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Experts Talk
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 | | Dr KC Mahajan | Emeritus Consultant, Department of General Surgery,
Sir Ganga Ram Hospital, New Delhi |
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| DoctorNDTV: Does the Indian health care industry have any problems? If yes, how would you tackle these? | | Dr KC Mahajan: The problem of the Indian Healthcare industry is the vast divide between the rural and Urban India, unless a balance acceptable to people living in the rural and semi urban areas is structured healthcare services would be a farce. The govt. and private sector together have to address this monumental problem. A model of public – private synergy based probably upon universal insurance may overcome the problem in policy, planning and delivery to our large population with vast pools of poverty. This has to be tackled by eliminating the poverty of ideas, poverty of imaginative solutions and poverty of infrastructure. | | |
| DoctorNDTV: What, according to you, are the attributes of a good doctor? | | Dr KC Mahajan: 1. High sense of responsibility
2. Strong urge to heal the sick
3. Keen and minute power of observation
4. Good judgment
5. Sociable temperament
6. Good memory
7. Intellectual honesty
8. Love for fellow human beings
9. Being a scholar holistically | | |
| DoctorNDTV: What has been your most recent professional milestone? | | Dr KC Mahajan: Having given up active surgery about a decade back and having an abiding interest in academics, I took on the responsibility of guiding the Academic Committee of Sir Ganga Ram Hospital. It facilitates all aspects of Continued Medical Education and Continued Professional Advancement. The department of Academics has been able to craft a Post-Graduates teaching programme, which is today regarded as a benchmark, and a path breaking effort.
1. Established a unique department in the country.
2. Academic Committee was constituted in 1996.
3. DNB started in 1984 in 5 disciplines.
4. Today it has, DNB programme in 17 Broad Specialties, 13 Super-Specialties and Post-Doctoral Fellowships.
5. It runs the maximum number of DNB disciplines in the country.
6. It is regarded as a role model by the National Board of Examinations (NBE).
7. Medical Library with 157 journals, 28 Online and over 2000 books with a budget of Rs. 74 lacs per annum.
8. State-of-art Medical Illustrational Unit.
9. Facility of live transmission from OT to any part of the globe.
10. Tele-Conferencing.
11. Tele-Medicine and Tele-Education via Edu-Sat and ISRO. | | |
| DoctorNDTV: What do you think are your greatest achievements? | | Dr KC Mahajan: I have always believed that nothing is impossible. As Paulo Cuelo (in his work – Alchemist) has said 'if you sincerely aspire for something and work passionately towards it, entire universe conspires towards completion of your dream and passion'. Hence I can look back with satisfaction that I could achieve whatever my vision enabled.
One of my major achievements was to resurrect and revive the Sir Ganga Ram Hospital. The trust decided to close it down because of lack of funds. Mr. Dharma Vira, who was the chairman of the Trust Society, asked me if it was possible to restructure this hospital so that it is viable and continues to serve the public of Delhi. I offered to structure a Board of Management of 21 people from Active Visiting Consultants, each one put a sum of 15 thousand from his personal funds and also raised Rs. 85,000 from other sources, ensuring an initial kick start for the hospital to continue. The only condition was that an agreement be drafted that the Trust Society would not interfere with the decisions of the Board of Management for a period of 12 year. The management would have complete and full financial power to raise money on their personal sureties. I was the first Chairman of the Board of Management, which took charge in 1976. The Board of Management raised money by holding Kishore Kumar Night, publishing a souvenir every year and organising other money spinning events. A loan of Rs. 25 lacs was negotiated with the Punjab National Bank, the Consultants giving their personal guaranties for the loan, which was repayable in 12 years at 12.5 % per annum. With these funds a five-storey building was completed in 1981.
All consultants ensured the financial health of the hospital by giving 33% as collection charges deducted from their emoluments received from patients. In 1982 more funds were raised with the active involvement of the consultants, mostly the members of the Board of Management. In Nov 1982 another loan of Rs. 80 lacs was negotiated for completing phase II of construction. In Jan 1986, loan of 75 lacs with ICICI 11.5% per annum was negotiated. All loans were duly discharged by 1988. The Department of Urology was recognised by the Ministry of Health as a Centre of Excellence. A soft loan of Rs 2 Crores at 10% per annum was sanctioned in1988. Most of the funds were used for buying equipment for urology.
By 1988 there was a quantum jump from 116 beds with 40% occupancy to 500 beds with near 100% occupancy, in 12 years after the Board of Management took over. Fixed asset increased from 35.96 lacks to 697,15 lacs. Even the members of the Trust Society never anticipated this success story. In one of the meetings of the Trust, they congratulated the Board of Management for this feat and placed it on the record. | | |
| DoctorNDTV: What are your most satisfying patient moments/outcomes? | | Dr KC Mahajan: My greatest and most satisfying achievement is to act as a catalyst for the ‘live liver donor’ transplant programme of the Sir Ganga Ram Hospital. I headed a task force to ensure the feasibility of this programme. Earlier because of some setbacks the administration decided to close down the programme. In this task force with the help of my colleagues special mention needs to be made of Dr. S.K. Sama, Dr. S. Nundy and Dr. A. Soin we achieved the following:
- Statistics: Live liver donors transplant 10-12 per month
- Results: Over 350 successful transplants till date
- Less then 5% morbidity
Ours is among the top ten Live Liver Transplant Programmes in the world and We perform the largest ‘Live liver donor’ programme in West Asia. I gave up active surgery for a decade and involved myself in teaching and facilitating other programs of the hospital. Very heroic surgery in my days gave me a sense of satisfaction and earned the gratitude of patients. Today with advances in technology, Biophysics, Molecular Biology and Pharmaceuticals such operations are being done every day. | | |
| DoctorNDTV: Would you like to tell us about any recent development in your specialty? | | Dr KC Mahajan: The recent advances in organ transplantation overwhelm me. End stage heart, liver and kidney disease is eminently amenable to restore people to normal health. By transplanting an organ harvested from a brain dead cadaver or diseased person with an intact circulation, a critically ill patient can be salvaged to continue to be a viable productive unit of society. In areas such as liver and kidney, a live donor is used, but it has its downside, a complication or mortality involving the donor can be an unmitigated disaster. In end stage kidney failure due to diabetes the only workable solution is a simultaneous pancreas and kidney transplant.
The numbers of people needing transplant of kidneys, Heart and Liver far excel the number of donor organs available. A concerted effort has to be made to increase the pool of cadaver donors. In India, apart from a few states such as Andhra Pradesh, Gujarat and Tamil Nadu, harvesting organs from the brain dead patients. In rest of the country cadaver donor programmes are non-existing. In Delhi the Army (R and R hospital) is doing a commendable job of harvesting organs from donors, which are brain dead, working in the defense services.
I am sure the private sector can fast forward a similar a program provided there are vibrant, intensely passionate, and, robust people wanting to pursue a workable cadaver Donor program. Apart from these organs, lung and pancreatic transplant are also feasible, as they are highly successful in the west. In India Cornea and Bone transplants are carried out in many centers.
Also I admire the advent and advance of minimally invasive surgery. Thanks to Dr. P.K. Chowbey, our institution is an international leader in this development and has come out with the most notable innovations in the field of laparoscopic surgery to date. While in most of the fields we have matched or bettered the best anywhere in the world but in the field of laparoscopic surgery we have given to the world what is considered the best and most innovative. | | |
| DoctorNDTV: Do you think Indian health websites are useful? Your views about DoctorNDTV? | | Dr KC Mahajan: The Indian health websites are very fragmented and non-structured as compared to the information available on search engines. In the later the information is comprehensive and all embracing. The drawback is that it is likely to confuse a patient as different and varying views are expressed. The patient runs into the trouble with a clinician who is outstanding but hasn’t enough time to explain the drawbacks and shortcomings of information gathered from the net. The health Website of NDTV (DoctorNDTV) is patient friendly, frequently updated, nurtured and projected by the doctors who are experts in their fields. What we need is a website that incorporates evidence based best practice guidelines and standard operating protocols on national basis. | | |
| DoctorNDTV: What is your opinion about medical education in India? | | Dr KC Mahajan: The format of Medical Education in India needs some engineering but the biggest drawback is the vast shortfall of good teachers. Mushrooming colleges, especially private medical colleges recognised by the Indian Medical Council because of their money power have poor faculties. Most of the present curriculum is quite sound, intense and robust but to execute it we have very few competent people. We need to encourage talented people by opening lateral entry to institutes of eminence like the Sir Ganga Ram Hospital and institute a system of appraisal to weed out non-performers. | | |
| DoctorNDTV: What would you have been if not a doctor? | | Dr KC Mahajan: In 1942 when I had to make a decision, the Administrative Services seemed to be very attractive. My father being a doctor explained to me the advantages of the profession and uncertainties of being selected in the Indian Civil Service. In 1947 the steel frame (ICS) left behind by the British was doing an exemplary job ensuring security, good administration and planning for the future. | | |
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