Medical and Health Care Service Centres 01.

INTRODUCTION In any society, services lie at the very axis of economic activity. They play a very important role in the day-to-day activities of individuals and society. According to Philip Kotler A service is an activity that one party can offer to another, that is essentially intangible and does not result in the ownership of anything. Services are activities, benefits or satisfactions, which are available to consumers through sale connection. Many management experts have given varying definitions to the word services. It carries different connotations under different circumstances. The services that exist in the market today have made a tremendous impact on human lives. They have become essential for good living standards on a daily basis, making them, valuable service aspects of the society today. One such important service sector is the Medical & Health Care Sector. Health Care: The Health Care Services come under the category of Personal Services. Health care services cannot be stored at any place and one has to hire someone else to perform the services. The result is a positive social existence. The preservation of health and improvement of general standards of fitness are goals common to both individuals and nations. The broad objective of the Government so far has been to eradicate communicable diseases & to provide curative and preventive health services to its subjects. The Central and State Governments primarily provide medical services. Certain Private institutions also contribute their relief efforts to provide these services. The following chart briefly indicates the various services included under Medical & Health Care Services. Specimen Centres have been included to simplify the structure.

Medical and Health Care Service Centres Medical & Health Services:

Hospitals

Dispensaries/ CGHS Clinics

PHC

Medical Colleges

Pvt.

Govt.

Municipal

Govt. Semi-Govt. Municipal

The Medical and Health Services began with the Hospitals and its kind. There are three basic kinds of Hospitals and their areas are as follows: 1. Private Hospital 2. Government Hospital 3. Municipal Hospital And these service proceeds with the Dispensaries/Clinics managed by the private doctors and specialist. The government of India provides Central Government Health Scheme to their employees and their families. There is Primary Health Care Centres found in rural areas. And also there are Medical Colleges run by the various authorities and trust. It can be classified into various terms. But those from the project-report point of view are: 1. Government Medical College 2. Semi-Government Medical College (run by both Trust and Govt.) 3. Municipal Medical College. In this way, the Medical and Health Care Services have been explained in the further part of the study.

Medical and Health Care Service Centres 02. CENTRAL GOVERNMENT HEALTH SCHEME (CGHS): The central government has introduced Central Government Health Scheme (CGHS) on 1st July 1954 to facilitate services for medical treatment of the Central Government Employees and members of their families and to do away with the cumbersome and expensive system of re-imbursement of medical expenses under Civil services (medical attendant) rules. The scheme, which was started with 16 allopathic dispensaries in Delhi\New Delhi covering 2.33lakh beneficiaries, which was gradually extended to other cities like Allahabad, Mumbai, Calcutta, Chennai, Bangalore, Hyderabad, Kanpur, Meerut, Patna, Pune, Nagpur, Jaipur, Ahmedabad and Lucknow. The scheme presently covers about nine lakh families, and the beneficiaries are 41lakh comprising central government employees, pensioners, members of parliament and other entitled persons. As on 1st October 1996, the number of dispensaries/laboratories established under the scheme was as under: Allopathic: Ayurvedic: Homoeopathic: Homoeopathic: Unani: Siddha: Yoga: Policlinics: Dental unit: Laboratories: 241 31 41 34 09 02 03 20 01 72

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03.

PRIMARY HEALTH CARE CENTRES (PHCs): Primary health care is being provided to the rural population in the country through a network of 1,37,683 Sub-centres, 24,354 Primary Health Centres (PHCs) and 1923 community health centres by 5.99 lakhs trained women officers and 4.17 lakhs health guides, beside a large number of rural dispensaries working under the State Government\Union Territory Administrations. It is proposed to expand these facilities further in a phased manner so as to have one primary health centre for every 30,000 people (20,000 in the hilly and tribal areas), a sub-centre for every 5,000 (3,000 in hilly and tribal areas) within a short period and one community health center for about every 1 lakh population by 2000 A.D.

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04.

LIST OF HOSPITALS

MUNICIPAL HOSPITAL: Bhagwati Bhabha Cooper G. T. K .E .M Kasturba Khar T. B. M .G. Memorial Municipal Nair Raja Wadi Sion

GOVERNMENT HOSPITALS: B. A. R. C. BPT Cama Albless Civil Hospital ENT Hospital J. J. Hospital Police Hospital Nagpada E. S. I. S. HOSPITALS: Dhobi Talao Kandivali Mulund Worli Police Hospital Naigaon Police Hospital Worli Poddar Hospital Sewree T. B. St. George Haji Ali Ch. Ortho. Mental Hospital

HOSPITALS RUN BY TRUST: Asha Parekh Bombay Hospital Bhatia Hospital Breach Candy Bhartiya Arogya Harkishondas Haji Bachoo Ali Hindu Sabha Hindu Sabha Jaslok Kumballa Hill Lilavati Massina Nanavati Raheja Sarvodaya Singhania Sushrusha Tata Wadia (Children) Wadia (Female) Parsi Hospital Mah. L. Samaj Ashwin Kumar

Medical and Health Care Service Centres 05. GENERAL ORGANISATION STRUCTURE OF HOSPITALS Superintendent (Dean) Medical Administrator Chief Medical Officer Medical Officer (RMO) Registrar (RMO) Houseman Interns EXPLANATION OF THE STRUCTURE: The above chart defines the flow of authority in the general organization structure of Hospitals. The flow began with the Superintendent or Dean of the Hospital who is the main head of the general authority and holds complete responsibility for proper functioning of Hospital. Its a very responsible job for the authority to perform in the best way possible, because the ultimate success is laid on his/her shoulder. The authority flows downwards to the Medical Administrator who looks after the general affairs of the hospital as well as day-to-day functions. Then there is Chief Medical Officer in almost every department who are specialized in their profession and they are more responsible towards the health of the patients. Medical Officer or RMO (Resident Medical Officer) who works under the guidance of Chief Medical Officer and their duty is to examine the patients twice or thrice a day and report the same to their respected seniors. There is a Registrar who is also an RMO where he looks after the formalities of hospitals in terms of patient admittance, medical and drug, maintenance of daily reports, etc. The flow chart proceeds with the Houseman who looks after the comfort

Medical and Health Care Service Centres and basic care of the patient. Interns are the people who look after the on-job training 06. for the beginners in the field of Medical and Health Care. GENERAL ORGANISATION STRUCTURE OF MEDICAL COLLEGES Dean (Head of the Institute) Departments (Medicine, Surgery, ENT, USG, Endocrinology) Honoraries for each of the departments Associate professors for each of the departments Professor Lecturer Senior Registrar Registrar Houseman Intern EXPLANATION OF THE STRUCTURE: Organization structure of Medical College is similar to Hospital. In this, the general authority is with the Principal or Dean of the college. He is also known as Head of the Institute. The principal has the responsibility to carry out the functioning of the college in more effective way. He has the ultimate control to lead the Institute and direct its members in the best way possible. Under the head, there are various

Medical and Health Care Service Centres departments like Medicine, Surgery, ENT, USG, Endocrinology, etc. and every department is monitored by the head of the same. But the ultimate control is laid with the Dean or the Head o the Institute. There are Honoraries for each department who have work-experience in their specialized field and therefore guides the department on an honorary basis. There are Associate Professor linked with each department to maintain and co-ordinate the students with their local authorities. There are Professors who conduct the regular lectures for the students and impart them necessary and in-depth information about the subject. Below professors there is a lecturer who has being delegate almost similar type of authority to perform. But he /she will be junior to the Professors. There is a Senior Registrar who looks after the administrative affairs of the Institute, and carry out all the legal formalities that is required to be followed by every institute. Than there are Registrars who carry out the necessary functions of the institute and submits daily or weekly reports to their senior. A houseman also tries to provide the facility to the institute through their hard work and dedication. There are Intern personnel who provide internship to their existing students for gaining the practical experience in their respective field.

Medical and Health Care Service Centres 07. PRIVATE HOSPITAL Specimen: - HINDUJA HOSPITAL INTRODUCTION: The Hinduja National Hospital was founded in the early nineteen Fifties by the Late Mr. Parmanand Deepchand Hinduja who believed that his Dharma was 'to work so that he could give'. It has steadily grown in size and stature over the past 41/2 decades. His dream of bringing the miracles of modern health care to the common man has been realized and, after commissioning of the bigger Hospital complex in 1986, it has achieved its objective of Becoming a Centre of Excellence in Health Care. OBJECTIVE: The objective of the hospital is "To provide World Class Quality Health Care Services to all sections of the society". The Hospital has sophisticated state-of-the art equipment and well qualified-- doctors, nurses and paramedics to deal with any kind of ailment. The Management and Professionals lay great emphasis on quality. Several cross-functional committees regulate and monitor the quality parameters. Another step in this direction has been the ISO 9002 Certification Award that the hospital received from KEMA of Netherlands for Quality Management System. The Hospital complex, located on the busiest artery in central Mumbai consists of a 16 storied building which has: Inpatient capacity: of 330 beds (inclusive of 47 intensive care beds) in different specialties as well as some diagnostic facilities and support and ancillary services, connected by a bridge across the road to a 4 storied building which accommodates consulting rooms, outpatient facilities and a few diagnostic services. A nearby 14

Medical and Health Care Service Centres storied building provides residential accommodation for Doctors and Nurses to ensure that they are available round the clock. UNITS AND DEPARTMENTS: The hospital has a number of departments serving to the various needs of the patient. Some of the very important and essential units are discussed below. CRITICAL CARE UNIT (CCU): The Critical Care Unit of the hospital is dedicated to the patient care of the highest level. Super specialists specially trained to meet requirements of critically ill patients manage the Critical Care Unit. Patients in the CCU are thus jointly managed by admitting Consultant by Critical Care Super Specialists. These doctors supported by nurses and paramedic staff man the unit round-the-clock. The Hospital has a total of 47 Critical Care Beds distributed over the Intensive Surgical Care Unit, Intensive Coronary Care Unit and Pediatric Intensive Care Unit. Patients range from those that are Critically ill with multiple organ failure requiring intensive monitoring, therapy and nursing to post operative patients following cardiac and other major surgery, to stabilize patients requiring only monitoring. OPERATION THEATRE (OT): The hospital has eight (8) Operating Rooms, which are designed and equipped with state of-the-art technology. The hospital has separate rooms for conducting Cardiac / Neuro / Orthopaedic & other surgeries. Every operation theatre is complete with an attached recovery room, constant positive pressure air supply, total environmental control and an alert team of trained medical and nursing staff. The hospital has some of the latest technological instruments as follows: CUSA, Holmium Laser Specialized Endoscopic equipment,

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Medical and Health Care Service Centres Operating Microscopic with visual attachments, Viewing wand, etc. The hospital undertakes over 7000 surgeries, with over 1500 cardiac surgery procedures every year. PHARMACY: An in-house Pharmacy supplies all medicines, medical & allied appliances to the patient thus ensuring total control over the quality of drugs administered to them. The Hospital believes in providing medicines and drugs at the bedside of every patient. SERVICES OFFERED: Open and closed heart surgeries CABG and Valve replacements and repairs and Complex Paediatric cardiac surgeries. The hospital has excellent post surgical care facility in special Critical Care Units. DEPARTMENT OF GENERAL SURGERY The department of General Surgery is well equipped to manage all elective surgeries, acute trauma and surgical emergencies. SERVICES PROVIDED Hernias Hydrocoeles (All types), Oesophagectomy, Hemicolectomy, Gastrectomy (Partial/Total), Vagotomies, astrojejunostomies. Minilap cholecystectomies, cholecystectomies, CBD Exploration, laproscopic cholecystectomies. All Pancreatic Surgeries (Whipple's, pseudo pancreatic cyst), Hepatic surgery (patial hepatectomy, lobectomy), Portal Hypertension (devascularisation, spleenectomy). CA Breast (All breast surgeries), Surgeries for all GI malignancies (e.g. AP Disection, etc.), Laser for all Head & Neck Malignancies, Surgeries for all ischaemic disorders. The section uses staples for all GI surgeries.

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LABORATORY MEDICINE The Laboratory service is an important component of any health care center today. The department of Lab. Medicine is among few others in the country to offer reliable and reproducible quality results. The department boasts of its quality through the numerous quality control programmes (internal & external) that it carries out. The department functions "round-the-clock" throughout the year offering an extremely comprehensive menu of investigations to choose from which, it includes routine and specialized investigations. The Laboratory is fully automated and has state-of-the-art equipment that analyses all blood and blood fluid parameters. BIOCHEMISTRY The biochemistry laboratory is well equipped and is in keeping with the progressive outlook of the hospital. The laboratory has a sophisticated state-ofthe-art analyzer - the Synchron CX7 that has continues loading and reporting facilities besides having the primary tube sampling facilities and bar code identification systems. The lab carries out stringent quality control for all tests, which are, performed either by the analyzers, which is done at 3 levels twice a day or are done manually. The lab also participates in external Quality Control programmes from W.H.O, Chandigrah and College of American Pathologists in USA. BLOOD BANK The Hinduja Hospital Blood Bank is one among the few in the private sector, which has the approval of the Food and Drug Administration (FDA) for preparing and issuing Blood Components to patients. Providing "safe blood" to the patients

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Medical and Health Care Service Centres is the main aim of our blood bank. All types of blood components are available round-the-clock in the blood bank. The quality of blood components is closely monitored to ensure efficacy & safety. HAEMATOLOGY Haematology offers an exhaustive menu of investigations. Routine blood counts are done by Coulter Maxm Blood Cell Analyzer, which gives 24 parameters for every sample within a minute. Haematology lab also has a Facscalibur Flow Cytometer cum Cell sorter, which is a powerful tool for diagnosis, monitoring, staging & prognosis of a large number of haematological & immunological disorders and cancers. HISTOPATHOLOGY & CYTOPATHOLOGY Histopathology offers services for processing surgical specimens & biopsies. In addition, services of `frozen sections are provided for urgent diagnosis, enzyme studies, fat stains, etc. Specialized study of kidney biopsies in chronic renal disorders & transplants by Immunofluorescence and Special Stains is possible due to the availability of the fluorescence microscope The cytopathology laboratory handles both gynecological and non-gynecological specimens sent for cytology. MICROBIOLOGY The microbiology lab is well equipped with sophisticated systems such as Bactec NR 730 for Blood Culture (yield is 30% while with conventional methods it is 6%) and ATB (Automated Testing in Bacteriology).

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IMMUNO-SEROLOGY In addition to routine tests like Widal, VDRL, RA, CRP, etc., infection and autoimmune disease serology is performed in this lab. Serological investigations for "difficult to grow" pathogens as Mycoplasma, Leptospira, Pneumocystis, Cryptosporidium, Cryptococcus neoformans, Helicobacter pylori, Dengue, etc are performed by Enzyme Immuno Assays, Immuno-fluorescence & Immunochromatographic techniques. Polymerase Chain Reaction (PCR) for TB, HBVDNA, etc. is also performed for rapid diagnosis of infection. Elisa readers facilitate accurate results to ensure good sensitivity & specificity. BIOMEDICAL ENGINEERING A dedicated team of Biomedical and Clinical Engineers is always at hand to provide regular maintenance, rehabilitation and technical support to the advanced equipment installed throughout the hospital. CENTRAL STERILE SUPPLY DEPT. (CSSD) The CSSD (Central Sterile Emergency Supply Dept.) acts as an indispensable channel in the hospital's quest for total hygiene. An ingeniously built Escalator connects the various OTs to the CSSD, where all the operating instruments, gloves and linen are washed, cleaned, rinsed, assembled, systematically re-packed, sterilized and promptly dispatched to OT or the user Department. ACCIDENT & EMERGENCY MEDICINE The department of Accident & Emergency Medicine works round the clock through out the year and is recognized by the Royal College of Surgeons, Edinburgh.

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Medical and Health Care Service Centres The department has two theatres with facilities for minor surgery and endoscopies work. It also has 4 observation beds, 2 daycare / emergency beds and a trauma ward with 6 beds. About 27,600 emergencies were treated in the Department in 1996. The department also deals with Medico-legal cases, Medical Emergencies and Minor surgical work. The additional services offered by the hospital are as follows: SUPPORT SERVICES: ENGINEERING & MAINTENANCE DEPARTMENT Making the complex hospital infrastructure work is the responsibility of the Engineering and Maintenance Department. A dedicated team of engineers work day and night to provide, maintain and monitor the electric supply, water supply, medical gases, central air conditioning and the communication and fire-detection network. The department maintains a powerful Diesel Generator to supply backup power and fully shoulder the power needs of the entire complex, in case of any unforeseen power contingency. A dynamic water filtration plant provides a daily supply of over 300,000 litres of pure, bacteria free water to the hospital. The Incinerator is an ingenious device to dispose of unhealthy pathological waste, by burning such wastes at a very high temperature. FOOD SERVICES The food services department is fully equipped to serve nutritive vegetarian food, prepared in the most hygienic cooking conditions under the guidance of trained dieticians. Special meals, as prescribed by the Doctor, are also provided to the patients.

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Medical and Health Care Service Centres HOUSEKEEPING The housekeeping in the hospital is a specially trained task force that ensures clean, sterile and totally disinfected environment for your safety. Every hospital employee meticulously follows standard universal precautions. LAUNDRY The hospital reserves the highest standards of cleanliness & hygiene for its Laundry. To eliminate cross-infection in transporting clothing from one floor to another, an innovative Chute System directly transmit the soiled clothing from all the 16 floors to the basement, into the fully automated Laundry. Here fully automatic washing machines and electronic monitors help detect and eliminate the slightest risk of cross-infection. PATIENT RELATIONS (PR) The patient relations department helps in bringing various departments together to evolve ways and means of improving the services of the hospital jointly. The surplus generated over years is invested in improvement of quality patient care and in helping patients to lesser economic means. TELEPHONE SERVICES Public telephone booths have been provided for outside calls in the lobby and at other locations (most floors) in the Hospital. Telephone Facility is available in the Deluxe, Special and Median `A' rooms. TELECOMMUNICATION CENTRE Telecom Centre near the Casualty provides the following facilities for patient/patients relatives: a) STD/ISD Calls

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Medical and Health Care Service Centres b) Fax c) Trunk Calls d) Telegram booking The centre operates from 0700 hr. to 2300 hr. on all working days and 0800 hr. to 2200 hr. on Sundays and Public Holidays. Patient and relatives and also the doctors and staff members of the hospital can receive Fax messages; Telephonic messages from outstations can also be obtained at the centre for onward transmission to concerned individuals in the hospital. CARDIOTHORACIC SURGERY The Cardiothoracic Unit of the hospital is currently the busiest cardiac surgical unit in the city of Mumbai. The hospital has two regular cardiac surgical operation theatres and the third one is for thoracic and vascular surgery.

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Medical and Health Care Service Centres 08. MUNICIPAL HOSPITAL Specimen: - K.E.M. HOSPITAL INTRODUCTION: King Edward Memorial Hospital began its march to fame with a spirit of nationalism and an urge to serve, educate and innovate. The present eminence is the culmination of efforts of countless men and women who gave their best under good circumstances and also during difficult situations. In 1907, under the Police Charges Act, the work of medical relief within the city of Bombay was entrusted to the Municipal Corporation. Dr Jivraj Mehta was elected Dean of the college and hospital OBJECTIVE: Institutional priorities have been medical relief, medical education and research. The Hospital offers a balanced blend of preventive, promotive, curative and rehabilitative services to the society. The stress has been on health rather than disease, ethics and equality rather than concern only for a few elite and decentralization and dissemination of services to the unreached rather than centralizations of sophistication within the walls of hospital. PEOPLE INVOLVED: With about 390 staff physicians and 550 resident doctors, the 1800 bedded hospital treats about 1.8 million outpatients and 68,000 in-patients annually and provides both basic care and advanced treatment facilities in all fields of medicine and surgery. No. of Staff Doctors: No. of Resident Doctors: No. of Nurses: 390 550 250

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Medical and Health Care Service Centres No. of Attendants: 1000

The ratio as compared to the number of beds that is available in the hospital and the people that provide services can be calculated as: Given: Total No. of beds available in KEM hospital is 1800.

People involved No. of Staff Doctors No. of Resident Doctors No. of Nurses No. of Attendants

No. of people per head 390 550 250 1000

No. of beds served by per person 4.62 3.27 7.27 1.80

From the above ratio, we can conclude that one Staff Doctor serves to 4.62 beds per day in the hospital. The same case is with a Resident Doctor who serves to 3.27 beds per day. Also, a Nurse contributes her service to 7.27 beds per day. An attendant serves to 1.80 beds per day. YEAR 1956 1976 1986 2000 BED 550 1,450 1,615 1,800 STRENGTH In Patients 23,874 62,806 57,877 68,000 684,459 932,028 1,272,251 1,800,000 ANNUAL EXPENDITURE (in Rs.) 2,910,960 31,293,156 97,556,118 250,633,250

Outpatients

As most patients are poor, the Municipal Corporation tried to provide hospital services free of charge. But increases in costs over the past decades have made it necessary to recover some of the expenses from those who afford. SERVICES OFFERED: State of the art emergency medical services at K.E.M hospital

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Medical and Health Care Service Centres On October 5, 2000, a new state-of-the-art Emergency Medical Services area was commissioned in the hospital. Housed on the ground floor of the main hospital building, it is located where the old casualty, medical and surgical OPDs, minor surgery and Wards 20 and 20A were located. This approximately 15,000 square ft area, houses all emergency facilities. There are separate medical (adult and pediatric) and surgical (surgery and orthopedics) areas to cater to all emergencies. Each area is provided with all necessary monitoring and life support systems. The five fully equipped operating rooms are capable of handling all types of emergency surgeries including urologic, and vascular or thoracic surgery. Fully functional biochemistry, pathology and microbiology laboratory facilities are housed within this area itself. Plain radiography and ultrasonography are also available within this area. A CT scan specifically for emergencies will be commissioned shortly. A unique feature of this service is that all areas of this emergency care facility are computerized and are linked up through a Local Area Network, for both clinical and administrative needs. Dedicated software has been developed for the same. In time, this data will be exploited for evaluating and defining emergency management and treatment protocols in a typical urban Indian setting and could be used to develop and set standards for emergency medical practice in India. They have a well-equipped central lab. This helps them to undertake the emergency and other such cases and avoid the discrepancy that occurs during such time. A well-maintained Blood Bank facilitates to the hospital as well as to the patients to get the blood that is required during emergency.

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They have separate departments for the myriad diseases. This reduces the assembling of crowd at one place and every patient gets the treatment under the supervision of specialised professional.

LIST OF DEPARTMENTS: Anatomy Anesthesiology Ayurvedic medicine Biochemistry and Clinical Nutrition Blood bank Cardiology Cardiovascular and Thoracic Surgery Chest Medicine and EPRC (Environment Pollution Research Center) Dentistry Ear, Nose and Throat Surgery Emergency Medical Services Endocrinology Forensic Medicine Gastroenterology General Surgery Hematology Leprosy Library Medicine Microbiology Neonatology Nephrology Neurology Neurosurgery Nursing Obstetrics & Gynecology Occupational Therapy Ophthalmology Orthopedics Pathology Pediatric Surgery Pediatrics Pharmacology Physiology Physiotherapy School & Center Plastic Surgery Preventive and Social Medicine Psychiatry Radiology Sexually Transmitted Diseases and Skin Social Service Urology

ANNUAL WORKLOAD OF K.E.M HOSPITAL: DESCRIPTION Scheduled Beds Total No. of Admissions Daily Average of Admission Total No. of New O.P.D. Daily Average of New O.P.D. Total No. of Old O.P.D. Daily Average of Old O.P.D YEAR 2000 1800 64292 176 442170 1501 719403 2455

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Medical and Health Care Service Centres Total No. of Attendant (New & Old) Daily Average of O.P.D. Attendance (New & Old) Total No. of operations Major Minor Scopies Total No. of Deaths Death Rate Total Attendance in Casualty Total No. of Medico legal cases Total No. of In-patients days Daily average of Bed Occupancy Daily average of In-patients days 1161573 3965 5385 22641 30944 2218 4703 7.31% 106769 21,016 4,98,823 1,366 8.10

On the basis of this statistics of KEM hospital as given above, one can suggest that the hospital is having tremendous workload through out the year. Around 75.89% of the scheduled beds in the hospitals are busy throughout the year, which was one of the better ones in the industry. The OPD department is having 294 working days a year and is observing 2,455 patients per day, which is a difficult task to handle. Throughout the year, the hospital has successfully handled more than 5000 operations. 09.

COMPARATIVE STATEMENTS FOR THE HOSPITALS The comparative statements of the two distinctive hospitals are stated below: PRIVATE HOSPITAL OWNERSHIP: These hospitals are owned MUNICIPAL HOSPITAL and These hospitals are regulated by the

functioned by a group of individual Municipal Corporation to serve the coming together with a motto to serve health for low-income group of people. the people and earn. SOURCE OF INCOME: Highly charged fees, funds and donation Subsidies and grants given by the from the member of the institution. government, nominal fees from the

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Medical and Health Care Service Centres affordable patients. OBJECTIVE: The objective is to provide world-class The objective is medical relief, medical quality, health care services to all the education and research. section of the society. SERVICES OFFERED: Hospital has excellent post surgical care Provides both basic care and advanced facility in special critical care unit. TECHNOLOGY: Private hospital can afford to have Municipal hospital like K. E. M. highly advanced technology usually gradually uses advanced technology. imports of various equipments being They bring in those highly advanced used in different departments. equipments only when their sources of income are raised. India is a highly populated country. So as the population increases day by day the needs and wants of every individual also increase. Due to ever-growing population in a limited area, this leads to suffocation, diseases, accidents, etc. Thus, this gives an importance to Medical and Health Care Services. Basically, the population has been classified into three groups of income. They are as follows: a) Low income group b) Middle income group c) High income group Generally, the last income group, i.e. high-income group of people prefers to go to Private Hospital. Whereas, the last two income group, i.e. middle-income and lowincome group of people approaches Municipal Hospital. treatment facilities in all fields of medicine and surgery.

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Medical and Health Care Service Centres 10. COMMON PROBLEMS INVOLVED IN THE HOSPITALS

The hospitals face problems in many ways. A few of the many problems faced by the Hospitals are as follows: The basic problem that every type of hospital faces is strikes by Doctors, Union, Nurses, Administration Staff and Class IV Employees. It is necessary and very much critical in maintaining co-ordination among the line and staff employees. To deal with the relatives of patients and accept all types of good as well as bad behavior from them is really a very harsh problem. Getting their consent and explaining the matters to them in the best way possible is really an unbearable task. The hospital has to specially make arrangements for lobbies and space for the relatives and visitors who visit the hospital and proper care of any indiscipline that takes place. In the premises of hospital has to arrange a day-night drug store for the patients. The hospital has to maintain proper hygiene within the limited resources available to them. The authority of the lab. department has to monitor and check properly whether all the equipments, tools and apparatus are properly sterilized. Due to illiteracy in the majority of attendants, the hospital has to create awareness among them on the use of sterilized instruments. The cleanliness department has to look after the proper disposal of waste. The authority has to manage and control medico legal cases. The authority has to scrutinize the matter and fulfill all the legal formalities before conducting autopsy. The hospital has to maintain Morgue facility and also provides the relatives of deceased with good services. The hospital requires arranging fire extinguisher in case of incineration.

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Medical and Health Care Service Centres Maintaining up to date blood bank, coordinating with the requirements of the patients and arranging for the pathology tests of blood if bought from outside. As per the specification of World Health Organization (W.H.O), the hospital has to make available the number of beds for their patients. The hospital has also an obligation to maintain other general facilities for the patients and their relatives.

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11.

COMMON FUTURE PROSPECTS SHARED BY THE HOSPITALS The future improvements that the Hospitals aspire to achieve are basically an improvement in the standard of services. A few of their future aspirations are as follows: The present orthopaedics center in the

hospital will be converted into a convalescent centre. A facility for producing blood products that will meet our most complex needs is being evolved. The hospital is planning to build an intensive care unit for patients with serious neurological diseases. They will apply Preventive and Social Medicine centre in the new areas. The hospital also arranging and acquiring the latest possible equipments and technological advancement. patients. and health treatment. overcome from the same. The hospitals are trying their level best to satisfy their patients in any possible manner. By understanding the problems and hardships that are faced by the patients and providing the best solution to The authorities of the hospital are in a process to arrange and make available the worlds best doctors for the basic care The hospital is in a process of implementing the plan to provide better and up to date facilities and services, which satisfy the

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12. GOVERNMENT MEDICAL COLLEGE

Specimen: - GRANT MEDICAL COLLEGE INTRODUCTION: Grant Medical College was the first college, which was taken for the survey with very first step, being put on the field. Its a very big college regulated by the government and located in the premises of one of the familiar government hospital named as J. J. group of government hospital. This college has a two-storied building and various other departments located at separate places in the same premises. OBJECTIVE: The College has the objective of imparting undergraduates, the medical education and research facilities to the Post-Graduates and researchers and to produce quality doctors. PEOPLE INVOLVED: Total number of students only in M.B.,B.S. is around 200. Statistics regarding the PG students were not available due to some unknown reasons.

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There are around 156 lecturers, 150 honoraries and consultants, 500 registrars and housemen and 290 interns. SERVICES OFFERED: They have various departments (30) in all. To name few of them like: MBBS at the graduation level, and at the post graduate levels the departments are MD (general medicine), MD (medical surgery), MD (gynaecology) MD (cardio-vascular), MD (chest), MD (forensic), MD (paediatric), MD (ENT), MD (dermatologist), MD (orthopedic). Apart from this other departments are Anatomy, Physiology, Pathology, Haematology, Oncology, O. S. Academic section and administrative department etc. Duration of course: Duration of M.B.,B.S. course is four and half years consist of three terms and the fees for each term is Rs.6000/-. In addition to this, Internship is of 1 year and a bond has to be signed by the student that after completing their degree they cannot practice in foreign countries for a minimum period of 5 years and Rs.2 lakh is given to them for 1-year internship. Duration of M.D. course is 3 years and they draw salary as per the rules and regulations of the college and hospital. Information regarding the availability of the dead bodies: Dead bodies are kept at J. J. Hospital Morgue. Bodies are kept in Morgue so that the heirs of the body can claim it. If the body is not claimed within 2 weeks of time the bodies are allotted to the medical colleges as per their demand. The most important thing to be noted in this is that the body required for the anatomy purpose should have suffered a natural death.

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PROBLEMS INVOLVED: Faced by students: There are administration problems, clerical problems, lectures are not in an organised manner i.e., not all the students are aware of the timing of the lectures as it keeps fluctuating according to the availability of the lecturer. A very-very long day i.e., As the lectures are unorganized, students are at the discomfort, that mostly the time is wasted in a day, for most of the time they have to remain in the college as they themselves are not aware when and which lecturer will conduct the lecture (some students are informed about the lectures and the rest are not), canteen facility of inferior quality and lack of water facility in hostels. Lecturers are insufficient in numbers and the books available in the library are not enough. Information regarding Library: Funds are diminishing due to government educational policies and this is directly affecting the library facility as most of the books are of foreign authors and are very costly. According to Ch. Librarian they are heading nowhere as far as library is concerned. FUTURE PROSPECTS: Students after M.B.,B.S.: In today's scenario only M.B.,B.S. degree will not serve the purpose. There is a general practitioner every second lane. So to be successful, Post-Graduation and specialisation has to be there. Institution:

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Medical and Health Care Service Centres As described earlier "funds are diminishing" and this had a direct impact on the overall facilities, which is given by the college to the students particularly on Library, Hostels, Canteens, and Pathology departments that are suffering heavily. Overall, future prospects are not bright.

13.

SEMI-GOVERNMENT MEDICAL COLLEGE Specimen: - DR. I. M. J. TIBIA UNANI MEDICAL COLLEGE INTRODUCTION: The institute is managed by the trustees of Anjuman-I-Islam and the funds are partly provided by the government in terms of salary to the teaching and non-teaching staff. Tibia Unani Medical College was found in the year 1940 by some private individuals. But due to various problems like lack of funds, co-ordination between workers and the management lead them to take a long break of 20 years. In the year 1969, due to the initiative of Dr. Abdul Hameed Director of Cipla ltd. took over the task and resumes the function of this Unani Medical College. Then in 1993, the honorable trustees of Anjuman-I-Islam showed their keen interest in this part of education and thus brought this college under their head, named as Anjuman-IIslams Dr. Ishaq Mohammed Jamkhanawalas Tibia Unani Medical College. OBJECTIVE:

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Medical and Health Care Service Centres The objective of every organization varies with their functioning. This institute has an objective to impart Unani medicine and treatment course to the students for health care. PEOPLE INVOLVED: The institute provides B.U.M.S (Bachelor of Unani Medicine and Services) course to the students. The total number of students in this field is 225. There are around 10 numbers of Honoraries, consultants and lecturers as specified by the contacted person named Dr. Noor Patel. There is 1 Registrar, 3 housemen and interns. These 3 personnel are Superintendent, Resident Medical Officer (RMO) and Office person. SERVICES OFFERED: The institute caters to 225 students of B.U.M.S and therefore has 7 various departments for the same. They are as follows: 1. Medicine (Molejat) 2. Unani Pharmacology (Advia) 3. Hygiene 4. Anatomy (Tashreeh) 5. Physiology (Munafa-ul-Aza) 6. Surgery (Jaraheeyah) 7. Gynaecology & Obstetrics Duration of the course: The duration of B.U.M.S. course is of three semesters spread over 4 years and the fees for each term is Rs.7,500/-. The basic criterion as mentioned by the Central Council of Indian Medicine for entering into this course is that a student should be from Urdu medium because major portion of Unani Medical Studies is taught in

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Medical and Health Care Service Centres Urdu. After completing the course, student has to go for internship of 1 year; else the certificate from the University is not being awarded. The basic pattern followed by this institute is providing internship to the students in their attached Hospital itself under the guidance of RMO named Dr. Noor Patel. The students are asked to work in one department for 30 days, and then they are shifted to other department. Likewise, they have been given experience in all the departments. Under Hygiene department they are asked to do a fieldwork in rural areas for a limited period. Library facilities: The college provides a well-established library to the students. The books are well maintained and properly arranged by the librarian named Mr. Sirajjuddin Bukhari. The students have been provided all well updated notes to study and bring laurels to the college. Management: Students of Dr. I. M. J. Tibia Medical College have a good rapport with the management. From the management side, they provide best facility to the students as compared to other 4 colleges in Maharashtra who imparts the same course in Unani Medicine. Still they are trying their level best to give their students up to the mark being a limited size of organization. ACHIEVEMENTS: The college has stood first in the General Knowledge Quiz and Medical Quiz held at Anjuman-I-Islams Saboo Siddique Institute at national level in the year 1997. PROBLEMS INVOLVED:

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Medical and Health Care Service Centres After the personal approach to the student and collecting all the data possible, the following is what derived from: Experienced from the students who have completed their course is facing a very severe problem of placements. There is a big lacuna of staff facility. A very few members of staff are available for teaching. There is no proper Dissection hall and Autopsy room facility available for the students to perform their practical. The equipments used in the practical are not well advanced. They have a traditional approach. Due to small size of classrooms leads to suffocation and even the corridor is also very dark and shady. Though the library facility is good, but the area of reading is very small and congested. There is no proper and hygienic canteen facility available in the college premises. There is an increment in responsibility for the teaching staff members as they are limited in number. There is no proper Promotion policy for the members of the staff. Even there is no replacement cell for the old staff member who leaves the job or retires or deceased takes place. FUTURE PROSPECTS: Fields like Unani, Ayurvedic, and

Homeopathic are an alternative to Allopathic; therefore its scope is very high. In fact, the worlds interest is gradually growing up in Unani. In near future, the major step that will be taken by the management to solve the grievances of students in terms of shifting their complete department of B.U.M.S. into the new building at Versova. The project cost is estimated to Rs.8 crores. Also by the next year or so, the institute is coming up with PG degrees in Hygiene, Unani Pharmacology and Gynaecology.

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14.

MUNICIPAL MEDICAL COLLEGE

Specimen: - SETH GORDHANDAS SUNDERDAS MEDICAL COLLEGE INTRODCUTION: Seth Gordhandas Sunderdas Medical College (GSMC) was founded; it is amongst the foremost Teaching and Medical Care providing institutions in India. GSMC is located in the campus of K. E. M. Hospital. OBJECTIVE: Unremitting zeal, devotion and professional competence of the medical and paramedical personnel have ensured that on completion of study, our young doctors

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Medical and Health Care Service Centres do not want to play God, but they act as a tool in the hands of God to serve humanity. PEOPLE INVOLVED: G.S medical college incorporates one of the very best team of faculties. Many full timers and visiting lecturers are arranged. The college ensures that the best of the training is imparted to the students who in the near future would become doctors themselves. In their sixty-second year, these institutions continue to play important roles in medical education and patient care. Students can register for training in every branch of medical science. The teachers are qualified and recognized as guides for all diplomas and degrees offered by the University of Bombay and other academic licensing bodies. Residents and consultants in departments ranging from dermatology to psychiatry and neurosurgery to proctology attend to patients from all over India. Several departments have gained national renown.

SERVICES OFFERED: The medical college (school) provides training to about 2000 students in undergraduate, postgraduate and super specialty medical courses; in undergraduate and postgraduate physical and occupational therapy; Masters and PhD courses in various allied specialties. These institutions also maintain a nursing school. DEVELOPMENT: The Seth G.S. Medical College, the twelfth medical college in the country, opened its doors on 1st June 1925 to 46 students, six of them women. The formal opening followed the next year and it was affiliated to the University of Bombay. The hospital, with 125 beds, started admitting patients on 15th January 1926.

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Medical and Health Care Service Centres Both the medical College and the hospital quickly gained a reputation and patients were attracted in large numbers. The demand for more beds led to a progressive expansion of the hospital. 'Honoraries and full timers' - Initially the institutions adopted the dual system of teachers in keeping with the British pattern. Anatomy, physiology, pathology, pharmacology, preventive and Full-time teachers taught social medicine. Whereas medicine, surgery, obstetrics, gynaecology and other clinical subjects were taught by individuals who worked part-time for the institutions on an honorarium (and were, hence, termed 'honoraries'). As the number of patients and students progressively increased it became difficult for honoraries' to devote sufficient time to their wards, teaching and research. The situation was worsened by competition in private practice. Barring a few exceptions, the ''honoraries" found themselves unable to do justice to their three responsibilities. This organization is funded mainly by the Municipal Corporation of Greater Mumbai; these institutions render yeomen service - virtually free of cost - mostly to the underprivileged sections of the society. ACHIEVEMENTS: The achievements of the institutions that hit the national headlines or won awards such as the Lasker or Padma Bhushan include the contribution on Rauwolfia serpentina by Dr Rustom Jal Vakil, the first heart transplant in India by Dr P.K.Sen and the first documented Indian test-tube baby by Dr Indira Hinduja. The major contribution was made towards the development of a good system of undergraduate and postgraduate education, the creation of a system where the poor can obtain good and free medical care and the creation of an} ethos of service. PROBLEMS INVOLVED:

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With limited financial resources with the college, it is becoming difficult for them to meet everyday requirements and also it has not been financially possible to acquire modern equipment such as a computerized tomographic scanner for better research studies. The staff feels discriminated against in the allotment of fellowships; equipment gifted by foreign governments and grants from international health organizations. Moreover, because of commercialism there is a danger of work ethos being eroded. The harmony among members of the staff is under strain resulting in the neglect of patient care, student education and research. The college faces a problem in arranging the dead bodies for the practical of students. It is very difficult for the institute to work according to the specifications laid down by Medical Council of India. Those diseases that is rare in nature, so to bring and experiment on such patients is very difficult. To avoid strikes by students and also the teachers is a very challenging task. Also the Medical union is upset with honorary posts. The Maharashtra State Medical Teachers Association (MSMTA) have proposed that the Govt. should do away with the system of HONORARY teachers and replace them by full time teachers in a phased manner so that they devote more time for research and teaching activities. FUTURE PROSPECTS: In real life its a struggle to remain in the

forefront of Indian medicine however the institute tries to continue. A recently constructed twelve-storied building houses and new departments and has allowed the institute to expand some old ones. Other than the subject books, the institute is in a process of providing a novel library for the students.

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Medical and Health Care Service Centres To make known more about the medical

studies, the institute is arranging a lot of seminars and conferences on health and diseases that allows the students to interact with the experts. The college is also arranging visits by foreign delegates who can share their views and information on the advances in technology & research going on abroad with the students. for the study of the students. them. For better understanding, the college arranges atlases and visual display methods. The college also arranges the orientation programmes for students to inspire them and get to learn something more out of The college is arranging new and rare cases

15.

COMPARATIVE STATEMENTS FOR THE MEDICAL COLLEGES GOVERNMENT MEDICAL COLLEGE OWNERSHIP: by the government. SEMI-GOVERNMENT MEDICAL COLLEGE MUNICIPAL MEDICAL COLLEGE

This institute is regulated The institute is managed It is owned and controlled by partly the Trustees by of by the of Municipal Greater Anjuman-i-Islam funded and Corporation the Bombay.

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Medical and Health Care Service Centres government, it means it has a controlled of both Private Trustees and Government. OBJECTIVE: Objective education facilities is and to to impart The objective is to impart The Medical Unani the medicine objective is zeal, undergraduate and Unremitting

research treatment course to the devotion and professional post- students for health care. competence of the medical and paramedical personnel have ensured that on completion of study, our young doctors do not want to play God, but they act as a tool in the hands of God to serve humanity.

graduate and researchers and to produce quality doctors.

SOURCE OF INCOME: The income of this The capital is contributed The institute funds its institution can be sourced by the members as well as income from the BMC as from tuition fees as well as the donations are received well as tuition fees from subsidies government. from the from the students. Since, the affordable students. the government also contributes by disbursing the salaries of the staff. SERVICE OFFERED: The institute provides The institute offers The institute provides courses at graduate & B.U.M.S. course to the training to about 2000 they facilitate postgraduate & super-

post-graduate level. Also students at graduate level. students in undergraduate, there is a facility for Also research work in particular field. any internship for the students specialty medical courses. in their attached hospitals. It also maintains a nursing

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Medical and Health Care Service Centres They library. PROBLEM INVOLVED: From the students point of From the students point of From the student point of view, the lectures are not view, the lectures are view, they do not get to in those properly scheduled. There scheduled properly, but the experiment also have well school.

established and up-to-date

is a limited book available lecturers are very limited. diseases that are rare in in library due to high cost Apart from well-furnished nature. Also, due to limited against low income. availability of books, the finance, small and suffocative. make it available becomes modern area of library is very difficult for the college to equipments for the better research studies. FUTURE PROSPECTS: The institute is trying to The institute is in a process A improve the students. by recently and constructed building department, making of improving their services twelve-storied

available best facilities to by constructing a new and houses

well-furnished building at has allowed the institute to Versova so as to overcome expand in some old ones. the grievances of the Also, other expanding such the students. facilities in library and departments concerned.

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Medical and Health Care Service Centres 16. DISPENSARIES After visiting two dispensaries of Dr. Syed Ayaz Ahmed and Dr. Hanif, the overall information derived from the interview is mentioned below: INTRODCUTION: An average of 25-30 patients in normal days and in season of bad climate it gets up to 45-50 patients a day. There are two departments in these dispensaries: 1. Minor Surgery 2. Consultation department SERVICES OFFERED: Kinds of patients treated: General problems right from head to toe. Patients visit the doctors even for dental problems, skin problems, or even for orthopaedic problems. It they are able to serve the person best and do the job its fine, else they are directed to the specialists. There is a tendency in people, whatever happens, they first consult any general practitioner and then these general practitioners direct them to specialist doctors. Patients of asthma, bronchitis, B.P., and even diabetic and heart patients do come to them. Equipments used: The basic and a common equipments used by the Doctors in their clinic are Stethoscope, Thermometer, Sphygmomanometer, Cutter, Scalpel, Forceps, Knife, Scissors, Injections, Pulse oxymeter, Sterilizer etc.

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Medical and Health Care Service Centres When there is any emergency or some special treatments that are required to be given to the patients, Doctors prefers to forward the cases immediately to the relevant doctors with a letter. They at times don't even want to take a risk of trying to serve or treat to the serious patients as it may be very dangerous to the patients and if a patient dies then that will badly hamper the image and in return they'll loose their patients. PROBLEMS INVOLVED: Future prospects are not bright. There is a general practitioner every second lane. There is a lot of competition in the arena of dispensaries. OPDs run by the hospitals has eaten up the market of dispensaries. Specialization in this field is very limited. FUTURE PROSPECTS: Cannot think of development in todays condition due to the lack of financial resources. Even if we go for any development from the point of view of a dispensary to a Nursing home, that'll require finance, which is scarce in today's competitive scenario. (Even they are feeling the pinch of competition).

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Medical and Health Care Service Centres 17. HEALTH CARE CENTRE Specimen: - VANDANA LUTHRA'S CURLS AND CURVES (VLCC) OBJECTIVE: VLCC is one of the leading Indian brands in Scientific Body Solutions and Weight Loss, its motto being "Look good, feel wonderful". INTRODUCTION: Vandana Luthra: - She has been in this business for the past 14 years with centres all over India and is planning to go global in the immediate future. Vandana Luthra set up the first slimming center in 1989 at Safdarjung Enclave in Delhi. Today VLCC is the premier slimming and beauty chain in India, with almost 50 centres all over India; and will soon be going global by launching its centres in Bangladesh, Dubai and London. "In my clinic we use only the most scientific methods to reduce weight. All our machines are imported from Germany," says Vandana and each of these machines cost a staggering 50 lakhs. She studied under Huchel Hanz Jorgen who is a German weight loss expert and she follows his principles in all her clinics. Liposuction and other such techniques, for losing weight, are not used in this clinic. Even though they have a gym, aerobics does not form a big part of their programme. PEOPLE INVOLVED: An eminent panel of doctors is always available and any programme is finalised only under their consultation. To name a few associated with this clinic are: NAME OF DOCTORS Dr. Chandini. P. (Full time) Dr. D. Prabhakar DESIGNATION Dermatologist Physician and Cardiologist

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Medical and Health Care Service Centres Dr. Nandita Dr. Angela Xaviar (Full time) Gynecologist In-house

In each of the many branches they have a batch of full time doctors, beauticians, dieticians, trainers catering to the various programmes of their customers. SERVICES OFFERED: Once you enter the program, a detailed analysis of your body is done where the bone weight and the muscle weight are determined. This is known as the Body Component Analyser. Then the amount of extra weight that needs to be reduced is accurately calculated. Through this test the basic metabolism rate can also be learnt and this will help in formulating a suitable diet chart for the person. After this, a session is planned with a Counselor who briefs you about the entire schedule and clears all your doubts. Then a session is scheduled wherein the fat disintegration system begins. These machines have electrode pads that are placed in areas where fat has to be reduced. not happen in a single sitting. It takes a Then, through a series of vibrations, these muscles expand & contract and the fat content is diminished. However, this does month approximately to lose about five kg of fat. A definite time period to achieve results cannot be fixed, because it varies according to the body mass of each person and other health considerations. Simultaneously the skin firming process is also begun, so that the skin does not begin to sag after the fat is reduced. The dietician then prepares a suitable diet for the person, keeping in mind the essential amount of calorie intake necessary for the individual. Suggestions regarding a few simple changes in lifestyle, like going for a walk before dinner, or climbing the stairs instead of taking the lift, etc., are made. To make sure that you dont fall back into bad eating habits, you are given a diary wherein the calorie content of each dish is listed. So that you can pick and choose the different dishes according to the decided calorie intake per day. When the prices are broken down to lose one kg, the amount spent is approximately Rs.1200. All the methods are scientifically proven safe and have no side effects.

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Medical and Health Care Service Centres German therapy: It is a revolutionary, highly scientific, imported loose up to 10kgs of fat in just 30 sittings.

German system that can help you

Experience has proved that once the spectacular fat-loss is achieved, your beautifully sculpted figure is maintained with relative care. The treatments are scientifically proven and totally safe. But a note of

caution must be added. The treatment is given to persons suffering from hormonal disorders like thyroid, endocrine disorders like diabetes and other metabolic complications with medical consultation. A team of highly qualified and experienced medical specialists is available in-house, to help each client plan, prepare and achieve desired result. Target Area Reduction: Takes off the embarrassment of carrying that

extra weight on parts of your body, like hips, thighs and double chin! Easily, fast and without side effects. Micro massages and German gadgets are used for spot reduction. Body Firming and Figure Shaping: Loose fat tissues make your body

sag at certain parts. Firm up and shape up using a combination of manual massage treatment with specially developed oils, and German firming machines. Body Curving: Once your body muscles are firmed up, you can go for

body curving and opt for the dream figure you always wanted. Special German body curving machines are used to get the best results. Compact Variety For Beauty Treatment: Breakthrough treatments for

skin and hair, to bring you the best in international cosmetology. Laser Superior with Scanner: Soft laser treatment with double headed

scanner for the treatment of fine wrinkles, scan tissues, pimples, falling hair, skin tags, warts and other skin imperfections. Melfade (in combination with laser II): Revolutionary skin lightening treatment that dissolves pigmentation permanently, through non-toxic biological

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Medical and Health Care Service Centres extracts. Offers magical results in the treatment of pigmentation (concentrate), chlosma, under eye dark circles, acne scars and patchy skin. Skin Freezer: Advanced treatment for acne, acne nodules and hard

pigmentation. Treatment provided by extensively trained beauticians, under constant medical superinisition. Ionos: Used for the induction of serums in to the deeper tissue of the

skin by contophorosis treatment useful for skin detoxification to remove the dirt and grime, skin toning, pore refining and removal of fat tissues from the face. Thermodyn: Incorporates medicative creams in to deeper tissue for

skin detoxification, skin tightening pore refining, and specially to treat under eye wrinkles, finer facial wrinkles, double chin and for the toning of stomach, hips and thighs. High Frequency Treatment: Used with Argon and V.V ray treatment

for stimulation of the skin and breakdown of serums/liquids/creams in to finer molecules that is applied to the skin. Effective for hair problems like falling hair, rough and dry hair dandruff etc. The beauty therapies offered at VLCC are state-of-the-art, and nature-based. They believe in using the natural elements for the skin treatment. This is achieved through a deep understanding of the skin type. Skin as a whole can be defined and categorized into four broad types: dry skin; oily acne-prone skin; mature skin; and hyper-pigmented skin. At VLCC, this is taken care of by specialists who use special microscopes like Dermoscope, Woods Lamp, Derma Analysis and Potential Hydrogen, to determine the skin type and texture. The next step is the treatment, depending on the skin analysis. The treatment is also taken care of by experts who decide on the treatment only after the detailed picture of the skin emerges.

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Anti-Pollution Treatment: The skin these days faces hardships of all

kind, pollution being the foremost among all. Lack of oxygen in the air retards cellular activity. Waste lodges in the tissue and the skin loses its luster. VLCC offers an Anti-pollution treatment, which boosts oxygen supply to the skin. A High Frequency Machine raises efficiencies of active ingredients. The effect is both quick and dramatic, and the skin emerges soft, fresh and bright. Enzyme Therapy: Enzymes are natural catalysts that quicken reactions

at rates up to a billion times. Some enzymes tighten the skin the skin and tone up muscles. Others erase lines and crows feet and tighten sagging jaw lines. Essential Oil Therapy: This is basically meant for those facing a dry

skin problem. A body and face massage of exotic oils tone the body and relaxes the mind. The secret lies in the mysteries of oils extracted from flowers, roots, leaves and bark. The oils are tapped from peppermint, cedar wood, sage, juniper, angelica, basil, germanium, coriander, eucalyptus, nutmeg, jasmine and other exotic sources. They have a magical effect on sallow skin, sagging muscles, acne, blood circulation, tired muscles and so on. Fruit Peel Treatment: The skin of certain fruits is a common medical

prescription for epidermal problems. Rich in Alpha Hydroxyl Acids, the peels dislodge the outer damaged epidermis layers without side effects or toxicity. The treatment leaves no scabs, needs no hospitalisation and is comparatively inexpensive. The High Frequency Machine for Acne Treatment: The machine

provides a germicidal and anti-bacterial effect on skin. It limits sebaceous secretions, heals pustular infections and tones and stimulates acne seborrhaeic skin. It brings color back into sallow skin and aids and firms up skin that has undergone a therapeutic massage. It dilates the pores and removes impurities. It improves blood circulation, skin texture and oil-moisture balance.

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Medical and Health Care Service Centres Thermodyne: Thermodyne treatments have medicated creams and

serums for skin lightening and pore refining. When the creams and serums reach the deeper parts of the skin, they restore lost moisture, collagen and elastin. Lymphatic drainage and detoxifying treatment: Lymphatic drainage at the treatment area. This treatment also repairs damaged cells,

various points of the face stimulates the lymphatic channels, which, in turn, help in detoxifying improves blood circulation and oxygen supply to nourish the skin. Microbiolifting: The machine plays two roles in skin care. Firstly, it

warms the underlying skin structures leading to proper drainage and detoxification. Then it tones up the facial muscles, lifts sagging skin, erases fine lines and wrinkles, removes double chins and shapes up the bust. In addition treatment includes a manual massage of thermo active essential oils for tummy tucks and reduction of hips and thighs. Advanced Hyper-pigmentation Treatment: Excessive melanin in the

upper epidermal layer is known as Hyperpigmentation. The causes of this are heredity, hormones, the Nervous system, radiation, high blood pressure and certain medication. The treatment involves the use of the serum (plant extract) as the inhibitor. It inhibits skin darkening and also reduces hyper -pigmentation. The active ingredients used by Inhibitor are extracts of Berberry. Only natural ingredients are used. Laser Therapy: The Erbium Lag Laser, developed by a German firm,

presents an excellent and quick option to conventional dermabrasion for skin resurfacing. The laser has wide usage in cosmetology and dermatology for cleaning all kinds of skin blemishes. The treatment is monitored by qualified dermatologists and is available only in select centers. All these treatments are available at all the VLCC centers all over India. And the number of people who have benefited from these is increasing day by day.

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Medical and Health Care Service Centres PROBLEMS INVOLVED: The general problems faced health care centers are as follows: The clients usually come after they have tried every trick in the book such as crash dieting, home made medicines; they even try unauthentic prescriptions due to which everything has to be started from the scratch. Patients having hormonal disorders rarely get ready for incorporating the hormonal drugs. In India people are still not very self-conscious and therefore hesitate to approach these centers. People have many misconceptions about the working and treatments of these institutes and are not very positive about it. The maintenance of imported equipments, which are complex and sensitive. These centers are highly advanced and require maintaining standards with the latest developments in technology and the standards according to international levels. FUTURE PROSPECTS: The center is planning to go global with its treatments. They are intending to incorporate the latest advancements in cosmetology and other technological advancements in the field of health, beauty and skin care.

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Medical and Health Care Service Centres 18. SWOT ANALYSIS OF MEDICAL AND HEALTH CARE SERVICE CENTRES:

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Medical and Health Care Service Centres STRENGTHS: Computerized equipments: As in almost all the industries the trend of moving towards modern technology is common to the medical and health care industry also. It is more of a necessity than rather glamour, to detect and cure the upcoming problems related to health. Growing population: Extensive coverage of general masses: The medical and health care industry in India has grown up to a large extend, one of the major reason behind this is being population explosion in our country. Due to ever-growing population in a limited area, this leads to suffocation, diseases, accidents, etc. Thus, this gives an importance to Medical and Health Care Services. Well recognized education system: The level of medical education offered in our country is one of the better ones and well recognized throughout the world. The demand for Indian medical professionals is there in almost every corner of the world, e.g. 33% of the doctors in USA are Indians. Government support: Use of technical innovation: Better services can be provided by adopting innovative technology like operations via Video ConferencingInternet, Satellite and other such techniques. The constant rise in the population provides a larger scope for this service sector to perform. As per the current trends in the rise in population this service sector comes under microscope due to its importance in the society. It is mandatory for this sector to identify the various means of providing their service in a better way. OPPORTUNITIES: Scope of improvement in

service offered: There is a vast scope of improvement in services offered in the medical and health care industry. The advanced and modern technology can play a vital role for the improvement of services.

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Medical and Health Care Service Centres WEAKNESSES: Undesirable services: One of the cons for medical and health care services in a country is substandard quality of services offered, especially with reference to the government and municipal hospital. Poor performance in the quality of THREATS: Lack of trust in the

profession: People are very hesitant to admit in the hospital due to fear of kidney stealing. Basically this profession is looked from the religious point of view, and in our country a doctor is considered next to God. But this might not be a situation due to various unethical activities being carried on in this highly prestigious profession like carelessness on the part of the professionals and concentrating more on the financial aspect. Lack of competition between Public and Private Sector in our country: The competition is a must in any industry may be product or service oriented. More so in the service sector because of the quality of the service offered is always kept under check, hence the competitors focus more on quality of the service offered which leads to customer satisfaction and healthy competition in the market, due to which, the customer always gets better quality of service. Unfortunately this is not the state of affairs in the Medical and Health Care Services in India and there is lack of competitive

lower level of employees: The lower level employees in the industry have not delivered the goods as per requirements and the level satisfaction to the patients. They are not doing their duties regularly on time. They also at time leak important information of their concerned people and organization. Slow rate of technological advancement: The rate of technical advancement in the terms of equipment facility is much slower. For example, various operations require modern equipment facility, which unfortunately, are not available in our country.

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Medical and Health Care Service Centres spirit shown by the public sector. High cost of Medical

treatment: The cost of Medical treatment is increasing over the period of years. At times, it is unaffordable for lower and middle-income group people because most of the specialized services are offered by the private sector, and these services are not easily available in the public sector at a subsidized rate, or at times, these services are not available in the public sector.

19.

SUGGESTIONS TO IMPROVE MEDICAL AND HEALTH CARE SERVICE CENTRES: Professional approach: Centres should adopt more professional approach towards treating their patients and providing Medical and Health Care Services.

Computerization: More emphasis should be given towards computerization and use of modern technology to reduce the human error.

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Improvement in services offered: The level of services offered by the government hospitals is not up to a standard level as compared to private sector, so the government hospitals should try to upgrade the services to match their peers in the private sectors. Industrial support to reduce cost of services: The Medical and Health Service Centres should come in collaboration with the Industrial Units and thus provide such services at the lower and affordable cost. Also this will benefit to the employees of such Units. Counseling and psychiatric facility: The hospitals should make available such kind of counseling and psychiatric facility especially to those critical patients who are suffering from such incurable diseases and loose the hope of curing. Bureaucracy should be solved: There are n numbers of formalities and legal procedures to be followed in this field which, at times costs the life of a patient. These formalities should be flexible enough in time of emergencies and human life should be given priority over these formalities.

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CONCLUSION A detailed study of the different arenas covered under MEDICAL & HEALTH CARE SERVICE CENTRES helps to give a better understanding of their organization their operations etc. The problems that have been identified are but a few; there are many holding up here & there. The study has enabled us to identify these. Doing a project report has helped to understand the structure of these myriads and diversified services.

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Medical and Health Care Service Centres Medical & health care are indeed one of the most important and diversified services that are provided. These services are easily available and accessible too. The government makes constant efforts to provide preventive and curative measures to its subjects through these services. The future course of action of all the above organizations and institutes is very heartening. Now the task is to see whether these achieve what they have aimed for.

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