Corporate Medicine


I suppose it had to come: The corporatisation of medicine. One by one, the business world seeks new areas to target, devour and bring within its fold. As a corollary, it will subsequently dictate norms to be followed and introduce its own standard corporate practices. It will increase efficiency while reducing flexibility. It will bring in technology and kick out familiarity. It will increase capital, set targets and seek returns. And one more independent will bite the dust.

We have seen it happen before. To mom-and-pop grocery stores for example, or the neighbourhood bookstore. They used to be everywhere, always with their special niche role to play. Then department stores came thundering in, then supermarkets and hypermarkets with their bulk buying, their reach and their discounts. They changed the rules of the game. And bang! The corner store all but disappeared in a puff of smoke.

But coming back to the ‘noble’ profession, as we were once taught it was, how noble is the medical world now? Have time and attitudes converted it to a profession like any other? Like an architect or a banker or a real estate tycoon? How does being ‘noble’ fit in with today’s corporate world, with its numbers, cash flows, quarterly results, management compulsions, bonuses and the relentless pressure from shareholders to meet expectations?

There are benefits, undoubtedly. There is increased capital, which can buy better equipment, incorporate new ideas and access better research. It can bring in economies of scale. It can facilitate branding and allow for expertise and the professional touch. Along the way it brings in specialisation, and increased dependence on technology, both of which, I suppose, can cut both ways.

I don’t know if mine has been a particularly unhealthy family or if it’s only a coincidence, but we have always had wonderful doctor friends. I remember the times when doctors were the equivalent of mom-and-pop stores. They catered to their neighbourhood, they developed personal relationships with their patients and had both the time and inclination to make house calls whenever necessary. Some readers might recall the archetypical and revered Bollywood doctorsaheb who always wore white and carried a natty, black briefcase.

Sometimes I wish we could go back to that era. Why can’t doctors be more accessible? Shouldn’t the medical system allow the elderly to be treated at home? What is the point of advancement in medicine if a person who has difficulty walking needs to be taken to a hospital on a wheel-chair and in an ambulance every time a doctor has to be met? The answer probably lies in numbers. The world has advanced not just in medical research, but also – perhaps even more so – in population. We have almost doubled in the last 50 years, adding over three billion people.

The number of years it takes to become a doctor has increased and so has the number of diseases they need to treat. A few diseases have actually got eradicated, but several new complications have surfaced. Perhaps the unfortunate truth is that the only way that the existing pool of doctors can cope with the growing numbers is by simply treating patients as just that – numbers. It is a scary thought.

In many cases, especially in the world of ‘corporate’ hospitals, that is precisely what is happening. Particularly in developing countries with a fast growing population, the demands on doctors’ time and the pressure on them to meet and treat is so much that a patient is often just the sum total of laboratory numbers and reports. The prohibitive cost of medical studies and the difficulty in getting admission into reputed medical colleges puts immense pressure on young doctors to recoup their cost. Is it any wonder that deals between GPs and specialists and even pharmacies are rampant in some countries?

As corporatisation spreads its wings, it is unlikely to bow down to the influences of social good or personal relationships. Corporate giants have already taken over much of the food industry. They have brought in mass production and standardisation. Processed foods and genetically modified foods have substantially replaced natural foods. Organic foods which come from the earth have now started costing the earth. Having got food in their bag, corporates have now set their eyes on water. I see corporatisation spreading to other fields as well – education for one – seeking control and profits. Any commodity considered essential will naturally attract corporates in search of higher returns.

Capitalism is on a roll. Till when? I wonder.

-the writer is the author of Corporate Carnival and Jack Patel’s Dubai Dreams

-courtesy: the Khaleej Times