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Hospitals & HealthCare

1. Introduction To Hospitals 3.
2. Health Care Sector - Analysis 5.
3. Medical & Health Care Service .
!. Pest Analysis
"olitical #.
$cono%ical &.
Social '.
Technolo(ical 1).
*lo+al 12.
5. Accreditation o, Hospitals 1!.
. Models o, Accreditation 1.
#. SWOT Analysis
Stren(th 1&.
-ea.ness 1'.
/pportunities 21.
0pco%in( Trends 22.
Threats 25.
&. Types /, Hospitals 2.
'. Se(%entation 2'.
Marketing Mix
1)."roduct 31.
"roduct Mi1 33.
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2lo3er o, Service 35.
4uality 5i%ensions !1.
11. "lace !!.
12."rice !.
13."ro%otion 55.
1!."eople #.
15."hysical $vidence #).
1."rocess #2.
6lue "rintin( #!.
Service $ncounter #&.
2ish 6one &).
Service 7ecovery &3.
1#.2uture "rediction & Analysis &5.
1&.-ellness Industry &'.
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Until the early 1980s, Governmentr!n "os#$tals and those operated by
%"ar$ta&le or'an$(at$ons were the main providers of subsidized healthcare.
However, the last t)o *e%a*es have seen the mushrooming of %or#orate
an* #r$vately r!n "os#$tals+
The corporate hospital sector is most evolved in the south while
charitable/trust hospitals proliferate in the west. However, the north and east
are also showing a growing trend in private hospital expansion.
Previously hospitals were set up as charitable institutions to tae care of the
sic and the poor. Today it!s a place of diagnosis and treatment of human ills,
for the training research, promoting health care activities and to some extent a
center helping biosocial research.
"orld Health #rganization $"H#% states that hospitals are so%$ome*$%al
or'an$(at$on whose ,!n%t$ons are&
Patient services and
Training of health worers in biosocial research.
(ndia!s healthcare sector has made impressive strides in recent years. "ith
time the classes and )uality of hospitals have changed a lot today. *ost
hospitals today are trying to #rov$*e all !ltra ,a%$l$t$es and are in the
process of maing state o, t"e art "os#$tals. Hospitals provide the
infrastructure facility to healthcare. +arlier hospitals were thining inline of
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prolonging the duration of patient!s stay. ,owadays they are going for a
higher patient turnover ratio.
- hospital offers considerable advantages to both patient and society. -
number of health problems re)uire intensive medical treatment and personal
care, which normally can!t be available in a patient!s home or in the clinic of
the doctor. This is possible only in a hospital where a large number of
professionally and technically silled people apply their nowledge and sill
with the help of world.class expertise, advanced sophisticated e)uipment and
The excellence of hospital services depends on how well the human and
material resources are utilized to promote patient care. The hospital is not an
entity in itself. Today, the hospital is a place for the diagnosis and treatment of
human ills and restoration of health and well being of temporarily deprived
patients. The first and the foremost function of a hospital is to give proper care
to the sic and in/ured without having social, economic and racial
However, the hospitals must perform many more things in addition to the
patient care. The education and training of doctors and nurses, support to
medical research and assistance to all activities carried out by public health
and voluntary agencies to prevent diseases and further to promote health
attitude are some of the important services of modern hospitals.
The essential function of the hospital in the (ndian context is to cater to very
large masses of people by providing comfortable conditions for various users.
This necessitates creation of a system which encompasses patients, doctors
and nurses in a synergetic totality. The applications of mareting strategies
insist on the development of product or services of the hospitals against the
bacground of changing environmental conditions. Hospital planning in the
(ndian condition reflects re)uirements and comforts of (ndian masses. The
mareting management of hospitals diverts one!s attention on the planning
and development of the product in the (ndian environment.
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Healthcare is one of the most essential services in any growing society.
Propelled by an affluent and health conscious growing middle.class, the
healthcare industry in (ndia grew by more than 01 per cent per annum in the
last decade. (ndia!s healthcare industry is estimated at Rs 1,000 &$ll$on or
US1 23 &$ll$on+ This wors out to US1 23 #er %a#$ta which is 4 #er %ent o,
Healthcare statistics state that (ndia has&
2,31,433 doctors
5,15,333 nurses
067 medical colleges
081 pharmacy colleges
1,23,333 chemists
02,345 hospitals accounting for 9,53,060 hospital beds
There is an extensive three.tiered government healthcare infrastructure
comprising of&
71,333 Primary Health 'entres$PH'%
0,15,333 sub.centres $serving the semi.urban and rural areas%
1333 'ommunity Health 'entres$'H'%

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There are four types of facilities& primary health centers and rural
hospitals, government hospitals, private hospitals, and teaching institutions.
The %entral an* t"e state 'overnments are ma/or players in this sector,
running hospitals, nursing homes, medical/nursing/paramedical colleges and
medical insurance. - large ma/ority of the population, particularly in rural and
semi urban areas, receives free or highly subsidized treatment in such
hospitals and health care centres.
Pr$vate se%tor investment in the sector was opened up in 0491, to bridge the
huge gap between demand and government.owned healthcare services. :ince
then, the private sector has grown significantly and presently accounts for ;s
643 billion, nearly 93< of healthcare expenditure. There are almost 4233
private hospitals and nursing homes in (ndia, ma/ority of them located in
ma/or cities, some of them e)uipped for providing the most modern state.of. technology and e)uipment. However, more than 13< of the national
bed strength is concentrated in 023.odd corporate hospitals. (mportant names
in the private sector are +scorts, -pollo Hospitals, *ax Health 'entre, =ortis,
and "ochardt> several foreign healthcare chains have technical/financial tie.
ups with (ndian private healthcare chains.
The health care services $excluding pharmaceuticals% maret is estimated to
be growing at the rate of around 06 percent annually.
There are certain industries that directly affect and are directly affected the
status of healthcare in the region.
They may include&
0. Technology and +)uipment
7. ?rugs and Pharmaceuticals
1. ?iagnostic laboratories
8. *edical (nsurance
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The @overnment of (ndia places to# #r$or$ty to "ealt"%are in the
national agenda. (t is very serious about encouraging indigenous ;A?
and creation of human capital. The imminent %"an'es $n In*$an la)s
and #ro%e*!res relat$n' to re%o'n$t$on o, $ntelle%t!al #ro#erty
an* ,ore$'n $nvestments will allow global pharmaceutical and
biotechnology companies to set up partnerships with (ndian
"ith the se%on* lar'est #o#!lat$on in the world and a "$'"
$n%$*en%e o, *$sease, healthcare is being accorded priority by the
@overnment of (ndia and individual state governments.
- study of Government P!&l$% Healt" e9#en*$t!re $@overnment,
both 'entral A :tate . spending on healthcare is 0.5< of @?P% reveals
that only 06< is allocated to primary care and 98< is allocated to
secondary A tertiary care.
Bast year, the finance minister announced a list of $n%ent$ves ,or
#r$vate "os#$tals to create and upgrade infrastructure, as well as
reduce their operational costs&
0. Ta9 so#s to financial institutions lending to private groups setting
up hospitals with 033 or more beds.
7. In%rease $n t"e rate o, *e#re%$at$on from 72 percent to 83
percent for life.saving medical e)uipment.
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The =?( policy of (ndia is not up to mar. The 033< =?( route is not
opened in (ndia. (f the ,ore$'n "os#$tal wants to o#en $ts "os#$tal in
(ndia, then the only way it can do so is v$a :o$nt vent!re. Cecause of this
not many foreign players are interested to invest in (ndia.
The (ndian healthcare maret is e9#e%te* to 'ro) by around 01 per cent
per annum for the next six years.
(t is pro/ected as the next boom in the country after the (T euphoria.
The amount of hospitals in (ndia is very less when compared to the other
developed countries. +ven the urban areas do not have enough medical
facilities. (t is better not to tal about our rural consumers, where one
village at an average has one doctor only and the doctor is not very well
The country la's &e"$n* $nternat$onal stan*ar*s on basic healthcare
infrastructure and facilities. (ndia has 93 &e*s #er 100,000 #o#!lat$on
as compared to the "H# norm of 222 &e*s #er 100,000.
(ndiaDs healthcare industry is estimated at ;s 0333 billion $E 08 billion%. #f
this, pharmaceutical accounts for ;s 733 billion $E7.9 billion%. -s per some
estimates, ;s 092 billion $E7.6 billion% is spent on healthcare annually.
Public and private health expenditure is 01< and 95< respectively. Health
insurance is extremely marginal as indicated by F#ut of PocetF expenditure
percentage of 98.6<.
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'ertain percentages of beds have to be ept for poor people. +.g. in
Combay 73< of beds has to be ept reserved for poor people whether it!s a
private or public hospital.
Boo after the needs of local poor people.
#pen counseling and relief centres.
Teach hygiene, sanitation among the poor masses.
:afe disposal of hospitals wastes lie used in/ection needles, waste blood
etc. and taing due care of environment.
:preading awareness about various diseases through campaigns and free
medical chec ups.
(n brief the social aspect of hospitals industry is to see that latest treatment
and medicines are available to people at large at concessional rates or free
of cost and that its activities are not only restricted to rich people.
The people in (ndia *o not ava$l o, t"e "os#$tal ,a%$l$t$es very soon. This
is because of the "$'" %ost related to it. However this may all change
because of the increasing deployment of third party payment either in the
form of *edical and -llied (nsurance, or in the form of reimbursements
from the :tate. The people are now taing more to the hospital facilities.
This in turn will increase the employment opportunities to many people. -
study by ,#:U hospital consultants revealed that the hospital industry shall
employ a large proportion of the silled wor force. (n fact the Healthcare
(ndustry is poised to become the biggest +mployer in all 'ountries.
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The hospital is on the threshold of a ma/or @rowth :piral which shall
assimilate all new technologies to provide cost effective Healthcare. (t shall
also be the biggest consumer of all new technologies.
(nnovations such as computer based hospital information systems, medical
records> decision support systems, health information networs,
telemedicine, real time image transfers and newer ways of distributing
health information to consumers are beginning to affect the cost, )uality,
and accessibility of health care.
The technologies today can support vast databases, networ
communications, )uic distribution and reliable image transfers. The easy
availability of Healthcare related information is changing the traditional
relationship between the ?octor and the patient.
+mployment of *icroprocessor Technology to develop implantable devices,
which can be monitored with the remote sensors. Healthcare providers in
supporting various physiological defects shall use these devices.
- greater degree of employment of 'PU driven Technology, supported with
artificial intelligence, in treating or managing various physiological defect.
- greater degree of employment of ;obotics Technology in #perating
;ooms to provide precise and less traumatic as well as less destructive
:urgery $;obotics *
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- greater degree of employment of ;obotics Technology in Baboratory along
with traditional technologies to provide automated and precise diagnostic
- greater degree of employment of B-:+; Technology, in and outside of,
#perating ;ooms to provide precise and less traumatic as well as less
destructive :urgery.
?evelopment and deployment of instrumentation in *edical A :urgical
Practice which shall be based on capturing data on real time basis and
providing necessary electro.physiological interventions or Cio.chemical
interventions. This shall affect both . normal physiology and pathological
?evelopment and deployment of cultured tissues for control of vital
Ciological processes.
+mployment of (nformation Technology tools for networing of +xamination
;ooms, Treatment ;ooms, #perating ;ooms and ?iagnostic ;eporting
+mployment of (nformation Technology tools along with *icroprocessor
Technologies and modules of $-rtificial% (ntelligence for remote
maintenance of +)uipment and other instruments thereby enabling
development of remote controlled instrumentation for control of
Physiological A Pathological Processes.
?eployment of (nformation Technology tools for generation of specific
disease related ?atabases, classified by a number of variables.
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The healthcare sector is among the most rapidly growing services in the
world economy, est$mate* at 13 tr$ll$on yearly in the #+'? countries
The sector has seen new and rapidly evolving forms of %ross&or*er
transa%t$ons, spurred by factors as wide.ranging as technology,
demographics, costs, sills, growing private sector participation, natural
endowments, culture and geography.
@lobalisation of healthcare is also evident from the 'ro)$n' ,ore$'n
e<!$ty #art$%$#at$on $n t"$s se%tor and establishment of :o$nt vent!res,
all$an%es an* mana'ement t$e!#s amon' %are esta&l$s"ments,
resulting in the transfer of technology, sills and practices.
=inally, there is t"e 'lo&al movement o, *o%tors, n!rses an*
te%"n$%$ans, and the resulting networs of healthcare professionals that
are sources of investment and now how.
(nvestment flows into developing countries and the setting up of state.of. healthcare establishments there will attract overseas patients for
)uality care at low cost. "hich may, in turn, be supported by tele"ealt"
serv$%es an* %ross&or*er movement o, "ealt" #ersonnel+
(ndia also has #otent$al to e9#ort tele"ealt" serv$%es within the region
and is emerging as a base for outsourcing of clinical trials, ethical and
regulatory issues aside.
(ndia!s importance as a 'lo&al s!##l$er o, me*$%al #ersonnel to
developing and developed countries is long standing.
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(ndia is also emerging as a source of ,ore$'n *$re%t $nvestment =8DI> in
health services, as shown by the regional expansion plans of ma/or players,
such as the -pollo group.
However, (ndia "as &arely ta##e* $ts tr!e #otent$al in the global
healthcare maret. #nly 2< of all patients treated at reputed hospitals lie
+scorts are foreign, compared to 72< at e)uivalent Thai hospitals.
(nade)uacies in supporting infrastructure, e)uipment, supplies and
domestic regulation, lac of recognition of (ndian medical )ualifications and
disparity in standards of training and )uality remain ma/or constraints.
@lobalisation of our healthcare system can yield many benefits, including
$m#rove* <!al$ty an* stan*ar*s and more money for investment in the
Cross&or*er e9%"an'e o, #ra%t$%es, ?no)"o), an* te%"nolo'$es,
resulting from the flow of capital, consumers, health personnel and
information, can help in raising standards and the )uality of domestic
'oncerns have been voiced about the possible t)ot$er$n' an* %ream
s?$mm$n' e,,e%ts o, me*$%al to!r$sm and =?( on the domestic
healthcare system. -nd possible a*verse e,,e%ts on costs, resource
allocation and e)uity within the system. #ne has to assess their true cause.
This growth of Healthcare (ndustry shall be supported by Pol$t$%al @$ll and
So%$al Un*erstan*$n' at all levels of any :ociety. (t must, therefore, meet
the new challenges, by providing cost effective
Healthcare in a manner that improves the Guality of Humane Bife.
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AN O7-R7I-@
Health services in many developed countries have come under severe
scrutiny in recent years. Positioned against the bacdrop of
globalization, there is an intense move towards accreditation of health
Accreditation of hospitals is a voluntary process by which an
authorized agency or organization evaluates and recognizes
health services according to a set of standards describing the
structures and processes that contribute to desirable patient
-ccreditation can be understood as an indicator of professional
achievement and )uality of care. -ccreditation is opposed to licensing or
regulation of healthcare facilities, which is usually mandatory and state.
-ccreditation is not new to the health system. The first initiative towards
accreditation was taen in the United :tates of -merica as early as
0403. #ver a period of time after several experiments, the Hoint
'ommission on -ccreditation of Healthcare #rganisation $H'-H#%, a
national accreditation programme, established itself as an esteemed
accreditation body by 0495. H'-H# has high standards of )uality
assurance and rigorous process of evaluation, which maes it a much.
esteemed agency for accreditation. Health services certified by H'-H#
are given Ideemed status!.
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(n (ndia, accreditation of the health services has never been a
serious issue though some feeble attempts have been made to
evolve a voluntary accreditation system in the late eighties and
early nineties interestingly coinciding with the BP@ $Biberalisation,
Privatisation, and @lobalisation% reforms.
The attempts made by the (ndian Hospital -ssociation $(H-% at
both *umbai and ?elhi is worth mentioning. Their efforts were
not well received as the initiative did not involve the various
staeholders and had moved with predetermined standards of
evaluation, membership fees and assessment mechanisms.
(n (ndia, the initial premises of introducing accreditation were
based on the overall ob/ective to ensure the )uality of care. The
Cureau of (ndian :tandards $C(:% had laid down standards for
hospitals having 13, 033 and 723 beds. The ,ational (nstitute of
Health and =amily "elfare $,(=H="% had such rules laid for more
than 23.bed hospitals and only for e)uipment. *ost of the
standards laid down by both C(: and ,(=H=" were criticized for
having an urban bias.
There have been attempts in some states to institutionalize
uniform standards for hospitals. (n *aharashtra, the government
hospitals follow the Hospital -dministration *anual. The -ndhra
Pradesh Jaidya Jidhana Parisad has laid down standards for
secondary.level hospitals in the government sector, which comes
under it.
-part from this some efforts have been made by consumer
bodies, groups of health professionals, hospital organisations and
non.governmental organisations to evolve standards for
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-ccreditation across the globe followed three models.
The ,$rst mo*el of assessment gives priority to standards related to
available facility norms, e)uipment re)uirements, human resources and
space specifications. Here, the criterion of accreditation is based on the
availability of basic health facilities.
The se%on* gives importance to )uality assurance and sets standards
for those institutions striving to arrive or improve )uality of care, hence
accreditation is based on satisfying some basic indicators of )uality and
involves raning based on levels of )uality.
The t"$r* mo*el is based on the ground that health systems should be
accessible and acceptable to health.seeers. (t gives importance to the
health.seeer with an emphasis on evaluating health systems from
indicators such as user.friendliness, providing information to users
about the services available, setting up procedures for redressing
grievances, etc. (n the third model, the criterion of assessment is
explicitly geared towards people.centric indicators and brings
accountability of the health system to the health.seeers to the table.
"ith each model, the criteria of accreditation changes.
-t the threshold of globalization and increasingly opening.up of the (ndian
health sector, attempts are being made at various )uarters to draft systems of
accreditation. There are certain points, which cannot be missed. "hat does
accreditation mean for (ndiaK The answer to this )uestion would help us to
now which model can be adopted for accreditation of hospitals in (ndia.
(f it follows the ran?$n'mo*el based on <!al$ty o, serv$%es provided,
accreditation will have very little to contribute to the improvement of the
overall health system in (ndia.
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(n contrast, the ,a%$l$tys!rvey mo*el can be partially pertinent in putting in
place the basic facilities re)uired for providing care.
The most relevant model of accreditation for the (ndian health system is the
#eo#le%entr$% mo*el, which would ensure the presence of -cceptability,
-ccessibility, and -ccountability.
The accreditation process should begin with minimum or moderate level
standards and, over a period of time expand to higher, LidealM level standards
and should be achievable by local public health agencies regardless of size
provided that they conduct the essential services of public health.
:tate and local accreditation programs should coordinate with and conform in
essential ways to a national accreditation program to eliminate possible
duplication and conflict. To succeed in bringing about a perceptible change in
the delivery services of the health system and to go beyond mere an
survey and awarding certificates, any accreditation programme should address
all the dimensions of healthcare.
(ndiaDs independent credit rating agency ';(:(B has assigned a grade
- rating to super specialty hospitals lie -s%orts and multi specialty
hospitals lie -pollo.
,H: of the UN has indicated that (ndia is a favoured destination for
The Critish :tandards (nstitute has now accredited the ?elhi.based
+scorts Hospital.
-pollo @roup . (ndiaDs largest private hospital chain and +scorts
Hospital are now seeing certification from the U:.based Hoint
'ommission on -ccreditation of Healthcare #rganizations.

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(ndia!s healthcare sector has made impressive strides in recent years. (t
has transformed to a U:O 05 billion industry and is surging ahead with an
ann!al 'ro)t" rate o, 12A a year+
(n the last five years, the n!m&er o, #at$ents v$s$t$n' In*$a for medical
treatment "as r$sen from 03,333 to about 033,333.
"ith an annual growth rate of 13 percent, (ndia is already inching closer to
:ingapore, an established 5e*$%are "!& that attracts 023,333 medical
tourists a year.
Hospitals in (ndia boast of conducting the latest s!r'er$es at a very lo)
The healthcare industry em#loys over ,o!r m$ll$on #eo#le, which maes
it one of the lar'est serv$%e se%tors in the economy.
(ndian specialists have performed over 233,333 ma:or s!r'er$es and over
a million other surgical procedures including cardio.thoracic, neurological
and cancer surgeries, with s!%%ess rates at #ar )$t" $nternat$onal
The <!al$ty o, "ealt"%are "as $m#rove* considerably with the
availability of world class medical e)uipment and information
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(ndia has #oor so%$al se%tor indices, given the high population of the poor,
a%!te la%? o, me*$%al ,a%$l$t$es in the lesser.developed parts of the
country, and a la%? o, #!&l$% ,!n*s to provide ade)uate medical care and
attention to the entire population.
In*$aCs health expenditure is 0+4 #er %ent of @?P, whereas most
esta&l$s"e* mar?et e%onom$es s#en* D10 #er %ent of @?P on health.
U:- spends over 08 per cent.
Lo) *o%tor#at$ent rat$o& U: has 7,183 doctors as compared to (ndia!s
081 doctors for very 03,333 people.
L$,e -9#e%tan%y $n In*$a is amon'st t"e lo)est at 22.2 years
compared to U: at 52.2 years and 66.2 years for Thailand. #n an average,
93 out of every 0,333 children die. This figure is /ust 4 in the U: and 13 for
every 0,333 in Thailand.
H$'" *e#os$t ,ees and "$'" %osts of medical services limits itself to high
income level group or is out of reach for common man.
The LI *onCt %areE att$t!*e by the government hospital. =or e.g. 'ooper
5e*$%$ne an* *r!'s ,ra!* by the menials. +ven or'an sell$n' by
doctors to mae more money.
Com#le9 and lon' a*m$ss$on #ro%e*!re for admission, which can
sometimes be fatal.
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The common men and poor men are completely at the mercy of the
over%ro)*e* 'overnment "os#$tals and *$s#ensar$es.
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-t the current pace of growth, "ealt"%are to!r$sm alone can rae in over
O7 billion as additional revenue by 7307. =rom less than 03,333 patients
visiting (ndia for medical treatment five years ago, the medical tourism
maret in (ndia is worth U:O 111 million, with about 033,333 foreign
patients coming in every year.
Joluntary "ealt" $ns!ran%e mar?et is estimated at ;s 8 billion $O96.1
million% currently but is growing fast. (ndustry estimates put the figure at
;s 013 billion $O7.9 billion% by 7332. Hoint ventures for offering medical
insurance and other insurance services is one of the (nvestment A Cusiness
Tra*e $n me*$%al e<!$#ment and #ro*!%ts, including warehousing,
selling and servicing the latest medical electronics e)uipment, diagnostic
its, reagents and consumables.
Teleme*$%$ne systems, for treating patients in remote areas through a
satellite connection.
'orporate health care clinics for providing high )uality basic services in
%ons!ltat$on, *$a'nost$%s, m$nor s!r'er$es et%.
;!s$ness Pro%ess O!tso!r%$n' of medical transcriptions and other
hospital management administration tass.
R6D &ase for new molecule development, clinical trials, etc., utilizing the
high )uality scientific manpower and low costs.
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(t is the next big success story out of (ndia. =rom less than 03,333 patients
visiting (ndia for medical treatment five years ago, the medical tourism maret
in (ndia is worth U:O 111 million, with about 033,333 foreign patients coming
in every year.
Procedure costs
Procedure 'ost $U:O%
:urgery Thailand U: $O% (ndia $O%
Cone *arrow Transplant 67,233 833,333 13,333
Biver Transplant 52,333 233,333 83,333
#pen Heart :urgery $'-C@% 08,723 23,333 2,333 . 5,333
,euro surgery 74,333 9333
#rthopaedic :urgery 73,333 6,333
'osmetic :urgery 73,333 7,333
Hip ;eplacement 6,433 8,233
Hysterectomy 7,307 200
@all Cladder ;emoval 0,522 222
Nnee :urgery 5,333 06,333 8,233
PAll figures in US$. The Indian costs are based on the average rates offered by
top Indian hospitals like Escorts Heart Institute, Apollo and atra Hospital. The
Thailand rates are based on rates provided by urnrungard Hospital, angkok,
!hich is Thailand"s largest private hospital.
:ource& (C+= :yndication :tudies
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@rowing health consciousness among middle and high.income families in
(ndia is heralding a new business opportunity . preventive healthcare.
The addressable population for preventive healthcare in (ndia is
about 063 million. -t current estimates, not more than a million people
may have been covered.
=or hospitals, the preventive healthcare business is attractive. (t allows
them to build long.term relationships, as patients who come for health generally come bac to the same hospital if they re)uire any
Healthcare CP# could potentially be a U:O 8.2 billion opportunity for (ndia
by 7339, offering employment to about 733,333 people.
(t includes offshoring of processes such as medical billing, disease coding,
forms processing and claims ad/udication.
-s healthcare CP# players mature, other businesses lie claims repricing,
medical diagnosis and actuarial wor are expected to gain momentum.
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Telemedicine is a method by which patients can be examined, monitored and
treated, while the patient and doctor are geographically distant.
Potentially, the next big success story in the healthcare sector, several
examples already offer an insight into this emergent opportunity that is
changing the lives of over 633 million people in rural (ndia.
@u/arat& The #nline Telemedicine ;esearch (nstitute $#T;(%
provided telemedicine lins for teleconsultation, thereby
establishing 523 sessions in a period of 13 days in Chu/ after the
earth)uae in Hanuary 7330.
Narnataa& -sia Heart =oundation, Cangalore has successfully
been practising Telecardiology between Cangalore and cities in
eastern (ndia. Paramedics are guided to save patients suffering
from -cute *yocardial (nfarction by performing life.saving
procedures as per doctors! directions over video conferencing.
Tamil ,adu& -pollo Hospital, 'hennai is providing expert opinion
from its tertiary level hospitals in bigger cities to those in far.
flung towns of (ndia. #ver a period of 75 months, over 8,333
patients benefited from teleconsultations and over 52 per cent of
those teleconsulted were treated in their respective cities.
Haryana& Hiva (nternational, a healthcare venture on the outsirts
of ?elhi, is implementing a novel plan that taes medical care
right inside rural (ndia by using a @P;: enabled Hava application
available with ,oia!s 6933 model. The LTeledocM pro/ect won the
"orld :ummit -ward for eHealth, at the "orld :ummit on
(nformation :ociety $":(:% held in @eneva, :witzerland.
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Hospitals & HealthCare
The government is re*!%$n' t"e 'rants given to hospitals, thus maing it
impossible to cater to the poor people.
The !n$ons o, t"e men$als and even *o%tors& they can go on a strie,
disrupting the functioning of the entire health care unit.
Com#et$t$on from other $nternat$onal "os#$tal %"a$ns, which are more,
advanced in technology and better financial support.
The #!&l$% s#en*$n' on "ealt" in (ndia is a mere 3.4< of @?P and the
private spending on health is 8.7<. (ndia rans 050st out of 052 countries
in terms of public spending on health.
@overnment pays more attent$on on a'eol* #ro'rammes lie
tuberculosis, leprosy etc. and less attent$on on ?$ller *$seases Q cardio
vascular, diabetes, obesity and hypertension.
Un#lanne* !r&an$(at$on and ne'le%t o, t"e #!&l$% "ealt" system as
whole has led to the resurgence of water.borne diseases lie hepatitis and
cholera every year. *ore virulent forms of tuberculosis are being seen in
those infected with H(J, which appears to have spread widely in (ndia.
The number of people in (ndia infected with the HI7FAIDS virus has risen
sharply. -ccording to (ndiaDs ,ational -(?: 'ontrol #rganisation $,-'#%,
more than 8.2 million (ndians are infected. H(J/-(?: in (ndia is not only
confined to high.ris groups and in cities, but is gradually spreading into
rural areas and the general population.
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Hospitals & HealthCare
%!m Resear%"
These hospitals are tea%"$n' &ase*. They are found engaged in a*van%$n'
?no)le*'e, promoting the resear%" a%t$v$t$es and tra$n$n' t"e me*$%s+ -s
for example, AllIn*$a 5e*$%al Inst$t!te, Ne) Del"$, PostGra*!ate
5e*$%al -*!%at$on an* Resear%" Inst$t!te, C"an*$'ar", et%+
General Hos#$tals .
The general hospitals also offer teaching and research facilities but these
ob/ectives are secondary. The main ob/ective in the general hospitals is to
#rov$*e me*$%al %are+ -s for example, different medical colleges and district
and sub divisional hospitals lie D/ Pat$l 5e*$%al Colle'e+
S#e%$al Hos#$tals .
The main ob/ective of special hospital is to provide s#e%$al$(e* me*$%al
serv$%es. These hospitals concentrate on a particular organ of the body or
a particular disease. =or eg. T"e As$an Heart Hos#$tal, 5!m&a$+
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Tea%"$n' %!m
Hospitals & HealthCare
Government Hos#$tals &
These hospitals are ,!lly o)ne* mana'e* and %ontrolle* by the
'overnment. They are mainly involved in healing the needy and providing
healthcare to everyone at very affordable rates.
Sem$Government Hos#$tals.
These hospitals are #artly o)ne* &y 'overnment. Time to time government
assistance is provided to these hospitals may in the form of finance.
7ol!ntary A'en%$es.
There are some hospitals which are run and are in control of vol!ntary
or'an$(at$ons they can be of any form i.e. may be general hospitals or
special hospitals or even teaching institutes.
Pr$vate C"ar$ta&le.
These private charitable hospitals are owned and controlled by the
%"ar$ta&le or'an$(at$ons, which are private.
=or e.g. ;amarishna *ission Hospital, *umbai.
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Hospitals & HealthCare
Hospitals can also be classified on the basis of their size. There
are variations in the size of the hospitals.
-s such, the teaching hospitals generally have 233 beds, which
can be increased according to the number of students.
The district hospitals generally have 733 beds, which can be
raised to 133 depending on population.
The teshil / talu / sub.divisional hospitals generally have 23 beds
that can be raised to 033 depending on population.
The primary health centers generally have 6 beds that can be
raised to 03 beds.
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Primary Health
H#*+#P-THR U,-,(
Hospitals & HealthCare
1+ In%ome )$se.
,o income
Bow income
*iddle income
High income
J+ Gen*er )$se.
*aternity hospitals for females.
2+ 8am$ly l$,e %y%le.
'hildcare hospitals.
1. Inst$t!te o, C"$l* Healt" an* Hos#$tal ,or C"$l*ren
2. Center 8or Genet$% Healt" Care
The center is actively involved in @enetic Health 'are of
Unborns, 'hildren and -dults for the last 02 years. =acilities
available at the centre are uni)ue and under one roof.
3+ S#e%$al$(e* "os#$tals.
0. As$an Heart Inst$t!te 6 Resear%" Centre
:peciality Heart Hospital at Candra Nurla 'omplex, *umbai
?ental etc.
0+ On &as$s o, *$sease.
Tuberculosis, T!&er%!los$s Resear%" Centre
'ancer, Geevan Gyot Can%er Hos#$tal
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Hospitals & HealthCare
1+ Ty#e o, %are.
(ntensive care unit
,ormal ward
@eneral ward for chec up
J+ 8a%$l$t$esF%om,ort )$se.
-c room
,on.-' room
?eluxe room
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Hospitals & HealthCare
Notler says a product is anything that can be offered to a maret to
satisfy a want or a need. Products that are mareted include physical goods,
services, experiences, events, persons, places, properties, organisations,
information and ideas.
(n the case of hospitals, different types of hospitals offer different services to
their users. :ome of the hospitals give priority to medical education, training
and research while some others concentrate on medical treatment.
The product of a hospital can be any of the following&
5e*$%al tra$n$n' 5e*$%al
'ardiac :urgery ?entistry Heart diseases
?ental #peration #phthalmology 'ancer
?ermatology ,eurology -ids
T"e ,ollo)$n' $s t"e #ro*!%t )$*t", *e#t" 6 len't" o, L$lavat$ Hos#$tal.
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Hospitals & HealthCare
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:U;@('-B ?(-@,#:T(' -BB(+? ?+,T-B
'B(,('-B '-;+
7A5I/:/*; &
Hospitals & HealthCare
Level 1. Core F 'ener$% #ro*!%t.
This is the basic service product.
(n hospitals, health or well.being by way of the treatment provided by the
doctor to deal with the ailment of the patients is the core product or service.
Level J. -9#e%te* #ro*!%ts.
This is the basic product and minimum purchase conditions that must be met.
(n hospitals, in addition to the core product, all other supplementary services
lie a bed, waiting area, availability of medicines and drugs, meals, hygiene
'ooper Hospital "aiting -rea, Ceds
Bilavati Hospital "aiting -rea,
-vailability of medicines $78
-vailability of Clood Cans, etc.
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Hospitals & HealthCare
Level 2. A!'mente* Pro*!%t.
-long with the basic and expected offering, the service provider needs to
differentiate its services from its competitors.
Bilavati Hospital @reat (nfrastructure,
'ardiac -mbulances,
'entrally -',
Product -ugmentation is not observed much in case of C*' hospitals because
these hospitals are established to provide free $or at nominal rate% services to
the customers. They don!t find the need to differentiate. They are established
as they form a part of the basic infrastructure of the city.
Level 3. Potent$al #ro*!%t.
The potential product contains potentially feasible features and benefits that
play a significant role in holding and attracting the customer. These features
and benefits are useful or liely to be useful to the buyers.

-H(;' Ceds are provided for ('U attendants
free of charge along with other
communication facilities lie internet

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Hospitals & HealthCare
8LO@-R O8 S-R7IC-
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Hospitals & HealthCare
S (n a hospital, providing information refers to maing the patients or the
general public aware of the services and facilities offered by the hospital.
S The customer needs to have some &as$% $n,ormat$on about the service
provider so that he/she can mae a choice between the different service

(n the hospitals the basic information that a customer would re)uire is as
+ The different types of services that the hospital offers. +g&
@eneral, specialized
+ The technologies that are being used.
+ -bout the doctors and their )ualification
+ -bout the visiting doctors i.e. their )ualification, number of times
they visit in a day and at what time, etc.
The tools which hospitals use to provide information are television, internet,
radio, etc.
Dr+ ;atraCs Healt" Care Cl$n$% Q radio advertisements
Bilavati Hospital has used internet as one of its tool to provide information. The
webpage appears as&
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Hospitals & HealthCare
The customer after getting the information may need some help or further
information. The service provider has to find out the customers re)uirements
and develop solution.
The customer may re)uire help regarding the following&
The specialist doctors and their success rate for the ind of
treatment the customer is looing for.
The tie ups with the blood bans in case of emergency.
The prices of the different wards in the hospital
(n any hospital, treatment is provided only after a preliminary chec.up andTor
various test consultation.
,ow.a.days, consultation is also done via internet, .i.e. online consultation or
This petal is of utmost importance. The hospitals can differentiate their service
by way of their consultancies.
,ow.a.days the patient, who is going to undergo an operation, is explained in
detail what he is suffering from A how the surgery is going to be, the post
operation effects A so on.

-t Bilavati Hospital, -sian Heart (nstitute A ;esearch 'entre A many other
hospitals, the surgery or the operation is displayed Bive on the monitor which
can be viewed by the patient!s relatives.
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Hospitals & HealthCare
This refers to the promptness of the service provider in taing the order of the
Promptness should be in the following areas&
+ =ormalities& The paper wor A the legal formalities prior to the admission
must be minimum.
+ -ccommodation& the patient should be given the accommodation as soon as
heTshe completes the formalities.
+ ;esponsiveness& the patient must be attended as soon as he is
-t -H(;', a patient is re)uired to come in with two relatives. This is because,
when the patient enters the hospital, he is either sent to the bed allotted to
him $through prior booing% or to the pathology department if certain tests
need to be carried out. #ne relative accompanies the patient, while the other
relative remains at the admission counter to complete the admission
formalities. This way, the patient is not ept waiting while the admission is
carried out.
"hen a patient has to undergo a surgery or an operation, he always has a fear
that whether heTshe is in safe hands.
Therefore the doctors, nurses, ward boys and all the other employees, who
come in direct contact of the patient, must possess an ability to build trust,
win his confidence A mae him feel that he is in safe hands.
+g& *ost of the hospitals display the success rate of their doctors.
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Hospitals & HealthCare
This is becoming increasingly important in the healthcare sector, particularly in
hospitals as the expectations of people towards medical care are ever
increasing. ,o longer are they limited to only the clinical outcomes but also
involve the delivery process, margin of safety and behavior of personnel.
The -H(;' provides a host of conveniences to patients and their relatives.
Serv$%e to #at$ents.
+ - choice of pacages from twin sharing, single room and deluxe suites are
available to patients.
+ - lot of care has been taen to ensure that the patient does not feel walled
in. =or example, all rooms have natural and indirect lighting with huge
windows and in some cases, terrace gardens. - number of facilities are
provided to the patient such as a television, meals etc. :o as to
mae the room aesthetically pleasing and improve patient mentality $they
are usually depressed%, all medical socets, instruments or attachments are
hidden from view, behind a panel beside the bed.
Serv$%e to relat$ves.
The -H(;' is the only hospital in *umbai that has a separate family waiting
area for relatives of patients in ('U. +ach cubicle in the waiting area has
provisions for sleeping such as a bed, pillows, blanets etc. The reason for
such an arrangement is that , in the ('U cases, one person should be present
in the hospital 78 hours so that he is available to sign the consent form.
Patient number is allotted to the relatives bed and in the case of an
emergency, the relative is immediately called by the secretary in charge.
;elatives also en/oy facilities lie internet connection, a multi.cuisine cafeteria,
prayer rooms, library, public call booths, coffee machines, a gift shop etc.
There is even a travel agency located on the ground floor that caters to the
traveling and sight seeing needs of the visitors $particularly in the case of
patients from abroad%.
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Hospitals & HealthCare
+xceptional service is not what you are expected to give, it!s a ind of service
which you provide to your customers to win customer satisfaction so that he
would be loyal to you A spread good word.
This petal is deformed in case of many C*' hospitals. Private hospitals mae
use of this petal at its best to differentiate their service.
Hospitals should ensure that billing and payment procedures are )uic so as to
enable the patient to return home soon after discharge.-t -H(;', two types of
bills are generated i.e. (nterim bills and =inal bill. The interim bills are
generated to give on a bi.weely basis. They give the patient an idea about
the charge payable for the specified period. (t helps is avoiding any confusion
at the time of generating the final bill.
The final bill is generated at the time of discharge. This considers all the
interim bills and the advance deposit paid.
PA/5-NT &
The norms for payment of the bill must be simple.
0. The payment counter should be easily accessible. The customer
must be able to easily locate it.
7. The mode of the payment should be easy and )uic. The
customer should be able to easily settle the bill and leave.
(f the payment is made by the credit cards, even this must be )uic and
should be on the different counter.
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Hospitals & HealthCare
The ability of the service provider to meet the promises made by them
accurately. The customer must develop a feeling that they can depend on
that particular service provider for their problem.
0. The staff of the hospital has to be very accurate while performing their
/ob. #nly than the customers would rely on them. =or e.g. during
surgery the amount of anesthesia to be given to the particular patient
has to be accurate.
7. The service provided should be such that the customers develop a
feeling of loyalty so that the hospitals get the repeat customers as well
as new customers. e.g. if *r. U goes to Bilavati hospital for the bypass
surgery and the surgery is conducted successfully and he recovers
soon, he would not only become loyal to the hospital but also he will
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Hospitals & HealthCare
narrate the whole incident to many others thereby giving Bilavati more
The service provider and the employees must be capable of winning the
trust and confidence of the customers.
0. The customers can be assured by informing them that the doctors,
nurses, ward boys and the other related staff is competent enough in
providing them their expected level of service.
7. The frontline staffs have to be very polite and friendly to the patient and
the relatives.
1. The patient must develop the feel that he is safe in that particular
hospital. =or e.g. when a patient is brought to the hospital in emergency
he and the relatives must be attended with courtesy and also the
doctors and the nurses must politely tell them, that Lnothing will happen
to the patient, we will try our level bestM and not react with abrupt and
angry statements. His words should sound empathetic and at the same
time consoling.
This includes the ambience, the technologies used, the facilities used to
communicate things etc.
0. The ambience of the hospitals must be gentle and clean. The
technologies used in the hospitals have to be latest or updated regularly.
Cecause now a days people do not buy the product but benefits.
7. The environment of the hospital has to be peaceful. The corridors
outside the rooms should not be crowded. +ven in the visiting hours too
many people should not be allowed at a time.
1. The seating arrangements for the patient who have /ust come for some
tests and the person accompanying him have to be comfortable.
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Hospitals & HealthCare
8. The signboards must be the perfect indicators so that there is no
difficulty for the customer to locate the place, he wants to go to. =or eg.,
in -sian Heart Hospital, the technologies used are latest, the visitors are
given two passes so only two people can go and see the patient in the
visiting hours.
The attitude of the service provider should be caring and if possible individual
attention to each customer should be given
0. The attitude of the doctors and nurses should be concerned. They
should be approachable as and when re)uired.
7. The doctors and nurses must have the ability to understand the problem
of the patient and give the solution accordingly.
1. The doctors must communicate well to the patient and the relatives
about the disease the patient is suffering from.
8. The nurse and the ward boy should be assigned to loo after the
The service delivery should be prompt and up to the mar.
0. The patient should be attended as soon as he comes to the hospital and
registers himself. (n case of emergency he should be attended
7. The nurse should be able to locate the doctor soon if he is needed.
=or e.g. a patient suddenly starts sining or breathing at a faster rate
the nurse should be able to call the doctor immediately. =or this, a good
intercom facility is re)uired.
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Hospitals & HealthCare
=ifty.four per cent delivered their babies without the support of trained
=ifty.eight per cent of children have not completed their immunisation
schedule and 08 per cent have not received a single vaccine.
#nly one in two women sees treatment for illness, usually because
the nearest health service is too far away, or itDs too expensive.
These examples are only meant to illustrate the fact that peopleDs
access to health care is limited by their ability to pay, as well the
availability of services.
The most commonly recognized medical facility is probably the hospital. (n the
past decade, however, the shift has been away from providing all care in the
most expensive medical environment. -s a result, a number of other less
expensive options have developed. There are ambulatory surgery centers,
rehabilitation centers, nursing homes and other residential care facilities,
specialty service centers and home care programs, /ust to name a few.
1+ 5e*$%al %am#s
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Hospitals & HealthCare
They are the most common form of distributing the medical services. These
camps are generally held when there is a calamity. -s we recently saw,
these camps being held at various parts of *umbai, in the aftermath of
the floods of 76
Huly. :uch camps are organized on an even larger scale
when the calamity is of a very high magnitude. +g. The camps that were
set up in @u/arat $ areas of Chu/ A -n/ar% were huge enough to have
several #peration Theatres in them A they accommodate upto 033
patients at one point of time. They are e)uipped with )uite a lot of
e)uipments lie U ray machine, the +'@ etc. they are manned by nurses,
general practitioners, specialists, A other medical professionals.
J+ A$r Am&!lan%es
;ooftop heli.pad is available for the emergency airlifting of patients to and
from the hospital for specialized trauma treatment.
These air ambulances have a crew of up to 2 people, which includes one
specialized doctor, a Para.medical staff, 1 member rescue team. =amily
members of the patient are generally not allowed to accompany him. Though
not very common in (ndia, it!s a regular feature in the hospitals of developed
countries. +ven in (ndia, these emergency services are developed. +g. The
*ade Hospital in *umbai.
2+ Am&!lan%es
-s we all now, they are the most common mode of transport used in moving
in the patients from the place of illness to the hospitals.
3+ 5o&$le 7ans
*obile Hospital and ;esearch 'entre, was flagged off on #ctober 04, 7337 by
His +xcellency ?r.-PH -bdul Nalam, President of (ndia.
(t has been found to be extremely popular A a practical health care model for
The aim has been to bring advancements in modern medical sciences at the
doorstep of the common man, who otherwise would have been neglected of its
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Hospitals & HealthCare
benefits. The pro/ect has been conceived, eeping in mind the specific needs of
remote hilly terrain of Uttaranchal where negligible modern health care is
available to needy and poor people who are staying in far.flung areas of
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Hospitals & HealthCare
The pricing management of a so%$al $nst$t!t$on becomes %om#l$%ate* as the
policy maers are expected to tae social factors into considerations. The
lower sections of society loo forth to free and services, as they are
not economically baced to support their family!s healthcare expenses.
,aturally this /eopardizes the tas of top management. (t is close to impossible
for even the government, specially in an over populated country lie ours, to
mae available world.class services to all without charging any fee. Cut then, it
is also not rational that we expect free services, though we have the capacity
to pay, which is another problem with the middle.income class of the country.
The pricing strategy helps us to #ro:e%t$n' o!r $ma'e. ,ot only this, if the
strategies are welfare oriented, the tas of satisfying the users is also
simplified. Cut the satisfaction depends upon sophistication. -nd sophistication
can!t be possible unless we change our pricing strategies. +ven the affluent
sections of society expect low cost services from social institutions in general
and hospitals in particular the tas of innovating services in line with latest
developments in the field of physical sciences is difficult.
Healthcare services involve the use of expensive and complex machinery,
which involve huge investments. -part from that, the cost of maintaining them
and cost of running the hospital is in no terms cheap. ?octors! salaries along
with the salaries of the nurses and helpers constitute a great part of the cost
too. (n a developing country lie ours, where the level of income of the general
masses is found low, it is significant that pricing decisions are liberal to the
economically weaer sections of the society.
There are a number of )uestions that service mareters need to as
themselves as they prepare to create and implement a well Q thought Q out
pricing strategy.
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Hospitals & HealthCare
(n the (ndian setting where a number of persons are below the poverty line it
is challenging tas to formulate a pricing strategy, which is successful in
serving the social interests and generating profits. (t is due to this that most
government hospitals are in deplorable condition. The ultimate sufferers are
the society and specially the poorer sections. :ince the affluent sections have
an option to avail the expensive medical services made available by private
hospitals. The societal mareting principles mae an advocacy in favors of
protecting the public interests but it is not meant that the hospitals have a
uniform pricing/free structure for all the users. T"e ,ee strate'y ,or
"os#$tals s"o!l* &e $n #ro#ort$on to t"e $n%omes o, !sers, )"$%" )o!l*
en'$neer a so!n* ,o!n*at$on ,or <!al$tat$ve or <!ant$tat$ve
=or social institutions lie govt. hospitals a discriminatory fee structure is
preferred since it provides even the weaer sections of society, an opportunity
to avail the )uality medical services. This enables hospitals to innovate
services to eep pace with the latest developments in medical sciences.
0. 8ree serv$%e. @enerally speaing, all categories of hospitals should
adopt services to the weaer sections of the society having no
so!r%e o, $n%ome for paying even the nominal charges. (n this context,
the government hospitals should be given special grants to avoid an
imbalance in their financial management.
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Hospitals & HealthCare
7. S!&s$*$se* serv$%es. The users belonging to the lo)$n%ome group
should be made available subsidized services. That is, the public or
hospitals mae nominal charges for the services made available to
them. (t is more or less clear that subsidized services are a bit lower
than the cost involved on treatment. Coth the central and state
governments would give the subsidies.
1. Cost&ase* Serv$%es. This is based on the principle of no.profit, no.
loss. #r say, the cost based strategy in which prices or fees are e)ual to
the costs involved on treatment. This is basically for the m$**le
$n%ome group.
8. Cost #l!s S!&s$*y. This strategy allows charging more than the costs
involved on the services, but only from the &ettero,, se%t$ons of
society. The transfer of these surpluses to the account of subsidy for
compensating the losses on account of providing free or subsidized
services to the weaer sections and low.income group users is also
- !' -
*overn%ent Hospitals
<2or 9o Inco%e (roup=
<2or :o3 Inco%e (roup=
Hospitals & HealthCare
0. 7.
1. 8.

#n one hand, it is /udicious that no discrimination is found in respect of
maing available the medical aids, but on the other hand, we can!t adopt
uniform policy while maing available to the users and their attendants other
facilities lie standard of room, indoor facilities and other non medical
This is /ustified on the ground that all groups are not paying e)ual fees for
availing their services. *oreover when no income group has been availing the
services without paying any fee, their expectations would not be more than the
proper medical aids.
-t Coo#er Hos#$tal all the patients are not charged. #nly those who can
afford to pay would pay others can pay whatever they can or pay nothing at
- 5) -
C/ST > :/SS$S 27/M 2
<Middle Inco%e (roup=
C/ST > S07":0S T/
MA?$ 0" TH$ :/SS$S
/2 1.
<Hi(h Inco%e (roup=
Hospitals & HealthCare
(t is difficult to offer free or subsidized services to the masses. #n the other
hand, the technological sophistication has raised the cost of services as the
inputs used in maing available the medical services are found costly due
to rising inflationary pressure.
Thus private hospitals tae the following approaches to pricing&
1+ Cost ;ase* Pr$%$n'.
D$re%t #r$%e O over"ea* %osts O #ro,$t mar'$n+
This approach involves setting prices relative to financial costs. The
hospital sets a price sufficient to recover the full costs $variable, semi
variable A fixed% of providing the service. These ads a sufficient margin
to yield the described level of profit at the predicted sales volume.
Hospitals generally incur high fixed costs due to expensive physical
(n hospital services, this method is cumbersome because the tracing A
identification of costs apart from doctors fee, is difficult.
(n spite of this, some hospitals in the private sector do follow this
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Hospitals & HealthCare
J+ Deman*F7al!e ;ase* Pr$%$n'.
This involves settling a price consistent with the %!stomerCs
#er%e#t$on of service value. That is, prices are based on what
customers will pay for the services provided.
Hospitals with a reputation for high )uality successful treatments etc.
can A do charge a premium simply based on the sheer perception of
)uality health care. Those who can afford are generally willing to spend
high amounts on )uality care.
However there was a case during the out brea of leptospirosis , when
the was a huge re)uirement of white blood platelets they were not
easily available in the city. -s a result its charges rose from ;s.723. 133
to ;s.0333S deposit of ;s. 633
2+ Relat$ons"$# Pr$%$n'.
Hospitals may undertae relationship pricing with regard to corporate
clients so as to develop A maintain long.term customer relationships.
Here the hospital offers company!s o n treatment of its employees over
a period of time.
3+ Com#et$t$on &ase* #r$%$n'.
Using other price as an anchor for the hospitals price, heterogeneity of
service across and within providers maes the approach complicated.
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Hospitals & HealthCare
Pricing in hospitals may be based on the following&
0. T$me &ase*. (t is based on the time of use. =r example& (n case of
an admission the duration of the patients stay is un predictable, so
rooms may be charged on a daily basis. (n -H(, the rate of a suit is
;s.2233 /. per day.
7. 7al!e &ase*. it is based on the value or the importance of the
service. (n case of consultation with a doctor or out patients, doctorDs
fee may reflect till expertise or be tied to the complexity of the
diagnosis etc.
1. 8lat rate &as$s. This is charging flat/ standard rates for some
services. -gain, there may be flat rates assigned to various
treatments for example& charges for an U. ;ay, +'@ A so on.
-t ;rea%" Can*y Hospital on admission, an $n$t$al *e#os$t is collected
at the in.patient billing counter. The amount depends on the category of
room and the treatment / surgical procedure planned.
The doctors are paid salaries by the hospital as per the hospital
norms whereas the v$s$t$n' *o%tors *e%$*e t"e ,ees $n %ons!ltat$on
)$t" t"e #at$ents and only 03< of this fee is retained by the hospital.
-ll the billing transactions are done through the hospital.
Jarious categories of rooms ranging from a shared room to the deluxe
suite are available.
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Hospitals & HealthCare
;oom 'harges and ?eposits at Creach 'andy Hospital&.
;oom 'ategory Tariff $;s.% ?eposit $;s.%
?eluxe 8,233 83,333
,ew wing 8,733 83,333
:ingle ;ooms $"est% 1,333 13,333
:ingle ;ooms $+ast% 7,233 72,333
:ingle ;ooms $:hared Cath% 0,233 73,333
?ouble :hared ;oom 0,133 73,333
,on Q -/' :ingle ;oom $:hared
0,733 73,333
;oom 'ategory Tariff $;s.% ?eposit $;s.%
?eluxe *aternity 8,233 73,333
:ingle ;oom $"ith -ttendant 'ouch% 1,233 73,333
:ingle ;oom 1,733 73,333
:ingle ;ooms $:hared Cath% 7,833 73,333
?ouble :hared ;oom $:hared Cath% 7,733 73,333
:hared ;oom $:hared Cath% 0,133 73,333
Babour ;oom 0,933
;oom 'ategory Tariff $;s.% ?eposit $;s.%
:urgical 2,333 83,333
*edical 2,333 83,333
,eonatal 0 1,233 12,333
,eonatal 7 7,733 13,333
High ?ependency Unit 1,733 13,333
?ay 'are 433 73,333

'ategory -mount $;s.%
0. a% #utside patient. for case paper
b% 08 days after for re.checing
7. a% Bight checing
b% +.'.@
1. a% Ultra sonography ;s.033
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Hospitals & HealthCare
b% (f they need the imaging film ;s.23
8. +.+.@. . brain 'hecing for
2. +xtra special :urgery ;s.2333
6. :pecial :urgery ;s.233
5. ,ormal :urgery ;s.733
Cuoyed by corporatisation of healthcare, (ndia!s promotion as a sought after
medical tourism destination and threatened by the mushrooming of new
hospitals, it is becoming difficult for hospitals these days to depend on mere
word of mouth promotion to attract patients.
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Hospitals & HealthCare
The 'ode of *edical +thics of *edical 'ouncil of (ndia says that a doctor
cannot solicit business by advertising, but nowhere does it mention that a
hospital cannot advertise.
Hospital managements are putting extra effort in carving a brand image of the
hospital and improving hospital!s visibility. (n other words, many would agree,
that hospitals mareting has evolved from being subtle to aggressive.
@enerally a lot depends on the brand name of the hospitals. "ell.established
hospitals all ready have a brand name lie Creach 'andy hospital, Bilavati
hospital. These are well.established hospitals nown for their excellent service.
They are distinguished by their services provided. - few of the used promotion
methods by hospitals are as follows&
=a> Personal sell$n'.
This involves an immediate and interactive relationship between two or more
;!s$nessto&!s$ness mar?et$n'.
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Hospitals & HealthCare
Hospitals usually resort to personal selling for &!s$nessto&!s$ness
mareting. Coth in the case of corporate and approaching doctors for
patient referrals, it is the hospitals mareting executive who personally
approaches the corporate or the doctor so as to pitch and finalize the deal.
Net)or? o, *o%tors.
#n the other hand, they also have a net)or? o, *o%tors lined to them.
These doctors are P%ons!lt$n' *o%torsC who don!t have clinics of their own.
Thus, they treat all their patients in the hospital premises itself. #ther v$s$t$n'
*o%tors are also lined to the hospital and even they pull their patient.base to
the hospital for surgery, treatment and recovery. *any hospitals also provide
incentives to the doctors so as to ensure that the hospital is the first
preference of the doctors for referral.
A#ollo Hos#$tal in 'hennai interacts with doctors on one on one basis. They
regularly conduct seminars and continual education programmes to explain to
doctors the advances in the medical sciences and the infrastructure that their
hospital has.
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Hospitals & HealthCare
=&> C!stomer serv$%e an* tra$n$n'.
(n hospitals, almost all the services are delivered in the customer!s presence.
8rontl$ne #ersonnel are directly involved in the process of offering the
services, due to which they must be efficiently informed, trained and
=or instance, if nurses neglect patients, receptionists misbehave and doctors
do not show a human approach, the hospital will fail in delivering good service
to the society in spite of the availability of most sophisticated e)uipments and
technologies, efficient doctors and nurses and most comfortable buildings and
infrastructure facilities.
Thus, hospitals invest a lot in internal mareting by way of training so as to
ensure that the employees are at their best of behavior with the patients and
well informed about the various activities of the hospital, including free chec.
up camps and tals. (mportant ways of internal mareting is analyzing
feedbac from regular customer satisfaction surveys and improve service
delivery so that the way of service delivery itself is the mareting of the
-9am#le. #ne way in which -H( ensures good customer service is by holding
training programs for nurses every 02 days, enlightening them about how to
handle various patients etc.
-t =ortis Hospital at ,oida, there!s also a system of taing feedbac from
patients and visitor, which enables them to chec flow in their service.
=%> @or* o, mo!t".
(n *edicare services, word of mouth plays a very important role, as people are
more liely to trust a hospital if they have heard about its success in
treatments or )uality care from a patient. Thus, by ensuring good customer
service, hospitals also get a lot of promotion by way of word of mouth.
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Hospitals & HealthCare
They conduct camps in rural areas to give medical chec ups at reasonable
prices, they sponsor visits to old age homes etc. Participating in the country!s
biggest medical conventions and conducting health camps are also other
prominent forms of maing their presence felt.
=or example& Hindu/a Hospital had also sent a team of their medics to Chu/
when the catastrophic earth)uae hit the place some time ago.
They are not used fre)uently in hospital mareting. Hospitals can focus on the
)uality of their services, their contribution to the social transformation process,
but they cannot advertise for generating profits.
*ostly, advertising through mass communication media lie T7 = s#e%$al
#ro'rammes, $nterv$e)s o, s#e%$al$sts>, #r$nt me*$a =,$tness
ma'a($nes, ne)s #a#ers> etc. is only used in social mareting where the
ob/ective is to pass on a social message lie family planning, child
immunization, health and family welfare etc.
(n hospitals, sales promotion usually by way of&
. :ign up rebates or discounts, especially in the case of corporate clients
. @ift premiums, for ex. ?octors are offered various gifts and benefits in return
for patient referrals.
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Hospitals & HealthCare
Hospitals may sometimes issue press releases regarding the success of rare
and crucial operations and surgeries. This is because its success rate of crucial
operations and surgeries reflects the technological and nowledge. based edge
of the hospitals over the competitors. "hen many successes are discussed in
health magazines and newspapers, it becomes a natural advantage for the
To reach the consumers, -pollo Hospitals rely mostly on public relations.
"henever their doctors perform pioneering surgeries or winning awards for
their achievements, they tal to the media and when people come to now
about their achievements they get confidence to go for the services.
Use of traditional approaches lie #r$nte* mater$als, ranging from &ro%"ers
an* $nstr!%t$on man!als to instructions are used by hospitals
they also follow printing and maing readily available various emer'en%y or
a##o$ntment n!m&ers.
-H(' has a Ipatient guide! in every patients room which gives patient valuable
information regarding booing, cancellations, various facilities available, what
to expect during the stay, discharge procedure, billing and payment
procedures etc..
They also have a patient education service, wherein brochers regarding the
heart, what the various heart ailments are, what the various heart surgeries or
treatments involve, how heart disease can be avoided by way of healthy eating
and exercise etc.
-lmost all the private hospitals have )e& s$tes with information for patients,
doctors, facilities available, price for the same etc. #ne of the most effective
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Hospitals & HealthCare
mareting tool of Haslo Hospital is a web site $www./, which
is constantly updated by their technical staff.
;ro%"!res an* #r$nte* mater$al are also available at certain other places.
=or ex. Printed material at the blood ban helps educate patients or donors on
why to donate blood, precautions to be taen before donating blood etc.
There are 7 ways of doing this&
D$re%t T$e U#s.
Hospitals may either t$e!# *$re%tly )$t" %or#orate and offer health chec.
ups and treatments at *$s%o!nte* rates to the employees of the corporate
:ometimes ,ree %on,eren%es or %am#s are also conducted for the
employees of corporate by the hospital so as to educate them on prevention of
heart diseases etc. 'orporate . entitles executives to consultation and
admission without payment formalities.
The bills are settled directly by the company, simplifying the admission and
discharge procedures for selected employees. ;egular correspondence is
maintained with their corporate clients, they are sent brochures and flyers
=or +xample, ;rea%" Can*y Hos#$tal has with 023 corporate
companies and consulates, -lso Hindu/a hospital has around 053 'orporate
The mareting strategy of Haslo Hospital involves tying up with corporates,
some of them being #il and ,atural @as 'ommission $#,@'%, *umbai Port
Trust $*CT%, Chabha -tomic ;esearch 'entre $C-;'% and -ir (ndia.
-t AHIC they undertae corporate mareting by approaching various
corporate and inviting them to /oin their panel. ?ifferent pacages are offered
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Hospitals & HealthCare
to these corporate such as discounts of 2.03< depending on the strength of
employees, health chec ups and programs for employees etc. corporate are
also offered credit facilities i.e. the bill of employees is sent to the company
after 02 days for settlement.
PPOCs =Pre,erre* Prov$*er Or'an$(at$on>.
They can attract corporate business through PPOCs =Pre,erre* Prov$*er
Or'an$(at$on>+ PP#!s have an understanding with corporate and in case an
employee falls sic, the corporate refers the employee to the PP#, which in
turn sends them to the hospital for and treatments. which brings
them a lot of business and also, helps in promoting the high Q class )uality of
service they provide.
This can be an important mareting tool as a patient attending a free health
chec up camp or tal at the hospital, goes bac with a nice and charitable
image of the hospital. Thus, the next time he is sic, he thins of coming to
that hospital. *ost hospitals feel that if more than 23< of the patients who
attend these free camps turn for further chec ups, then organizing the camps
are worth the trouble.
=or example Creach 'andy Hospital conducts conducts ,ree #e*$atr$% %am#s
an* eye %am#s. They also offer free chec ups and free treatment to
outpatients from time to time.
#ther mareting strategies of Haslo Hospital involves that the hospital
conducts free health lie diabetes and cardiac chec ups for the
general public.
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Hospitals & HealthCare
Under this, hospitals hold sem$nars an* %on,eren%es relating to specific
diseases or latest technology, where they involve the doctors from all around
the country, for detailed discussion. This maes the hospital well nown
amongst the doctors, who could in future refer complicated cases to the
=or example Biver ?ay was celebrated at A#ollo Hos#$tal, which was aimed at
educating and creating awareness amongst children and parents, they
organized a fashion show and health )uiz, which generated a lot of interest
8ort$s Hos#$tal at No$*a was the first hospital to organise an exhibition in
the ,ational 'apital ;egion, wherein the general public could visit all
departments of the hospital and get answers from experts. :econdly, =ortis
launched a dialysis technician programme for women from the weaer section
of society in which they were given free training by the hospital and they will
be assimilated in the hospital itself.
In &oar* o, tr!stees.
*any hospitals have eminent personalities from the industry in their Coard of
trustees so as to create a sense of confidence in the minds of people.
As Pat$ents.
'elebrities, who, when admitted, are spoen about in the newspapers which
gains a lot of $n*$re%t #romot$on for the hospital. Creach 'andy!s clientele
consists of a lot of celebrities treated which includes the 8ormer Pr$me
5$n$ster 5r+ 7a:#ayee, Late 5r+ D"$r!&"a$ Am&an$, S"amm$ Ba#oor,
S"a"r!?" B"an, et%.
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Hospitals & HealthCare
"ith medical tourism picing up, hospitals are emphasizing on mareting
themselves in the developed special pacages for those overseas #at$ents
and have tie ups with various hotels.
-t AHIC (nternational mareting is done by organizing cutting edge medical
programs A inviting foreign doctors to participate in them. Cesides, many
members of the surgical A cardiology team hold positions in international
bodies pertaining to cardiac care and are on the editorial boards of
international /ournals. :ome of them are also visiting professors to various
universities abroad.
-lso with ,ore$'n %ons!lates help them mae their brand name. =or
the same reason Gaslo? "os#$tal has recently tied.up with =(''( to utilise the
potential of this upcoming sector. They are also inviting foreign faculty and
holding /oint symposiums with the foreign delegates to share their sills,
nowledge and experience. The hospital has a tie up with :tanford University
*edical 'entre, U: and they hold video conferencing every month with the
doctors of the centre, who interact with the faculty of their hospital.
- small hospital set.up that caters to the needs of the local community may
not feel the need to create a brand. =or them, local identity through word of
mouth is sufficient. However, brand plays a vital role in the growth of
ambitious healthcare service providers lie corporate hospitals. The healthcare
industry is moving towards corporatisation.
Unlie other industries, healthcare is highly consumer driven. :ince &ran*$n'
'oes #arallel to any %ons!mer relate* a%t$v$t$es, hospitals are moving
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Hospitals & HealthCare
towards satisfying consumer needs. Therefore, the need of getting branded is
originating from the consumer itself.
;ran*$n' $s an em#o)erment o, t"e In*$an "ealt"%are %ons!mer+
+xperts feel that without a strong branded customer service, a hospital!s
mareting budget is wasted.
"e live in a very different healthcare world today where the consumer is far
more nowledgeable about the diseases and their choices of treatment.
(nstitutions which will focus their energies in identifying the needs of their
patients and create seamlessness in the experience of their patients will
become the trusted brands of the community
(t is formed by eeping tin mind the following ,a%tors&
1+ Re#!tat$on.
*areting or brand building may not be a conscious attempt+ Crand speas a
level of reputation. (f one has developed a good reputation, this will lead to
creating a brand. "hen one achieves a superlative reputation, it extends into a
great brand. =or instance, institutions lie '*' Jellore, Bilavati hospital,
,anavati hospital have created a strong brand for themselves through their
decades of dedicated service.
J+ -9%l!s$v$ty o, t"e Hos#$tal.
- brand should have some exclusivity and must be built around t"e v$s$on
t"at t"e "os#$tal stan*s ,or. Crands should convey this upfront, otherwise it
is futile spending on brand building. Crands communicate in a certain
- Hospital should as oneself. "hich language does my hospital speaK
Hospital should find its ey strengths and then build its brand based on these
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Hospitals & HealthCare
ey factors. =actors lie service delivery, clinical expertise, and medical
technology help to create an image.
2+ @or* o, mo!t".
This being a promotional techni)ue adds to build a brand. Unlie consumer
brands, healthcare is a very sensitive, personal experience. (t depends on a in
a hospital. Crands are established in healthcare through and therefore brand.
building in healthcare is a lengthy process.
3+ Pat$entCs e9#er$en%e.
Healthcare brands emerge not through advertising but through the power of
patient experience. Hospitals should see things from a patient!s perspective.
+ach patient has different needs. The hospital should be able to satisfy every
patient!s needs.
0+ Cons$sten%y.
Cesides, there should be consistency in the process of delivering healthcare in
a hospital. - patient!s experience differs from hospital to hospital. (f there is
consistency in the processes it will relate to the consistency in the image the
patient carries in his mind.
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Hospitals & HealthCare
@"$%" "os#$tals "ave &een t"e P,orer!nnersC $n t"$s
-cross geographical regions in (ndia we do find hospitals which are powerful brands in
those specific regions. -pollo and "ochardt Hospitals are the (ndian healthcare
brands which have a pan (ndia presence.
Crand Cuilding of @o%?"ar*t Hos#$tals.
The @o%?"ar*t Hos#$tals brand has been established over a time frame
of 02 years. Their brand has been built by a synergy of excellent clinical
expertise with a professional management team which has constantly
strived to give their patients a great healthcare experience. Their entire
focus is to excel in their health care delivery process.
They started with a single speciality cardiology institute in Cangalore which
is a front runner in the country, followed by a idney institute in 'alcutta,
followed by cluster of specialty hospitals in Combay which have excelled in
the area of cardiology, orthopedics, neurology and ophthalmology.
They have also established a single speciality heart hospital in ,agpur
which has made its mar as a cardiac institute of central (ndia. Today
"ochardt is a super specialty brand.
H$n*!:a Hos#$tal an* Resear%" Centre
:peaing about brand positioning of Hindu/a Hospital and ;esearch 'entre,
*umbai, the three elements around which the brand of Hindu/a Hospital is
positioned is PCre*$&$l$tyC, PDel$very o, 5e*$%al serv$%eC an* PH!man
To!%"C. -ll their actions, right from patient care to various mareting
exercises are aimed at reinforcing these elements.M
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Hospitals & HealthCare
:ervice personnel play an important role in an organization, which provides
services. (n a hospital the behavior and attitude of the personnel providing
services is very important as far as the customers overall perception of the
service is concerned. (t is necessary that the staff in a hospital be trained to
provide )uality patient care using state of the art technology.
$+,-CB+: TP N++P TH+ $*-N+: P;#*(:+:%
(,T+;,-B *-;N+T(,@ +UT+;,-B *-;N+T(,@

The triangle comprises of the company i.e. the hospital, employees i.e. the
doctors, nurses and the customer or in this case, the patient
1. The company here is the hospital which promises of a service offering by
way of treatment, which will satisfy the customers i.e. patient!s
expectations of getting cured.
2. The patient who sees to get cured is the customer for the hospital as
he is the one who avails the benefit of the service and pays for it.
3. The employees comprise of all the people who are involved in providing
the service, namely doctors, nurses, technicians, attendants,
administrative personnel etc.
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5/CT/7 "ATI$9T
Hospitals & HealthCare
=rom the triangle we see that three inds of mareting activities tae place in
a hospital.
1. -9ternal 5ar?et$n'
The hospital undertaes external mareting as to promote the service i.e.
treatments and facilities to the patients. This is explained in detail in the
promotion mix.
. Intera%t$ve 5ar?et$n'
:econdly interactive mareting taes place between the employees and the
patients. (nteractive mareting describes the employees! sill in serving the
client/patient. "e now the customer of the hospital is the patient who is in
some degree of discomfort or suffering when he is admitted/comes in.
=rom the time he enters to the time of discharge, the patient has to
continuously interact with the hospital!s employees by way of taling to the
nurses, attendants, etc.
Thus in his vulnerable state of suffering or sicness the patient expects )uality
care along with empathy and consideration of his every need by the hospital
staff. Thus the selection, motivation, training of the hospital staff maes huge
difference in the well.being and recovery of the patient.
!. Internal 5ar?et$n'
@ood and effective interactive mareting is made possible only through
efficient internal mareting. Hospitals undertae internal mareting to train
employees and motivate them to serve customers well. :uch training will help
improve employeeDs competence and improve employee responsiveness,
problem solving ability as well as their attitude, goodwill towards patients, all
of which in turn will result on patient well.being and recovery or customer
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Hospitals & HealthCare
Thus internal mareting ensures that the employees are at their best behavior
with the patients and well informed about the various activities of the hospital.
-n important way of internal mareting is analyzing feedbac from regular
customers satisfaction surveys and improving service delivery so that the way
of service delivery itself becomes the mareting of the service.
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Hospitals & HealthCare
Physical +vidence is the environment in which the service is delivered with
physical or tangible commodities and where the service provider and the
customer interact.
'orporate image plays an important role in terms of physical evidence when it
comes to hospitals. This can be developed with corporate relation programs.
*odern hospitals need to create a good ambience because when a patient
wals into a hospital, he immediately forms an opinion about the hospital.
The staff should follow a dress code to show professionalism and maintain
The staff also needs to be trained to be understanding, warm and
comforting because the clientele that goes to the hospital is usually
disturbed or unhappy.
(t is necessary for a hospital to be well organized and segregated into
different departments.
-ll the doctors should be provided with a well Q e)uipped cabin. (f possible,
the hospital should be centrally air Q conditioned. However, good lighting
and ventilation is a must.
:pecial care should be taen to maintain hygiene> cleanliness and the
whole hospital must be well Q lit. This is generally taen care of by the
houseeeping department.
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Hospitals & HealthCare
?evelop way finding systems that allow users, and particularly outpatients
and visitors, to find their way efficiently and with little stress.
'onvenience store, public call booths, coffee vending machines, library,
prayer rooms, information ioss, etc.
:eparate waiting area with counselors for relatives of patients undergoing
surgery or angioplasty. 'linical pathways $more effective if placed on
individual patient!s chart%
- #2 -
Hospitals & HealthCare
Process is a set of activities that tae an input, convert it and add value to the
input and finally, create an output. - process is divided into the following
phases in a hospital&
0. T"e :o$n$n' #"ase Q which includes
The arrival of the patient
;egistration Q where a patient has to mae an initial deposit at the
inpatient billing counter after which a file is opened in the patient!s
name to now the patient!s medical history
7. Intens$ve %ons!m#t$on #"ase Q which includes
?iagnosis Q where the consultant diagnoses the illness by maing the
patient undergo various tests
Treatment Q where the illness is treated with proper medication or
(nformation about further actions Q the consultant will instruct the
patient regarding the diet to be followed, the medication to be taen
1. Deta%"ment #"ase Q which includes
?ischarge of the patient
Payment Q after the patient is discharged, the bill will bee paid at the
billing counter.
". 8ee*&a%?
-t this stage, the patient is re)uested to fill an evaluation form, which
helps the hospital authorities to now the level of satisfaction derived by
- #3 -
Hospitals & HealthCare
the patient. Patient!s suggestions are always considered for improving the
hospital services.
- #! -
Hospitals & HealthCare
T"e :o$n$n'
Intens$ve %ons!m#t$on
(nformation about further actions
- #5 -
Hospitals & HealthCare
Clue printing is a tool of designing which portrays the picture or a map
of a service so that the employees can understand their part better and
the changes to mae service more efficient or better can be made.
The blue print that is prepared looing at the basic woring of the
hospital is attached. This blueprint is a very simple showing only the
basic steps of the service at a hospital.
(n this blue print the customer comes in initial contact either through
phone whereby if he needs to tae appointment then he comes into
contact with the receptionist or else for general information he contacts
the customer care bac office.
Then the patient or customer needs to register by filling some necessary
forms and maing some advance payment. The form then goes through
various levels as every aspect it has is checed by the bac and front
Then the customer meets the assigned person who checs and
examines the patient and then sends him to his room. Here the dress,
the cleanliness, assurance of doctor is very important.
-fter the tests such as U.;ay, +'@ etc depending is done and laboratory
tests are done bacstage which are important but not with direct contact
with the customer.
-fter this the last and final interaction is with the discharge department
or the payment department. -ccounts department in the bac office
prepares the bill and the cashier has to collect the payment from the
There are many other stages of which blue print can be prepared but
then it will become too complex. Thus given is a simplified format of
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Hospitals & HealthCare
C # S T O M E $
A $ $ I % E S
$ E C E P T I O N
C A S # A & T '
$ E ( I S T $ A T I O N
D I A ( N O S I S T $ E A T M E N T
) # $ T * E $
I N ) O $ M A T I O N
D I S C * A $ ( E
P A ' M E N T
) $ O N T
O ) ) I C E
+ A C ,
O ) ) I C E
C # S T O M E $
S E $ % I C E
X - $ A ' . + & O O D T E S T
S O N O ( $ A P * ' . e t c .
C # S T O M E $
D E P A $ T S
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Hospitals & HealthCare


Prescription (nvestigatio
?ressing A
to in.
ward A

U.;ay Baboratory
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Hospitals & HealthCare
;eception A


- #' -
-dmission ?ressing
Hospitals & HealthCare
- service encounter is the time at which the customer comes in direct contact
with the service provider. Hospital services are the one, which involves very
high service encounters in which the patient is the direct recipient of a
service and the physical presence of the patient is prere)uisite for a series of
)uite tangible operations to be carried out. The patient!s opinion about the
service is influenced by his/her opinion of the service production and the
consumption process. The service production at hospitals includes the
patient, the facilities $U.ray, +'@Ds testing instruments, etc.% The service
consumption process includes the behavior of nurse and doctors, the manner
in which the production facilities are used, and the way the physical
resources, technology and systems support the consumption of the service.
(n medical services the /oining phase occurs when the patient /oins in the
service production process in order to consume a core surgical service. The
actual service encounters at hospitals can be distinguished into three distinct
Pre treatment #ro%ess
A%t!al treatment #ro%ess
Post treatment #ro%ess
The )uality of the final service delivered depends on the following factors &
'omplimentary services $sanitary facilities, hygiene facilities, some sort of
entertainment may be magazines, boos etc%
Professional expertise $nurses and doctors%
Physical evidence and service.scope $e)uipments, signs and symbols for
direction guide, information%
Pleasantness $catering facilities%
=inal surgery operation $the surgery team, the technology used etc%
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The process of delivering )uality service at hospitals starts from the point at
which the patient enters the hospital. The elements of paring, registration
formalities, telephone services and the receptionist friendliness of delivering
the service, location and easy availability of information, the ability of the
ward personnel $friendliness, openness, trustworthiness etc% are all very
@etting the re)uired information of, for and to the patient and his relatives is
extremely important at hospitals because of the uncertainty factor prevalent
in this ind of service. ?octors and nurses should mae the patient
comfortable and should be polite with them as the trauma the patient goes
through in hospitals is very high. The life of the patient is in the hands of
doctors and nurses so any small mistae while delivering the service at
hospital or any healthcare center could result in either delay in recovery and
pain or the loss of the patient!s life. Thus, no mistae or mishandling of any
aspect in its minutest form is not tolerable at hospitals.
=ailure to diagnose or delay in diagnosis . "rong diagnosis made
=ailure to recognise complication of treatment . =ailure / delay in
admission / referral to hospital
#perate on the wrong patient / body part . :urgical foreign body left in
?elay in performing an operation . (ntra.operative problems
=ailure to warn $informed consent% . =ailure in follow up arrangements
(mproper delegation to unsupervised
=ailure to U.ray / interpret correctly . (nfusion problems
Problems with medical records . Bac of ade)uate facilities / e)uipment
+)uipment malfunction . :elf Harm
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=ailure/delayed availability of operating theatre . =ailure/ delayed
availability of anaesthetist
/ T H $ 7 S
C 0 S T / M $ 7
2 7 / 9 T : I 9 $
" 7 / C $ 5 0 7 $ S
5 $ : A ;
I 9 2 / 7 M A T I / 9
6 A C ? / 2 2 I C $
M A T $ 7 I A :
$ 4 0 I " M $ 9 T
T"ere are ,$ve t"$n's $nvolve* $n serv$%e ,a$l!re.
0. +)uipment failure
7. =rontline A failure
1. (nformation failure
8. Procedure failure
2. *aterial failure
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1+ -<!$#ment ,a$l!re
This failure may occur due to some problem in the e)uipment used in
diagnosing or during an operation or at any other time during the patients
stay at the hospital. -n e)uipment failure in this industry is very dangerous
as the life of a person could depend on it. :urgical instruments need to be
sterilized before they can be used. -ny negligence here can lead to severe
problems resulting dreadful diseases and pain.
J+ 8rontl$ne 6 ;a%?o,,$%e
This includes both the frontline officers and the supporting staff. The hospital
provides healthcare facilities. Healthcare involves high contact between the
customer and the service providers. The doctors should be above par in
terms of the )ualifications needed to deal with the respective illnesses of
The nurses and other frontline staff too have to be well trained to tae proper
care of the patients. Hospitals are always surrounded by uncertainties,
trauma, chaos and the overall environment is always tensed so the patients
and their relatives are to be best received by the frontline officers offering
them easy and reliable service. They need to maintain a constant smile so
that they can bring some relief for the patients.
2+ In,ormat$on
There should be ade)uate collection of all possible related information
about the patient and his records should be properly maintained so that
diagnosis can be done properly.
=iles containing all patient reports and medication should be maintained.
Cefore operating or prescribing heavy medication, all the re)uired tests
and information that needs to be collected should be done preciously such
as allergies and consideration of previous medical history.
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3+ Pro%e*!res
'onsistency of results is never guaranteed in this industry. The main
operation or surgery itself may be unsuccessful, as it is not always
possible for a doctor to save a patient. (t may not even be his fault, but in
the end, one cannot assure the safe completion and success of such
complicated procedures.
-ll activities supporting the procedural system must also be in place and
the doctors and other personnel should be aware of all the related
information and related procedures.
=ew procedures such as filling the pre.treatment form or registration
form, etc. should be simple and short so as to avoid delay in medication.
0+ 5ater$al
This includes failure due to wrong usage of drugs.
"rong usage of drugs that implies different drug used for curing
disease for which it is not implied.
?rug used after the expiry date.
?uplicate ?rugs
:hortage of drugs
(neffective sterilization of clothes and e)uipment could lead to several
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"hen the company $hospital% fail s t o meet it s promise s made to the
customer $patient% on the basis they build expectation, it!s to be said that
there is service failure. This might result in losing the customers as well as
the goodwill earned. 'ustomer is very important in any industry, hence
retaining them is the biggest challenge, and however service failure acts as
an obstacle to it. (n order to overcome such failures we undergo the :ervice
;ecovery process.
:ervice recovery is an aspect of the total customer service strategy that is
often overlooed by hospitals and health care worers. :ervice recovery
provides the tools employees need to help customers LrecoverM from negative
perceptions, thus becoming satisfied patients
The first thing that is expected is to involve senior management in the
planning phase. :ome necessary arrangements should be made by the
hospital so that in case any service failure taes place by the hospital in
whole necessary compensation can be made however there is no
compensation that can be made for loss of life. -t the same time, if the
doctors and other staff put in everything to try and save a persons life, but
are not able to due to certain circumstances, if the fault is not the hospital!s
and if they can even /ust give the patient a few hours more to live, both the
patient and their relatives are sure to show their gratitude towards the doctor
and the staff and these relatives would surely come bac only to that
The following points should be taen into consideration while handling
-cnowledge any inconvenience and apologize.
Bisten, empathize, and as )uestions.
#ffer a fair fix to the problem and/or offer some value.added atonement.
Neep your promises and follow.up.
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The following criteria are used by the customers to /udge how a hospital
responds to their complaint in case of service failure &
The treatment the customer receives while lodging the complaint
The response of the organization with particular emphasis on time
The outcome of the complain such as apology or compensation
Bey ,a%tors to)ar*s e,,e%t$ve serv$%e re%overy #ro'rams.
0. +mphasize the importance of listening.
Hear the patient.
+mpathize with the patient.
-pologize to the patient.
;espond to the patient.
7. +mpower the employees to tae control of service recovery efforts.
Cy empowering any employee to tae some action to the service failure
patients can receive an immediate response to any complaints. Thus the
perception of the hospital might add to the customer loyalty towards the
=ocus on selected departments with high visitor interactions.
1. :olicit immediate feedbac
+ffective programs typically incorporate some sort of proactive
solicitation of patient!s feedbac. This may tae the form of comment
cards in the patients room or hospital lobby, staff rounding around
hospital beds, or using interactive television or bedside (nternet facilities
to solicit patient comments.
8. Trac and review all patient complaints.
2. @enerate staff support in the service recovery process
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Health is a common concern of almost every individual on this planet. (t is
also well nown to us that we cannot ignore taing care of our health to gain
or achieve other goals lie financial success. (n fact a healthy person is a
much more competent person in any sphere of life. Thus, we must have
some nowledge about our body, how it wors, what does it need etc.
-s we proudly say that our country is developing fast, we have also been
noticing the drawbacs of this development. The levels of stress and Pollution
are rising at unbelievably high rates. This is resulting in increasing numbers
of heart attacs and cancer and many other such diseases. Headaches and
Jiral infections are nothing unusual to any body. ;esearchers all over the
world have been recognizing the potential damage of this ind of a life and
the damage is bigger than what our minds can yet conceive.
-ll this is excellent for the Health industry. *ore the number of people falling
sic, more the industry grows. ?octors and lawyers are some of the richest
people in -merica. "e will not comment on the lawyers but doctors sure
seem to have a very prosperous future in (ndia too.
Cut is it going to continue the way it has always beenK "e now how
constant the variable change is. (s the Health (ndustry going to witness
changes tooK
"hat possible changes could there beK :cience has developed so much that
medicines act lie magic. =all sic, go to the doctor, tae some pills, and start
woring again.
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The ma/or changes that ( feel are going to be implemented in the hospitals
would be in their services.
Hospitals are becoming business organizations. They mae huge money for
the services they render. The rooms and operations in a private hospital cost
a lot more compared to @overnment hospitals. (t is lie the ratio of rates
charged by @overnment bans to the rates charged by the private bans.
Hospitals are also competing and thus they form strategies lie&
0. *aret :egmentation
7. ?istinguishing their product/service
1. Promotional techni)ues etc
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5o&$le Hos#$tals.
This includes Helicopters being used by the hospitals to airlift the patient
to save the time it taes to reach the hospital.
(t is a fact that there are a lot of incidents where the doctors failed
because the time taen for the patient to reach the hospital was too long.
This will be a great brea through and could save a lot of lives.
The practice is already followed by some of the developed countries.
The helicopter itself can have some life saving e)uipment so that the
doctors can immediately start their wor on the patient.
However, This service will most probably be accessible by the richer class,
as it may be )uite expensive.
"e observe the following strategies here&
0. *aret :egmentation& -s only the richer class will be able to access
7. ?istinguished Product/:ervice& ,ot all hospitals will introduce it
simultaneously. Thus, whoever does it first can get an edge over
the maret.
1. Promotional Techni)ue& 'an be advertised to lure the potential
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5e*$%al To!r$sm.
This (s a concept which has already been introduced by some hospitals.
-polo hospitals was the one to introduce it.
(t aims at promoting (ndia as a great destination for medical treatment.
*edical services in U:- and +urope are much more expensive compared to
(ndia. Thus if (ndia matches the (nternational :tandards in this industry, it
would get millions of people to get their treatment done here.
The hospitals have collaborated with the tourism industry to mae the
pacage even more interesting. :ince the foreigners have already come to
(ndia to get the treatment, they might as well travel around (ndia a little bit.
Serv$%es o, an e9#ert no matter )"at yo!r lo%at$on.
"ith the growth of technology, computers and (nternet, the world today has
become very small or much better connected.
(n the near future it may be possible that the patient is in -merica but he
wants to be treated by the doctor he trusts the most but that doctor is in
(ndia. Technology maes it possible for the doctor he wants to be able to
observe perfectly, the body of the patient through cameras and internet etc.
He can then instruct the doctors in -merica to do exactly what he feels
should be done. Thus to a great extent, the patient is actually en/oying the
service of the doctor in (ndia while he is in -merica.
These were some of the additional service ( visualize that the hospitals will
introduce in the coming future.
There is one significant movement that has started. The Health industry is
observing a path different from the traditional path.
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LET FOOD E T!" #ED$%$&E !
- famous line that was )uoted 033!s of yrs bac holds true even today. The
scientists are taing this thought very seriously.
,obody generally has a deficiency of vitamins or minerals. (f we had we
would suffer from specific diseases. ?eficiency of vitamins and minerals
cause specific diseases.
:curvy is a disease where your tissues brea down and you bleed into your
tissues. (n the old days when they use have long sea voyages they use to not
carry fresh fruits and vegetables because they would decay anyhow. - man
went out for a voyage and after 7 wees he had scurvy. His son followed his
?ad!s footsteps and did the voyage and even he developed :curvy. :o :curvy
is a genetic disease.
"e now now that :curvy is not a genetic disease and is caused by
deficiency of vitamin '. "e do not suffer from such diseases any more. ,o
one gets Cerry Cerry, which is a deficiency of Jitamin C1.
"e are dying of Heart ?iseases, 'ancer, and ?iabetes. These are diseases
caused by free radicals and not by Jitamin deficiencies.
=ree ;adicals can only be combated by -nti #xidants.
#ne of the free radical caused disease is&
0. ,o one can avoid
7. +ffect of =ree radicals in our cells and ?,-
1. +veryday, these free radicals that we introduce in our body are
attacing our ?,- and we get older.
8. *ore the free radicals )uicer we get age.
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There was a person who looed lie he was in his 63!s. Booed lie a healthy
63 years old. He drives his car himself to the mechanic.
#ne day when he too his car, he was looing tired. The mechanic ased him
what was wrong. He replied that he is coming straight from ,ashi by road.
He had /ust opened a new manufacturing plant there. (t is expected to
generate profits after 2 years and he is looing forward to it.
His actual age was 47. Passion is what drives him.
-ging is a free radical disease.
#ther =ree radical diseases are&
Heart D$seases
42< of modern day diseases are caused by free radicals
They are generated by over use of oxygen
#xygen is very essential. "e have to breathe to live. Cut we do not need to
go overboard.
The body is taing more and more oxygen because&
"hen we introduce synthetic chemicals, the body taes a lot more #xygen
and energy to get rid of it.
The waste product is #xygen based =ree ;adicals
#xygen based free radicals are unstable chemicals that lac an electron. (t
needs an electron from somewhere to stabilize. :o it goes around the body
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to get the electron and attacs the blood cells and the ?,- and rips the
electron out disturbing the natural, normal functioning of the body.
:tress again burns more oxygen.
Therefore, =ree ;adicals are caused by excessive :ynthetic 'hemical!s and
:tress $*odern :ociety%
The city life today is very unhealthy. "e don!t breathe fresh air> neither do
we eat pure food. The food, the water, everything we consume is generally
not as clean as it should be. (t!s even got remains of pesticides and
insecticides, which are poisonous. ?octors, scientists, and those concerned
are realizing the severity of the damage done by modern city life and are
trying to device ways of regaining a pure healthy life.
- balanced diet is only a term that we are unaware of. There are very few
people who now what maes a balanced diet. Coos have been written on
the advantages it has.
There was an observation that an average man spends his entire life trying to
save money and looses his health in the process. The rest of his retired life,
he spends all that money to regain the lost health.
This situation can be changed.
- person!s body is compared to a machine. (t re)uires good food in the head
and the stomach and needs regular maintenance to function smoothly for a
long time. "hen the food is not sufficient or is not of good )uality, and if
regular maintenance is not taing place, this machine lie body will start
malfunctioning and may even die.
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In%reas$n' t"e a)areness $n #eo#le+ T"$s $s &e$n' *one &y
var$o!s )ays l$?e.
a. ,ewspaper articles. +veryday in Combay Times we see articles
about food, exercise, and how to avoid various health problems.
b. Hoardings displaying slogans motivating people to live a healthy
c. -nti.smoing campaigns and maing a lot of places smoe free.
d. (ncreased stress on )uality food.
e. :eminars and T.J shows educating the audience about the
harmful effects of an urbanized life style and remedies. +tc.
Resear%" an* Develo#ment o, ,oo* s!##lements.
f. ,utrition being extracted from plants grown in pollution free
fields. These plants are grown without the use of pesticides or
chemical fertilizers. +g. ,utrilite products.
g. Production of various health tonics and drins. +g. ?rins lie
+nergy and flavored mil are gaining popularity and with increased
promotion such category of drins will replace our purchase of 'olas.
h. Bot of research is taing place for the development of capsules,
which could replace our re)uirement of food. However, this concept is
being designed for the people in the city. (t would save the time it
taes to have a meal. That is a little contrary to the philosophy of the
wellness industry. Though it could ensure people not sipping meals,
which often happen.
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T"e Cor#orate Coo#erat$on.
i. *anufacturers of products lie refrigerators, microwave!s etc are trying to
engineer their products in such a way that they eep the food fresh.
This is one of their main promotional tools these days. They are trying
to help restore the nutritional value and freshness of the stored food.
However, they are interested in their own profits. 'old storage is not a
healthy solution. (t is a fact that as soon as a fruit or vegetable is
pluced, its nutritional value starts decreasing even if you put it in cold
storage. ;efrigerators are only worsening the situation as people buy
in bul and store it and do not prepare fresh food every day.
/. 'hanging the company policies and maing /ob!s less stressful. People are
becoming more aware of the harmful effects of stress and the
companies are considering this problem.
. There are few companies, which have even adopted a model, which
could provide financial freedom to those, willing to wor for a few
years. This is one of the most successful and beautiful concept
because research has proved that most of the problems of an urban
man are because of money issues. (f money is not an issue, the whole
perspective towards life will change and one can en/oy a stress free life
with a positive outloo.
l. 'ontributing in the funding for more research.
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@rowing publicity of motivational boos, seminars, worshops etc, which
focus at minimizing the negative thoughts from your head by giving you a
very positive outloo towards life. This is very important but a lot of
people tend to ignore it. @ood food in the head can do wonders to your
:preading awareness of the benefits of yoga, meditation, gyms, aerobics
and various other activities, which could be done for daily maintenance.
"e are aware of intense research happening on unconventional
treatments across the globe. (t includes things lie music therapy for
curing cancer and other big diseases, metaphysics that is researching on
the spiritual energy and various such ways of ensuring a healthy life.
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The wellness revolution basically aims at spreading nowledge and
suggesting ways to live a healthy life.
(ts focus is on providing an alternative treatment to various diseases with the
help of natural things rather than medicines and in/ections.
(ts deeply researching on how to mae the defense system of the body
stronger to fight the free radicals. The defense system includes&
0. =ood
7. =ront line defense Q Jitamin +, Jitamin ' etc.
1. ?iscovering super anti oxidants which is lie a bac up system. (t still
needs the front line defense though.
'(E %A&&OT %!A&)E T!E %*++E&T ,+OLE#- ($T! T!E -A#E
T!$&.$&) (E *-ED TO %+EATE T!E#/
These concepts do not go in harmony with the concepts of the illness
(n the whole 2 years course of *CC:, there is only one chapter on ,utrition.
The doctors in the hospitals complain that if people will not fall sic, their
business will go down.
However, there are some very dedicated doctors in the illness industry also
whose efforts are helping to save the lives of many people.
-lso the wellness industry came out of the illness industry and will tae a lot
of years still to outgrow the illness industry.
"e will have to wait and see what predictions come true.
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