unless there is a medical reason for a cesarean.” They pointed out that cesarean delivery can increase the risk for infections, bladder and bowel injuries, and serious complications in future pregnancies. They noted that babies born vaginally have fewer respiratory problems. Thus as a society we should be concerned about high cesarean rates that are not medically justifiable.

“We are not only disclosing the cesarean rates in our unit, but are also providing guidance on how to interpret those rates.”

How does one decide or choose the doctor and the hospital ?
Many of us do extensive research before buying a mobile phone or a car, booking a hotel for a holiday or even selecting a new restaurant. But when it comes to choosing a doctor, many of us do little more than get a word-of-mouth reference. Unfortunately, what often drives patient satisfaction and thus recommendation of a practitioner to others is “bedside manners” and may not always reflect evidence-based medical practice. Doctors are picked on reputation, and yet some of the most popular doctors have undesirable outcomes such as high cesarean rates!

Is it important for maternity providers to disclose Cesarean rates?
Most hospitals don’t collect data on clinical outcomes – they may not have electronic health records or lack the manpower to manually collect the data. Doctors and hospital administrators may also be hesitant to disclose quality-related data because of concerns about misuse by competitors or patients. Yet these concerns should not hold back efforts at promoting transparency if we want healthcare to become better and safer. The National Patient Safety Foundation of USA has identified transparency is “the most important single attribute of a culture of safety.” We at Sitaram Bhartia Institute are taking a step towards becoming more transparent and accountable to our patients by disclosing cesarean rates of our staff Obstetrics and Gynecology(O&G) unit. We are not only disclosing the rates in our unit, but are also providing guidance on how to interpret those rates.

What are the cesarean rates at Sitaram Bhartia?
Our staff O&G unit delivered 561 babies in 2013 with a cesarean rate of 40 percent. This rate is much above the 10-15 percent rate recommended by the World Health Organization and the average rate in countries like Sweden (17 percent), UK (26 percent) or USA (33 percent). However, our 2013 rate is an improvement over the 52 percent rate in our own unit in 2011 and the 65 percent rate reported by a leading health insurance company in India for their claims.

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