Specialty clinics are offering solutions to many lifestyle and health related issues we face

By Sharmila Das, Elets News Network (ENN)

Ever since the emergence of life-style diseases, it is regular to see people visiting doctors/clinics for reasons like stress, infertility, performing dialysis etc more often than a serious medical issue. Urban corporate utives prefer visiting a Trichilogy, Allergy, Nephrocare than visiting a super specialty hospital offering similar kind of services. Specialty clinics are definitely emerging as a trend in India because people today want dedicated services on their health is- sues without wasting much time, says Dr Bharat Inder Singh, Chief Administrator, Max Healthcare Centre.

Specialty clinics save the pain of traveling to crowded and far distanced big hospitals and thus it has received good response from consumers over the years

The rationale behind approaching a specialty clinic is that, In a specialty clinic you get medical attention from experts under one roof whereas in a hospital you have to keep running from one department to another, says Dr Puroshottam Lal of Metro Clinics. Its also cost- effective, he adds. For instance, at Metros anti- smoking clinic, which is popular with professionals, pulmonary tests sessions with an expert panel of doctors and carbon monoxide uation tests cost around `500. A follow-up would cost `200. The same tests in any hospital would cost at least `2,500 because the consultation fees can be anywhere between `500-700.

In one of its reports, WHO said that the End Stage Renal Disease (ESRD) rate in India is 850 in 1 million people and the patient getting treated is just 60. So you can see there are huge demands of people to be treated

Dhruv Chaturvedi,
Managing Director, Fresenius Medical Care India

Popular types
Specialty clinics save the pain of traveling to big hospitals and thus it has received good responses from end consumers over the years. However, there are some sort of demarcation exists that differentiates the popular types of specialty clinics in India. Suresh Soni, CEO, Nova Medical Centers Pvt Ltd says, Eye Care, Dental Clinics, IVF, Cosmetics, Dialysis Centres, Day Surgery, and Primary Care (emerging specialty) are the popular types of specialty clinics in India. And the target groups are people from the lower middle class to the rich (except for cosmetics surgery which would be targeted at the upper middle class onward).

Factors responsible for the booming market of specialty clinics in India
The sudden rise of specialty clinics in India has been caused by certain supporting factors like increasing disposable income, desire for special treatment etc. Fresenius Medical Care, one of the global leaders in dialysis treatment, product and services industry, has recently launched their first dialysis clinic in India by the name of Shrinath Nephro- Care in the heart of Jalandhar, Punjab. Dhruv Chaturvedi, Managing Director, Fresenius Medical Care India says, India is very fast growing country when it comes to GDP knowledge sharing and , information flow. But one of the draw- backs that the country has is that India with 6.22 crore diabetic patients is fast becoming the diabetes capital of the world. So diabetes, hyper-tension, life- style diseases etc are affecting the renal diseases. In one of its reports, WHO said that the End Stage Renal Disease (ESRD) rate in India is 850 in 1 million people and the patient getting treated is just 60. So you can see there are huge demands of people to be dialysed and the facilities that are available are not sufficient. So there comes the role of a specialty clinic in India like Nephrocare. You can see the medical facilities are all mostly confined to the state capitals and metropolitan cities, so there is a huge gap in the tier I and tier II cities too. One of the reasons, Nephrocare has started its operation in Jalandhar.

Dr Kiran Lohia, MD – Dermatologist and Founder of Cosmedic Skin Solution, a registered brand of Future Skin Pvt Ltd says, The factors responsible  for the rise of specialty clinics in India include-increase in the income of the middle class, more awareness of taking care of ones health and of prent diseases such as diabetes, heart disease, cancer and more, affordable cost of healthcare in India, health insurance rise, resulting in people having more access to medical care and finally a large young population, who are more aware of the specialty options available to them due to their cognizance of the web, facebook, etcetera.

Increasing health awareness among the population, focus on specialty healthcare in non hospital ambience, diagnostics centric, better accessibility and faster services with less queuing, asset light models with multi specialty offerings have lead this development, says

Dr Vijay Singh,
Chief Administrator Officer, Heart Centers & Diagnostics, Narayana Hrudayalaya.

Dr DP Saraswat, CEO, Action Group of Hospitals says, Healthcare scenario in India is gradually shifting towards specialty clinics. Patients are now looking for centers of excellence, rather than going to the same doctor or OPD every time. Specialty clinics being centers of excellence assure to deliver high standards of clinical out- comes. Because specialty clinics focus on any one organ, system of the body or any one disease. These clinics are staffed with para-medical and nursing personnel of specialised skills which have been perfected over a period of time, besides adhering to predefined protocols through high-end equipments, better service quality add value so that patient gets more than other set ups.

Specialty clinics are expanding in size as well as reach in India. The major segments are the Eyecare, ENT, Dental Care, Joints Replacement, Trichology, Dialysis, Diabetes Clinics, Weight Management and Endocrine disorder(s) clinics etc. Apart from these wellness clinics, rehabilitation clinics of various kinds are going to be seen in near future.

Dr  Manoj Rai Mehta,
Medical Director and Mentor, Aster Eye Care says,

Specialty clinics are coming out of the general hospitals as a universal trend. Across the world, niche specialties are being catered to by specialty clinics. The reasons for this are: 1. Need for specific infrastructure and special support services in the ORs and outpatient offices. 2. Patients/customers do not like to mix up with general patients who have diverse problems. 3. Patients/ customers demand specialty care for which they are willing to pay for the services rendered.

Dr N Ramakrishnan, Director, Nithra Institute of Sleep Sciences & President, Indian Sleep Disorders Association says, Healthcare consumers in India pay out of pocket unlike in the West where third party payment is predominant. This allows them to exercise their choice of healthcare providers. In an attempt to get the best possible care they are increasingly move away from generalists to specialists which seems to be driving the booming market of specialty clinics.

Market size
Though the market is fragmented, the popularity of specialty clinic has come in a big way lately. Dr Lohia says, Indian healthcare market was USD 22.8 billion in 2005. Share of specialty care in this segment is approximately 15-20 percent. Dr Singh says, Currently in nascent stages with a small share of the healthcare market with less than 10 percent market size, with few groups focusing on specialty clinic models like Fortis, Vasan, Nova, Kaya, Apollo, Narayana Dental, and few more.
Dr Mehta says, Specialty clinics are expanding in size as well as reach in India. The major segments are the Eye- care, ENT, Dental Care, Joints Replacement, Trichology, Dialysis, Diabetes Clinics, Weight Management and Endocrine disorder(s) clinics etc. Apart from these wellness clinics, rehabilitation clinics of various kinds are going to be seen in near future. It is difficult to quantify the business as of now because the trend has just begun and industry has captured only a small portion of the potential business.

Role of technology
Here, technology is a vital element that makes the functioning of these specialty clinics possible. However, technologies used in various categories of standalone specialty clinics are different and therefore the clinics founders require sound understanding of these technologies. Dr Lohia says, Technologies used in dermatology clinics include cosmetic lasers such as Q-switched Nd:Yag lasers, Fractional lasers, Diode lasers for hair removal. They also include technologies such as dermabrasion, microdermabrasion, chemical peels etcetera.
Suresh Soni says, Technologies we use range from advanced techniques like laparoscopy, use of fibre optics and imaging in devices like Embryscope (only offered at Nova IVI), In Vitro Fertilisation (IVF) involves uniting the ovum (egg) with the spermatosoid inside glass “ in vitro “ in order to achieve a number of embryos to transfer to the mothers uterus, Cryopreservation and vitrification of eggs and embryos.
Dr Santanu Chattopadhyay, Founder & CEO, NationWide Primary Healthcare Services Pvt Ltd says, Technology is a value addition in 21st Century. In Nationwide, all the medical records are kept in electronic records format, anytime you call up Nationwide and if you have customer ID number, the doctor can easily see all the medical records and then start treating you. Today if you write a piece of paper nobodys knows, why did you do that; but If you feed that on electronic records every- body will come to know about this. So I think technology will be a great aspect.

Challenges for the specialty clinic founders
As every coin has two sides, running of a single specialty clinic has its own challenges too. Soni says, Challenges include paucity of professional talent, attrition with staff, very expensive real estate, regulatory framework etc. To over- come these challenges we need good planning, hiring good talented staffs with profit sharing schemes.
Dr Singh says, Though they are asset light models, operationally re- quire the same attention and initiatives for better outreach, care, having specialists round the clock or for the whole day becomes difficult at times, transit times need to be managed well, hospitality at its best, hospital equivalent care and outcomes expected which have to be met.

Future of specialty clinics
The future of specialty clinic in India is certainly looks good. As more and more players coming into the space, there will be more competition in the coming years. Soni says, The future is very bright. Single specialty clinics are focused on providing a comprehensive range of services for a particular medical specialty. As they require lesser investment than multi-specialty hospitals, they are easier to put together. They will lead growth in healthcare services segment in India. At the end it can be said, no one can deny the fact that, standalone specialty clinics are here to stay if the sector continues to show the present developments.





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