Wednesday, 20 April 2011


It's been a while since I've done OBGYN -- in fact, I haven't delivered a baby since January of 2010.  So it is refreshing to have a chance to be in the ob clinic and hone in on my pregnancy knowledge (even though I won't really use it in the future too often, I think).   The preceptor that Steph, Anjoli, and I have for OB is great; she's a very competent, straight-forward, and medically open-minded physician that has been very pleasant to work with.

I asked her, on our second night there, how her billing system works.  Surprised I was to learn that she was going to answer that question quite literally, quite exactly.  For example, it costs 200 rupees for a consultation (5 dollars) and any repeat consultation within a 10-day span is free.  This does not apply to any emergency consultations at the middle of the night, which are totally acceptable by her perspective, as she lives in her clinic and she is virtually available 247 for emergencies.  Then when she told us about the cost of deliveries (birthing, babies, ... not pizza) I was stupefied.   Assistance in a spontaneous vaginal delivery is 15000 rupees (300 dollars).  Cesarean section is 25000 rupees (500 dollars).  That is the total cost for each of those events -- her patients aren't going to get a separate bill for the hospital fees or for the anesthesiologist (patients at her clinic don't get epidurals as the additional financial burden would become too much).  I'm not sure what type of anesthesia she does for the c-section, but I will ask tonight.   Her patients are expected to pay at the time of their consultation, or, in the event of a delivery, at the time of discharge.    How radically different is this from the US model of health-care??   I understand that the operating costs and overhead between the two models are not comparable -- however, I find it remarkably less stress-provoking to think of a model where the physician dictates the price of his/her services, not some middle-man insurance company who has no concern about the patient or the physician's well-being.

In non-medical news, we went out for lunch today -- and it was delicious.  Biryani, hot and sour soup, and vegetable kofta in manchurian sauce.  Only to be completed later in the day with some Baskin Robbins; it tastes as good here as it does at home, and probably even better due to the fact that it was scorching hot today.

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