By Rajan Narayan
Don’t private corporate hospitals practice any kind of nobility any more when it comes to targeting young and old patients for surgical procedures, turning it into an opportunity to loot wealthy as well as not-so-wealthy patients?
ON Saturday, October 21, 2023 I had a narrow escape from being crucified at the Manipal Hospital close to my residence in Panaji. With worsening health problems I thought I would go to the Manipal Hospital to consult with orthopaedic doctor, Dr Deep Bhandari. In the early hours of the morning I had got up to go to the bathroom and tripped over my walker and fell flat on the floor, not seriously injured but in pain at right elbow and shoulder.
I have already been diagnosed with a “crushed spine” (also called cervical myelopathy) which has affected my neck, shoulders and left leg. Which is why I was using a walker even in the house. But the fall resulted in my right side showing signs of numbness and I was unable to use my hand to hold a cup. It was terrible situation for I could not eat and drink something by myself and had to be attended to in my morning ablutions.
I needed somebody to help me drink some coconut water and help me eat my omlet for breakfast. Suddenly, I found myself being restricted in pain to my bed and painfully shifted to my armchair in the living room at home. I spoke to Dr Deep Bhandari and he asked his junior resident doctor Dr Vikranth from Manipal hospital to visit me at home, Dr Vikranth checked me and said I should seek admission at the Manipal hospital to do a fresh MRI and CT scan.
So the Manipal ambulance came to my residence at Caranzalem near the Dona Paula Circle to pick me up (although it was such a close ride it cost me Rs780). I was shifted by stretcher to Casualty but I was treated as OPD patient so that I would not be charged the emergency Casualty charges which are higher.
It seemed to me that I was conned into doing an MRI at the Manipal hospital itself. I did not protest as I had been advised earlier in a message by Dr Lalita of the Chest Disease & TB hospital to do a repeat MRI almost after six months from being discharged from the GMC without any evidence of what is called Koch’s disease or spine tuberculosis infection.
Soon after I consulted the neurologist Dr Sanat Bhatkar who after a meticulous check-up with me ruled out any spine TB. I was very relieved to hear that but my condition continued to deteriorate. And so I thought of consulting with Dr Deep Bhandari at the Manipal hospital and Dr Vikranth was very convincing about the fact that I should do another MRI after consulting their Dr Parul Dubey.
LONG WAITLIST
ALTHOUGH we went early at 9am to the Manipal hospital Casualty there was a long waitlist and my turn for MRI came only past 3.30 pm and by which time I was very tired. All this time I was lying on a stretcher in a side room from 9.30am to 4pm when the helpers came to get me for the MRI. It lasted for almost two hours. It was required to inject a dye (costing Rs3,000) in me for some fine MRI scanning for contrast reading of the final diagnosis.
Afterwards Dr Vikranth in detail told me that the walker fall at home had affected my “crooked spine” and that I would have to consider undergoing a major surgery on my spine so that an iron rod may be inserted and fixed to perhaps relief my spine going crooked. The surgery would straighten my spine in a crucial junction. My spine was going more and more crooked and that is why the pain from the nerves too which are being affected.
He also said that they would like to collect some fluid from a formation at spine at C1/C2 to confirm if it was not Pott’s spine TB, a form of spinal TB. It would be like a biopsy when a needle would be inserted to collect the spinal fluid.
Since earlier Dr Sanat Bhatkar of the GMC whom I have a high regard for as a qualified neurologist had ruled out any TB in my spine I told Dr Vikranth No, I do not want any more testing done. I was very tired please admit me to the hospital to see if I could be taught to manage my pain. Then I was introduced to the well-known neurosurgeon who was present, Dr Omkar, who too after looking at my new MIR results tried to persuade me to consider surgery while I still was fairly in good condition to do it, it would improve my spinal posture or something like that. If I suffered another fall I may be in more serious trouble, I really have no option but to consider the surgery. Or I may not be able to stand on my feet at all and what if I become paralysed completely. I tell him that Dr Ajay Netalkar, a senior neurosurgeon, has ruled out surgery in my condition. His opinion has also been endorsed by neurosurgeon Dr Pondraj at the GMC. I am 76 going on 77 years and my chances of surviving any major surgery are surely less 10%.
When I refused surgery but sought another solution for me Dr Vikranth and Dr Omkar as option to do surgery the two doctors refused to admit me to the Manipal hospital. I thought it was like blackmail to admit me only if I agreed to the surgery which would also cost me over Rs10 to Rs20 lakh or more. I needed some time to think it over, I was not ready for surgery right away.
CORPORATE POLICY
I AM aware that Manipal hospital is a corporate hospital where doctors have to meet a target in turnover of patients they admit to the hospital. It is all about billing. I had already paid about Rs13,000 for the MRI testing. Radiance Diagnostics nearby charges much less for MRI testing. The whole day at the Casualty I was not given anything for my acute pain during something like a 14 hour wait and I went without something to drink or eat or visit the washroom which is a very painful process for me with my rectum prolapse.
I pleaded with the doctors to admit me at least for two days to give me time to consider the decision for surgery and give me injection for my acute pain. They were reluctant to do so until I agreed to a program of treatment. Since it was close to midnight now I just said please discharge me and I will go home, they said officially I was not admitted to their Casualty but was an OPD patient and I was free to go. They did reluctantly say I could be admitted for pain management but I was presented with a projected billing of over a lakh plus, plus for pain management treatment alone. Single room was about Rs6,800 and twin sharing was about Rs4,000 and there would be the add-on charges of visiting consultants to review my case as in all corporate hospitals.
I thought the charges were exorbitant and finally decided to say goodbye to Manipal hospital. There is this practice in billing for medicines and drugs at high rates in corporate hospitals. An enraged Dr Vikranth said even an aspirin and other medicines could be charged Rs30,000 for a few doses. That I would not be treated unless I considered their surgery package which they had worked hard on. Pott’s spinal TB would have to be ruled out first and some more pelvic x-rays and scans done.
TB BOOGEY
SINCE at GMC last year I had been started on treatment for tuberculosis without confirmed results I was very wary now. This unconfirmed diagnoses of spinal TB which GMC dean, Dr Shivanand Bandekar, a noted orthopaedic surgeon himself, noting in my discharge papers that Koch’s disease could be behind my crushed spine syndrome infection and pain. The fact remains that Xray and CT scans were done during my stay in private room at GMC, and even a lump beneath my arm was checked with fine needle aspiration and biopsy…but there was no clear evidence of TB — although I was started on TB regime medicine which I reacted to very badly. Even sputum test revealed no signs of TB. So why the treatment for TB in anticipation?
Since I was reacting very badly to the TB medicine I stopped taking it and they discharged me with remarks of some latent TB in my discharge paper. Only Dr Sanat Bhatkar told me, no TB, on consultation. I trust Dr Sanat because he is a highly qualified neurologist with postgraduate degrees from UK and US. He advised me physiotherapy, more protein intake and vitamin supplements for me. In general conservative treatment, not surgery. I am suffering from cervical myelopathy (“crushed spine”).
FINAL BLOW
THEN came the latest experience in Manipal hospital and I decided enough was enough. Mercifully, the Manipal ambulance dropped me back to my home at about midnight in an utterly exhausted state of mind. Manipal ambulance charges are steep even if you live right next door to the hospital. I am very fortunate to have found a nursing helper who attended to me and made me comfortable at home after the exhausting experience at Manipal hospital and I am grateful to him. The several stretcher transfers during the day in hospital had taken a toll of my already frail body. One is lifted on a bed sheet for transfer from one stretcher to another several times and every time one feels like one is slipping down.
I recall some time ago a patient at Manipal hospital was admitted or an appendix operation. After the operation it was discovered that the surgery was not so thorough and some portion of the infected appendix remained, there was a repeat operation and the presentation of a huge bill. The patient was denied his records of the first operation and went to court, the court verdict indicted Manipal hospital and told it to award damages.
Again the father of a former colleague of ours had gone to Manipal as a serious diabetic patient. Doctors told him he had gangrene and both legs would have to be amputated. The patient got himself discharged and went to the GMC where a reference to a very human and humane endocrinologist t Dr Ankush Dessai saw to it that nothing was amputated and the patient treated with medicines and a controlled diet to reduce diabetes damage. His daughter shared with me that her father’s legs are now stronger than ever before.
Manipal hospital was originally the Goa Cancer Society Hospital with all the land belonging to the Dempo family. The Cancer Society was Jay Vaidya and many senior citizens had contributed towards the building of the cancer hospital. Dr Shekar Salkar was the secretary of the cancer society. He got the land sold to the Manipal hospital group without consulting all the shareholders. This is how Manipal hospital acquired the land to build its corporate hospital to ill-treat and loot Goans.
Please do not go the Manipal hospital unless you have unlimited money in your bank account or reliable cashless insurance. You will either go bankrupt or be dead. Such hospitals don’t hand over a dead patient’s body until all bills are paid. In fact, I was warned by a doctor not to come to Manipal hospital since I was a poor media patient without a good cashless insurance policy and my DDSY card may or may not apply at private corporate hospital like Manipal hospital.