Need to Inform the Patients Transparently says Abhishek Bhartia, Director ofSitaram Bhartia Institute of Science andResearch, a nonprofit hospital, that hascarved a niche in womens health. Inconversation with Shahid Akhter of ENN, hefocuses on the changing scenario in birthing.
When was the Sitaram Bhartia Institute of Science andResearch founded and what it its legacy?
Sitaram Bhartia Institute of Science and Research (SBISR) wasfounded in 1979. It took off under the aegis of its first director, Dr NGopinath, a renowned cardiologist noted for his expertise in heartbypass surgery. The institute conducted one of the largest communitybased studies of coronary artery disease in India. It then took up a large study of blood pressure in Indian schoolchildren. Similar studies yielded valuable information onthe risk factors for cardiovascular disease in our country.SBISR was established with a spirit of serving societythrough research and the motivation was to establish excellence in healthcare delivery, research and education.With the passage of time, we have evolved into anorganization that combines medical research with excellencein patient care.
When did you shift to patient care and whatwas the outcome?
Our research continues to focuses on collecting health relatedinformation, translating evidence-based guidelinesin clinical practice, developing cost-effective interventions forimproving 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 waslaid by eminent physicians and surgeons from All India Institute of Medical Sciences. Professors J S Guleria (Padma Shree), the late M MS Ahuja, R Tandon, I K Dhawan, and V L Bhargava were among theearly faculty members to join. Today they serve as outstanding careproviders and role models for the next generation of doctors.
What clinical specialities andservices Sitaram Bhartia offer?
Our specialities are spread acrossfrom anaesthesiology to urology, withspecial focus on obstetrics and gynaecology.We offer radiology and diagnostics,laboratory tests, pharmacyand preventive health check-ups.
Sitaram Bhartia is noted forwomens health. Tell us more onthe services in this speciality?
We care and support women in everyphase of life, from adolescence tomenopause. True, Sitaram Bhartiais a leading centre for womenshealth. The patients admitted hererate Sitaram Bhartia high on desirableoutcomes and quality of care. Inobstetrics, our comprehensive birthingprogram spans a duration of ninemonths. It lays emphasis on educationand empowerment as key elementsfor a fulfilling journey to motherhood.An inter-disciplinary team consistingof obstetricians, womens health educators,physiotherapists, nutritionists,paediatricians and nursing staffdeliver the comprehensive program.When it comes to labour, delivery andpost-delivery care, Sitaram Bhartiaoffers a safe and satisfying birthingexperience. The patient is comfortablewith physical and emotional supportthat reduces the need for medicalintervention and improves infant outcomes.The mother is given lactationcounselling, and informed about post dischargecare after the delivery.
What are your views on thesurge in caesarean rates?
Cesarean section is a major surgeryand like all surgeries, it carries risk.Recently, the American College of Obstetriciansand Gynecologists issueda statement that pregnant women plan for vaginal birth unless there is amedical reason for a cesarean. Theypointed out that cesarean delivery canincrease the risk for infections, bladderand bowel injuries, and seriouscomplications in future pregnancies.They noted that babies born vaginallyhave fewer respiratory problems.Thus as a society we should be concernedabout high cesarean rates thatare not medically justifiable.
“We are not onlydisclosing thecesarean rates inour unit, but arealso providingguidance onhow to interpretthose rates.”
How does one decide or choosethe doctor and the hospital ?
Many of us do extensive research beforebuying a mobile phone or a car,booking a hotel for a holiday or evenselecting a new restaurant. But when itcomes to choosing a doctor, many of usdo little more than get a word-of-mouthreference. Unfortunately, what oftendrives patient satisfaction and thus recommendationof a practitioner to othersis bedside manners and may notalways reflect evidence-based medicalpractice. Doctors are picked on reputation,and yet some of the most populardoctors have undesirable outcomessuch as high cesarean rates!
Is it important for maternityproviders to discloseCesarean rates?
Most hospitals dont collect data onclinical outcomes they may nothave electronic health records orlack the manpower to manually collectthe data. Doctors and hospitaladministrators may also be hesitantto disclose quality-related data becauseof concerns about misuse bycompetitors or patients. Yet theseconcerns should not hold back effortsat promoting transparencyif we want healthcare to becomebetter and safer. The National PatientSafety Foundation of USA hasidentified transparency is the mostimportant single attribute of a cultureof safety.We at Sitaram Bhartia Instituteare taking a step towards becomingmore transparent and accountable toour patients by disclosing cesareanrates of our staff Obstetrics and Gynecology(O&G) unit. We are not onlydisclosing the rates in our unit, butare also providing guidance on how tointerpret those rates.
What are the cesarean rates atSitaram Bhartia?
Our staff O&G unit delivered 561 babiesin 2013 with a cesarean rate of40 percent. This rate is much abovethe 10-15 percent rate recommendedby the World Health Organization andthe average rate in countries like Sweden(17 percent), UK (26 percent) orUSA (33 percent). However, our 2013rate is an improvement over the 52 percent rate in our own unit in 2011and the 65 percent rate reported by aleading health insurance company inIndia for their claims.