Hospitality @ Hospi IITB

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Chief Editors: Shreerang Javadekar, Shreeyesh Menon
Mail to: insight@iitb.ac.in

It is a universally acknowledged truth that a residential campus in possession of a large populace must be in want of a good hospital.
However, little is known about the functioning of IIT-Bombay’s in-campus hospital also referred to as ‘the hospi’, and an air of mistrust and resignation surrounds students when they talk about experiences with the hospital. It’s hard to escape the feeling that students think that the hospi is ineffective in dealing with issues it has been set up to face.
Here, we hope to inform students of the hospi’s capabilities and limitations in turn (after a tete-a-tete with Chief Medical Officer Dr. Nisha Shah), and do so by looking at:
→Some general trivia.
→Is the hospital equipped to deal with mental health issues?
→The curious case of reimbursements.
→Problems plaguing the hospital.
→The issue of pink slips.
→An appeal from the CMO.

General Trivia

What is the primary function of the IIT-B hospital?
The hospi serves as a primary referral centre and is equipped to perform basic diagnosis and treat common ailments. For complex cases, specialist doctors visit the hospital, or the doctor refers the patient to other hospitals. The cases which are referred outside are usually of those students who had been initially admitted to the hospi, and the institute itself takes care of all the expenses.

What are the hospital timings?
The Out Patient Department (OPD) remains open from 8 am to 6 pm on all working days (Monday to Friday). It also stays open from 10:30 am to 12 noon on Saturday and Sunday to treat patients.
Emergency services are available 24 x 7. If there’s an emergency, you can walk in at any time of the day and get first-aid treatment or a referral.

What procedures or rules exist to ensure a high quality standard amongst doctors working at the hospi?
Similar to applications for staff and official positions at the institute level, an advertisement is released in the newspapers broadcasting the availability of positions. A written test followed by interviews conducted by a director-appointed board ensue, following which the final selections are made. Most doctors either have an MD or an MBBS with some having additional qualifications.

I want to get vaccinated for a certain disease. When can I visit the hospital?
Vaccines are available every Monday between 3 pm to 5 pm. You need to pre-register for the vaccine on any day from Monday to Thursday before 5 pm in the hospital.

Can I get a surgery done at the IIT-B Hospital?
Elective surgeries are discouraged as far as possible. However, if one is planned at the Hospital, the consent and presence of a parent or local guardian is essential for surgery.

Where can I lodge a complaint if I am not satisfied with the treatment provided?
The first person to contact in such cases is the Chief Medical Officer (CMO) of the IIT-B Hospital – Dr. Nisha Shah. The best way to do so would be to send her an e-mail on nishas@ iitb.ac.in. If you’re not satisfied with the actions, you can also send a mail to the HHAC (Hospital and Health Advisory Committee) Chairperson on hhac@iitb.ac.in, or contact the ISHA in charge of the HHAC.

What are the best places to obtain the medicines on my prescription?
The Hospital pharmacy contains the common medicines prescribed by the hospital, while the chemist shop at Y-point gate has other medicines, which are mostly prescribed by specialists. Trying to reassure students who are worried about the quality of the medicines on offer, the CMO insists that hospi uses the best quality medicines possible, and that the hospital staff avail the same medicines when they fall ill.

What’s with the cough syrup they prescribe for almost every disease I have?
The cough syrup merely provides a soothing effect to the throat. It has little therapeutic value, except perhaps in curing mild allergies.

On Mental Health

The issue of mental health and various mechanisms available in the institute to cope with stress and related problems has come to surface on a number of occasions. While the IIT-B hospital does have a clinical psychologist who visits the hospital bi-weekly, she mostly attends to the cases that require medical attention and not the ones related to psychological ailments such as depression, which is an issue we, at Insight, believe needs concerted, specific and effective countermeasures to be taken up by the Institute.
Mental health on campus is an issue that isn’t just going to go away.
The institute does, however, have an active Counselling Centre in place comprising of one Counselling Coordinator and two fulltime counsellors. Students can reach out to the counsellors via email or telephone, or can contact the counselling coordinator through the Facebook page ‘iCare IIT-B’ – an attempt by the institute to reach out to its students and address their stress, anger and related
issues in a friendly, unconventional and nonintimidating way, via social media.

The Curious Case of Reimbursements:

According to the Hospital Guidebook, all bonafide students of the institute are entitled to free medical attendance and treatment available in the institute hospital. The operative word here, of course, is ‘free’.

Cases that can be reimbursed:
The expenditures associated with indoor treatment, under the advice of the Appropriate Medical Authority (AMA) in a recognized hospital in the General Ward Category, will be reimbursed by the institute, with the reimbursement limit being Rs. 1 lac.

Cases that can’t be reimbursed:
Treatment of chronic cases or prolonged illness requiring special medical treatment for a long period will be responsibility of the parents or guardians of the patient. Any treatment taken outside of the headquarters during vacation will be the responsibility of the student.

Cost of Medicines not available at IIT-B Hospital:
Cost of medicines purchased from the market as well as pathological or radiological charges incurred in recognized hospitals, only on the advice of the AMA, is reimbursable.

Accidental Injuries:
Students have insurance for accidental injuries. They may be referred to any hospital for treatment. The reimbursement in this case is routed through Dean of Student Affairs Office.

Special Cases:
Dental treatment, cosmetic corrections and treatment of infertility are not reimbursable. No maternity reimbursement is available to students.

Medical Advances:
Medical advances can be availed from the Institute for treatment outside, only on recommendation by the IIT-B Hospital. The Medical Advance limit for students is fixed at Rs 50,000

Problems plaguing the Hospital

We looked at some of the grievances that usually trouble students while visiting the hospital.

Specialist appointment schedule
Students have expressed concerns over the fact that most of the specialist appointments are scheduled during the regular class hours, which entirely defeats their purpose. Ojas Gupta, Institute Secretary for Hostel Affairs, stated that it is very difficult for the specialists to find alternate timings for their duty in the IIT-B Hospital since they have their own practice to attend to.

Lack of equipment
The hospital’s lack of certain basic facilities and equipment has been brought to light on a number of occasions. It is understandable that the hospital authorities don’t feel that buying expensive equipment like MRI machines, which require manpower as well as maintenance charges to operate is worthwhile; but, when it come to the basic needs like the plasters for fracture, the absence (even occasionally) of the same certainly puts a question mark on the service that the hospital is providing.

Incorrect diagnosis and treatment Though no official complaint has been registered against the hospital as yet, unconfirmed cases of incorrect diagnosis and ineffective medicines keep circulating. Cases of someone who was put under observation for 3 days on suspicion of malaria that he did not have, someone who was prescribed medicines that did not lessen the symptoms of the disease, or someone who got fed up of the treatment offered by the hospital and had to resort to outside medical care do regularly come to light among the student populace.
The CMO is of the opinion that diagnosis is never 100 percent accurate. However, she emphatically states that the Hospital has always ensured the best quality of care from its side.

Pink Slips

The pink slip issued by the hospital is provided to anyone who wants proof that they visited the OPD. It usually provides a mechanism for students who are too ill on the day of an exam or a lab to opt for a re-test. But loopholes in the process have ensured that a pink slip is utilised for some ethically questionable actions, to put it mildly.
The pink slip is now being used as a method to opt out of giving exams students are not prepared for. A student simply recites symptoms of a disease to a doctor, who is then coaxed into advising rest for a couple of days and issuing a pink slip to that effect. The pink slip is then presented to the professor, invoking the right to a retest. The process is helped by the fact that most professors do take pink slips as an unimpeachable proof of illness and conduct a retest willingly.
Pink slips are being freely exploited-from students who did not prepare for a quiz to those who could not wake up at the required time to those who did not know the correct time-the cesspool of delinquency is getting murkier. The CMO has, in the past, suggested to previous Deans of Student Affairs (DoSA) to allow re-examination on the basis of pink slips only to admitted patients and not to those who haven’t been advised bed rest by the doctor, but the administration didn’t agree. The doctors at the hospital are aware of this problem too, but can’t refuse treatment to the students on ethical grounds.
The current DoSA feels that professors should be more proactive and clearly examine the pink slip – this would tell if the student really was ill or faking it, in his opinion. He admits that this would happen on a prof to prof basis and that there is no institute wide overhaul of the process in the pipeline.
He also points at a larger problem: the lack of a honour code among the students. The DoSA is of the opinion that cheating is second nature to a large section of the student body and ethics are generally thrown out of the window. What he wants from the student community is suggestions on how to tackle this problem.
One way around this problem as suggested by a doctor is the creation of a detaining center in the Hospital. In case a student is so sick that he/she can’t go to the exam, they can go to the detaining center, where they will be properly taken care of.

The CMO’s appeal

The CMO, who has been with the Hospital for more than a decade now, has a few suggestions for the students to improve their health.
As students, we need to take the issue of vaccination seriously – half of the hospital admissions are for the diseases that can be prevented merely through the use of vaccination. The IIT-B Hospital administration tries its best to make even the rather expensive vaccines available to the students, as a result of which, incidences of German Measles, Hepatitis A, and even chickenpox have been significantly reduced now. However, voluntary action by the student is a prerequisite in ensuring vaccination.
The CMO also wants the students to understand that alcohol, drug, and cigarette abuse is detrimental for their future. She feels that the students should help each other, instead of promoting this culture, which has become prevalent in the campus.

Y-point gate private clinic

A policy point in the present GSHA’s manifesto was the establishment of a private clinic near the Y point gate at subsidised rates.The project is in the pipeline and the demand for space has already been put up. The GSHA states that the current hold-up is the space crunch in the institute; many other institute bodies have also placed their request for the exact same space.
Even if the space is allotted, necessary permissions will have to be taken from different departments and authorities such as the Dean IPS office and the Estate Department to name a few. The project does not look like it will see the light of day in this tenure.

A day in the life of

Isha, Nurse
Isha is a nurse working in the Hospital. She got the job on the basis of a written test and interview. She typically works for 8 hours each day taking care of the long queue of patients at the hospital. She, along with her fellow nurses have to put in extra efforts nowadays to compensate for the shortage of staff which is supposed to cater to 10000 campus residents. Occasionally some equipment like plasters are unavailable. She has to make do with what she has or procure it using her ingenuity. Even though she is a permanent employee of the institute, she doesn’t get any meals at the hospital. However, she has been allotted a house inside the campus. She and her family are insured and can avail free treatment at the hospital.

Dr. Omi
Meanwhile, Omi is a doctor working at the Hospital. He works 36 hours a week, which according to him is less than what the working hours of a doctor in a primary referral center should be. He has to work at least one night shift per week. He believes the hospital lacks in some areas such as digitisation of records and digital x-rays Interestingly, he has no say in the medicines prescribed. The CMO and the hospital committee decides which medicines to use. The hospital pharmacy contains common medicines, while the chemist shop at Y-point gate has other medicines, which are mostly prescribed by specialists.

Kavita, Receptionist
Kavita is a receptionist at the Hospital. She works eight hours a day on weekdays. On weekends she has to work only during the OPD timings. She feels that there is an acute shortage of staff and a need of two reception counters during rush hours. She is a temporary staff member and thus has to rent an apartment outside the campus, which nearly costs half her monthly salary. She also has to spend money out of her pocket whenever she falls ill and requires treatment at the Hospital. When speaking to her about the possibility of digitisation, she feels happy as there are several instances of misplaced files and lost records that she has to deal with.

Digitisation

Why aren’t the hospital records digitised?
There is both good, and not-so-good news on this front. The institute has taken up the issue and is planning to also include the hospital in its efforts to go paperless via its ambitious Enterprise Resource Plan (ERP). However, a plan of such scale and impact will take at least a few years to implement and will be implemented in phases; there will be a considerable amount of time before hospi records are fully digitized.

Contact details of the Student Counsellors
Ms Shivani Manchanda Telephone: 9072 FB: ICareIITB
Ms. Anjali Bhatia Telephone: 9071 She is in her office on Tuesdays and Thursdays, and rotates between H16, H12 and H10 on the other three weekdays.
Mrs Amita Tagore Telephone: 7071