Intro: This time on Socio Economic Voices, we have Dr Sanjay Arora, Group Medical Director, Dr. Lal Path Labs & Founder, Suburban Diagnostics giving us a deep insight into what he calls ‘unburdening the healthcare.’ And for this he calls to bridge the gap between demand and supply in healthcare in India, as well as tech collaborations at the global level. Speaking to senior journalist Mahima Sharma, he asserts some necessary changes in the health care systems as well as in the mindset of the masses, to bring about a wholesome health economics beneficial for the deprived. He also calls for the necessity of creating awareness about pledging our organs after death and for more people to speak about organ donation so that more and more lives can be saved. To know more about his views, take a read

MS: What kind of futuristic health law, measures and policies need to be adopted by India to ensure the reach of life-saving health facilities even to the poorest of the poor?

SA: There is a need to bridge the gap between demand and supply in healthcare in India. We need to reduce the demand and increase the supply. Presently, we are an illness focused country (and not wellness), since almost 90% of healthcare expenses in India are out-of-pocket. Reducing the health burden of acute conditions, like infections, is one way to move towards wellness. Improvement in hygiene, sanitation, safe drinking water and nutrition and policies that support such initiatives are necessary. Similarly, democratisation and increasing the access for medical education will drive improvement in the supply side.

As we try to bridge the gap between demand and supply in healthcare, my focus will be on reducing the demand. This can be achieved by understanding the burden of demand and quantifying them.

Using all resources, we should reduce this burden by interventions that can be treated in the OPD (Outpatient Department) so that we reduce the load on the IPAD (Inpatient Department). Diagnosing diseases at an early stage will allow treatment and cure to be managed easily and ensure the proactive management of chronic diseases. We need to incentivise positive lifestyle choices, which has been triggered since the pandemic. We need to use data more meaningfully to give personalised health outcomes. This concept is what I call unburden healthcare.

MS: To bridge the urban and rural divide in health care in India, what kinds of futuristics health care steps, including the tech innovations involved, need to be taken in India?

SA: While 2/3rd of the demand for healthcare is rural, the supply is 2/3rd urban. The medical supply side should feel motivated to move outside the urban ecosystem. Ensuring basic living standards are maintained and improving the quality of living in the rural setting will definitely help. As affordability improves in the country across all strata of society, so will the spending capability in the rural setting. While this continues to happen, improving the access to healthcare via technology has already begun, accelerated by Covid19 pandemic. As this momentum continues, it will provide a huge relief for access to quality healthcare.

MS: What kind of global healthcare collaborations must India eye, so that it can not only become a better health economy, but also ensure that the best of the facilities reach the poorest of poor /the masses?

SA: Using technology at scale is the biggest input we can seek from any global collaboration. Technology at scale will allow dissemination without incremental cost of delivery. Health tech can ride on the shoulder of how telecommunication has penetrated every corner of the country. Additionally, ensuring new developments in healthcare have a real time global reach is another area of focus. Areas where we can learn a lot is in building healthcare education and R&D facilities.

MS: You have been quite vocal about the deficiency related issues that the masses face, not just due to nutrition but also due to lack of awareness. What kind of awareness strategies, media laws and policies need to be adopted by India towards a proper health care by the masses?

SA: Everyone must get the opportunity of making an informed decision about their healthcare service delivery choices. Today that choice relies on word of mouth. However, making an objective decision is essential. For this, bringing in minimal standards as an entry level criteria, ensuring a level playing field for all stakeholders and making these standards visible for anyone wanting to seek a healthcare service delivery. This will not only democratise healthcare but also standardise the healthcare delivery channels, benefiting everyone.

The measures of success in healthcare must look beyond the economic indices to anchor medical indices. A regular review of medical (outcome) indices is critical in driving the country towards better health outcomes. Medical indices include impacting maternal mortality rate, infant mortality rate, prevalence of antibiotic drug resistance, incidence of anaemia and genetic disorders in pregnancy, elimination of cervical cancer by heightened screening, etc. All healthcare organisations must set goals to impact and improve medical outcomes in their settings - e.g., a hospital could bring down the rate of hospital acquired infections.

MS: The 'Red Cause Initiative' of yours is using Digital Technology to build the gap between the blood donor and the donors. Please throw light upon the same. And also what kind of ease of policies is needed for the same speedy implementation towards "organ donations" where so much more needs to be done?

SA: India faces a huge shortage of blood. Voluntary donors are the only source for blood. All diagnostic labs are benefitted by a huge data of people who have done a blood group test. The Red Cause attempts to use these levers in bridging the gap in shortage of blood. This platform encourages voluntary blood donation and creates awareness about who is eligible to donate blood. In time of need, the family seeking blood for their patient shares the request on the Red Cause. All individuals who have agreed to donate are geo-tagged and a message is sent to them about the need for their respective blood type. All those who agree to donate are then connected via the platform to the recipient. Hence this platform aims to bridge the gap between demand and supply, using data that already exists and helping a needy recipient.

Moving on to what you have asked me next, while India features in the top three countries world-wide in organ transplantation, ironically, organ donation does not feature very high on this list. According to WHO, only about 0.01% of people in India donate their organs after death. Lack of awareness, religious or superstitious beliefs and strict laws could be some of the reasons for these low numbers.

In 2019 the Govt of India implemented the National Organ Transplant programme. The main objective was to curb organ trading and promote deceased organ donation. In India, living donors are permitted to donate a kidney, part of their liver and a portion of their pancreas while deceased donors may donate life saving organs like kidneys, liver, heart, lungs, pancreas and intestine. After a natural cardiac death, the cornea, bone, skin and blood vessels can be donated. Currently, more than 95% of organ donations in India are LIVE donors. Herein lies a huge opportunity, by creating awareness about pledging our organs after our death which can benefit others. We need more people to speak about organ donation as well as pledging their own organs to lead the way.

MS: The need for palliative care has been on the rise, and cancer patient care is just one of the zones. Plus the mental health of the caregiver also needs a strong support system. What kind of future policies can improve this zone to come out of a dark area to a hopeful and mentally strong one?

SA: Palliative care must become a part of the curriculum of all medical professionals. As we increase life expectancy, so will the issues related to ageing. Palliative care is a multidisciplinary approach that needs awareness about the physical, mental, emotional and social aspects of terminally ill patients. As awareness is created, there is a gradual movement towards palliative care in the medical fraternity. But the gap is huge. Hence, making palliative care as a part of medical education will create a larger community of palliative care specialists. In parallel, community education and awareness programs will educate the society that such services exist not only for those suffering but also for the family members and caregivers.

MS: Mental health is the most neglected part of self-care in healthcare. What kind of awareness measures, anti-taboo thinking-generation strategies and medical facilities are needed so that this issue is addressed as a major issue?

SA: Mental illness is an illness like any other. For instance, due to the impact of the lockdown and work from home, there is an erosion of the social fabric of interpersonal relationships. People are feeling isolated and withdrawn. Those who are close to them must be alert to notice a change in behaviour and get the necessary professional support. As more people speak about it, the taboo associated with mental illnesses will reduce.

Millennials and Gen Z are more likely to talk about mental health issues as compared to the older generation due to the increased awareness and acceptance of this illness. Almost 20-25% of the population is suspected to be suffering from some form of mental illness and it is the younger generation that may have to lead. When we notice a change in normal behaviour or patterns, this must be an alert. Having an open conversation with the one who is afflicted could be the first step. Showing empathy is another aspect of making the other person feel accepted. Taking help from a mental health expert is the next step.

MS: Gender bias in healthcare and improper address to women's health has always been a concern for the medical fraternity. In your experience and expertise how can this problem be addressed in a better and futuristic way?

SA: In my view, this is changing. Women are professionally rubbing shoulders with men as well as becoming integral in decision making at home. Many national health targets aim at improving health outcomes related to mother and child. Creating awareness regarding the changes a woman’s body faces (more significantly compared to men) is bringing more focus on different stages of a woman’s life – pre-pubertal, puberty and adolescence, child bearing age, and menopause. Advocacy and public awareness initiatives as well as inclusiveness at the workplace by all institutions are avenues to make this happen.

MS: Digital Detox and Mental Health amid the remote work from home scenarios, where work hours have only extended over the time. What's your take on this and how can this detox be successfully achieved for a better well being?

SA: When the lockdown was announced, work from home found favour, celebrating the absence of travel. While this worked well initially, I believe, we have become always connected and always available. The barriers between work and home are no longer there. In my opinion, travel from home to work and work to home was the time of transition, from one zone to the other and a time for just oneself. Today, we have lost this time for self and the opportunity of transition. We must bring back time for self, where there is no home and no work, just time to focus on oneself.

Setting up white spaces in our calendar rather than scheduling meetings back to back will allow time to introspect, move from behind the laptop and stretch the body. Giving a break every 20 minutes for 20 seconds by looking away from the screen at something which is a distance of 20 feet is a simple technique to take a break. Such initiative gives the body and mind a break from the constant strain of screens.

When we get home from work, we remove our shoes and hang the car keys; these simple acts must remind us that our work part of the day has ended and we must now transition to the home part of our time, rather than overlapping the two.

MS: Last but not the least, a question for our student readers as well. There is an impression among students generally that being a doctor is the only way one can have a good career in the medical field. To break this myth, can you throw light upon other wings of the healthcare systems where emerging technologies can pave the way for the NEET aspirants, in case they wish to broaden their scope and things beyond MBBS?

SA: For every doctor, there is a need for 9 paramedical staff. Any hospital which has 100 doctors will have 900 paramedical staff to ensure smooth delivery. The opportunity lies in making paramedical education and paramedical careers aspirational. Healthcare technology and biomedical engineering are now an integral part of healthcare. Future looking technologies like genomics, molecular biology and biotechnology are making pivotal contributions in healthcare. Drug and vaccine discovery and epidemiology showed their importance over the past 2 years. Healthcare management is another area that will be critical in streamlining the delivery strategies. Data science (Data mining and data analytics) will be instrumental in helping make informed decisions and making healthcare personalised.

About Dr. Sanjay Arora

Dr. Sanjay Arora is the Founder of Suburban Diagnostics, a leading diagnostic center and pathology lab offering its services across Western India. A TEDx Speaker, Dr. Arora has spoken at various conferences and events, sharing his entrepreneurial journey, experiences and learnings.

Dr. Arora is known to be a thought leader in the Diagnostics and Healthcare industry. His visionary approach towards women’s health has helped bring a change and improve the health outcomes and health indices in the country.

He has been honoured with the ‘100 Most Impactful Healthcare Leaders’ Award by the World Health & Wellness Congress in 2018, the VCCircle Healthcare Investment & Awards in 2015 and the Frost & Sullivan 7th Annual India Healthcare Excellence Awards in 2015. Recently, he has been awarded as an “Influential Leader of New India 2021” by Teammarksmen in association with CNN-News18.

Dr. Arora has graduated from Grant Medical College and JJ Hospital, with a special interest in Cytopathology. He has trained at the esteemed Tata Hospital, Johns Hopkins Hospital and Henry Ford Hospital, USA. His visionary approach towards women’s health has helped bring a change and improve the health outcomes and health indices in the country.

About the Interviewer

Mahima Sharma is a Senior Journalist based in Delhi NCR. She has been in the field of TV, Print & Online Journalism since 2005 and previously an additional three years in the allied media. In her span of work she has been associated with CNN-News18, ANI - Asian News International (A collaboration with Reuters), Voice of India, Hindustan Times and various other top media brands of their times. In recent times, she has diversified her work as a Digital Media Marketing Consultant & Content Strategist as well. Since March 2022, she is also an Entrepreneurship Education Mentor at Women Will - An Entrepreneurship Program by Google in Collaboration with SHEROES. Mahima can be reached at media@indiastat.com

Disclaimer : The opinions expressed within this interview are the personal opinions of the interviewee. The facts and opinions appearing in the answers do not reflect the views of Indiastat or the interviewer. Indiastat does not hold any responsibility or liability for the same.