Doctors’ Day celebrated on July 1st is a tribute to Dr B C Roy and the medical profession. Dr Roy, a multi faceted persona was also an educationist, social reformer, freedom fighter, leader of Indian National Congress and later chief minister of West Bengal. Dr B C Roy passed away on July 1, 1962 which incidentally was his birthday too. On this special day DISCOVER BANGALORE salutes the significant role doctor's play in our lives. Being a doctor is not just a 'job'; it is a challenging commitment to service and society that places implicit faith in the doctors’ skill. Doctor's Day is the perfect time for patients to acknowledge and appreciate their doctor's ability to comfort and heal.

It’s Boom time in the once Pensioner’s Paradise. Namma Bengaluru’s economic power is just one aspect of this buoyancy. The plurality of culture and cosmopolitan nature of Bangalore has attracted expats, 50% of them staying in Bangalore. There has been a robust growth on the real estate front,(galvanizing the tax men ) hospitality sector, with the domino effect felt in the proliferation of pubs, eat outs, malls, flyovers with Medical Tourism making a late entry. With the ingress of hi tech multi specialty hospitals can our specialist doctors working abroad lag behind? With comparable salaries, opportunities for growth, good infrastructure they are homing in droves attracted by the magnet of a mother land in search of their roots and connectivity with loved ones. This newly acquired feeling of belonging is in tandem with the security that India offers today. Huttidere kannadanadu nelli hutta beku, mettidare ……. seems to be their theme song.

But has the medical profession today, the tenor of business rather than service? Are market forces dictating health care? Do ethics show the path and guide the doctor? Discover Bangalore presents a specialist whose “Duty of Care” echoes in his practice at Apollo Hospital, Banerghatta.

Dr.Kumaresh Krishnamoorthy is the Senior ENT Consultant with an M.S (ENT) from Madurai Medical College. He is the first Indian to obtain two prestigious fellowships- Head and Neck Surgery (Roswell Park Cancer Institute, Buffalo, USA) and Neurotology & Skull Base Surgery (Cincinnati, USA) in collaboration with Mayfield clinic, world pioneers in Neurosurgery. He is widely recognized for his clinical and interpersonal skills and his campaign for educating the patients. He is a regular contributor to some of the leading national newspapers, journals and websites.

Dr. Kumaresh is a doctor with a social consciousness and wants patients to have information about their condition and come prepared to the physician. Towards this end he sends patient information literatures pertaining to their problems to all his patients. He also regularly contributes medical articles in leading newspapers and is in the panel of experts with NDTV, Deccan Herald, NRIPulse.com, Garam Chai.com, NRI Pulse.com and NRIOL.net (popular websites for NRI's). He is also a reviewer (only people with credentials and who are considered experts in the article's field of study will be invited as reviewers) for some of the worlds well known journals like Laryngoscope, Otolaryngology and Head and Neck surgery and Lancet among others.

Our special correspondent Githa U Badikillaya interacts.

What prompted you to shift base when you were doing well in the States?

Family values and ethics. With 2 growing kids this is the right time to come back to India. Secondly the openings here are comparable to the West. India, positioned as a health care destination, is attracting foreigners. The infrastructure, facilities and remunerations are world class. For the foreigners the cost factor works to one tenth their medical bills where the health insurance is exorbitant. For instance, tonsillectomy that costs Rs 10,000 here is 6,000$ in the US. With insurance hiking the operation costs, 40% of Americans are denying health insurance when I left the US. The hospital picked my health insurance tab of 1,500$ per month. But what about the others? India is therefore very lucrative, upping the SE Asian countries.

How does the healthcare facilities in India compare with that of the West?

India is peculiar in many ways. High rise buildings are juxtaposed to slums and corporate health care with top of the line facilities to government hospitals. Unfortunately, for the Indian common man health care is not within reach. Though the gap is bridging there is still a long way to traverse. We do not have any monitoring committees; otherwise the episode of a teenager in Trichy operating a C-section would not have occurred. It’s not that the Westerners are morally born. Their laws are stringent. Insurance companies refuse to pay for unnecessary surgeries. It will duplicate here too when the system is streamlined. Why are the Americans coming here for treatment? Because we are good in all parameters. As of now it’s a miniscule, 4-5 % Americans but their inflow will increase in the years ahead if the insurance companies work out the medico legal angle. Open heart surgery costs a staggering 60,000$ whereas here it’s 6,000$ inclusive of air travel, and a tourist spot for recuperation.

Are we geared up to meet this influx?

Yes. With the number of corporate hospitals and a few more planning their entry, it’s easy to get the operation dates as the overseas patient go through a travel agent. At Apollo we are yet to venture into medical tourism. Recently I coordinated for the hospital’s foothold in the upcoming international airport for pharmacy and health care facilities.

Why did you choose Apollo hospital?

I returned from the US six months ago. I had the skill and Apollo just opened and so it was mutually beneficial to both.

What is the scope of your expertise at Apollo Hospital?

It’s your individuality and expertise that will bring patients. I asses the risk and complications by sending info about the surgery before I use the scalpel. The individual doctor also has to market himself as the marketing team’s priority will be the hospital. Recently i handled an advanced cancer case and an advanced disease of the inner ear which was eroding the bone supporting the brain and over the inner ear. Both the patients are doing fine and got me good reviews amongst peers.

Have you thought of rendering your service say once a week in a government hospital, or rural service?

You will be surprised to know the number of places i have tried. There has to be follow up care, who will do it? I can do free camps, but after diagnosing a patient of having cancer, what next? Where will the patient be sent? At Apollo hospital I can waive my fee thereby functioning in the limits permissible. (Period...) Can I walk into any hospital and ask them for treatment of the patient? The only place maybe-Satya Sai Hospital. But what about the distance? Any complication how do I reach from this end of Bangalore? (Questions and more questions)

Why have you not opted for private practice?

Infrastructure and equipment impediments The OPD equipment itself will cost Rs 20 lakhs. If I take a loan, my interest will be more in servicing the EMI. Will I be able to do ethical practice when there is a financial burden? Secondly the well known practitioners are those who have earned a name. It has taken Apollo 27 years to get walk in patients. Alternately the doctors must necessarily have a backing. A middle class doctor even if he is a foreign returned super specialist will find the going tough.

What is special about anterior skull base surgeries?

There are hardly 6 doctors in India performing Nuerotology and skull based surgeries but without any training. Probably I am the only fellow to have this one year intensive US fellowship training. Having gone on a 3 month observatory fellowship my skill was recognized by the present Chairman at Stanford and President of the American Nuerotology Society who recommended that I undergo the fellowship. I was fortunate to work with one of the world leaders.

Nuerotology is a clinical subspecialty concerned with the diagnosis, medical and surgical treatment of hearing and balance disorders (dizziness), ringing noise in the ears, the facial nerve, the ear and temporal bone, lateral skull base (housing the inner ear structures) and the brainstem among others. Skull base surgery was earlier handled by neuro surgeons but now the ENT specialists are doing.

In nose cancer patients, or those with tumours, both these doctors operate. One operates on the nose and the other at the anterior skull base area where the brain is sitting. I do not operate in areas where there are trained colleagues. At Apollo I am just doing general ENT as the oncology facility is yet to be operational. In the coming one year I’ll have the satisfaction of putting my skill to good use. I do cochlear implantation only when the patient is able to perceive the sound as the operation costs runs to lakhs of rupees. The patient also needs lots of perseverance as it involves assessing, investigating, implanting and finally training the patient to hear through the implant.

For further details Visit: http://www.drkumaresh.com/
Pen your thoughts at Dr. Kumaresh's blog at http://drkumaresh.blogspot.com

Your message to Discover Bangalore viewers is…

Health care is something that must not be taken for granted and not to expect instant cure. One has to go for regular check ups, be informed, cross check the doctor’s info, and stick to one doctor rather than window shop. Keep away from tobacco and Paan.

nih.com provides all medical information.

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