Hospitals have existed in India from ancient time. About 2200 yrs to 2600 yrs before during the period of Buddha and Ashoka many hospitals were built. This was the time when study of medicine in India was at peak. During 10th century, invaders attacked India and brought their Hakims. Similarly during British rule allopathy gained ground and many hospitals were constructed. Thus the organised medical training started in 19th century.
In 1923 Pondichery medical college was established by French government that was renamed in 1956 as Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). 1835 witnessed special event in the history of Indian medical education when Calcutta Medical College and Madras Medical College started functioning. Calcutta Medical College is the first medical college to teach modern medical science in Asia. In 1845 the Grant Medical College, named after Sir Robert Grant the governor of Bombay (Mumbai). Agra Medical College, known as S N Medical College was established in 1854. King George’s Medical College and Hospital was established in 1911. Prince Of Wales Medical College was founded in the year 1925 in Patna. KEM ( King Edward Memorial) Hospital and Gordhandas Sundardas Medical College (G S Medical College) was established in 1926 in Mumbai.
Today, according to Medical Council of India ( New name National Medical Council of India) there are 539 Medical colleges in India with total 76,928 seats for MBBS course.
As per the press release of Ministry of Health and Family Welfare July 2018, Number of Primary Health Centers (PHCs), Community Health Centers (CHCs), Sub-District/Divisional Hospitals(SDHs), District Hospitals(DHs) are 37,725 with 7,39,024 beds.
There are 19.810 rural hospitals with 2,79,588 beds and 3,772 urban hospital with 4,31 173 beds. There are 3943 AYUSH hospitals with 55,242 beds.
There are 151 Employees State Insurance Corporation Hospitals with 19765 beds
Additionally there are 133 defence hospitals with 34, 520 beds and 126 railways hospitals with 13748 beds. Thus there are total 45,870 government hospitals with 15,73,060 beds.
Appollo Hospital, Arvind Eye Hospital, Care Hospital, Fortis Healthcare, Max Hospital, Manipal Hospital and Narayana Health are some of key players in the market with 39,332 beds combined. Thus the private sector has strong presence in India’s healthcare system.
- IMS Reports Approx. 3.21 lakh doctors in India (MCI 10.2 L Registered, 8.2 L May be available for service)
- 539 Medical colleges (Govt+Pvt), 76928 seats
- 9 AIIMs + 10 upcoming AIIMs
- 36 % are General Practitioners (GP)
- Specialty doctors constitute 64 %
- Doctors are being met by at least 60 – 100 companies
- No advertising mentioning brand names is allowed in the lay press
- Medical representatives play a major role in the promotion process by directly meeting the doctors. Other media like Direct mail, journal, advertising and conferences also play a role but a limited one
Indian Healthcare System and emerging trend
India has less than one doctor for every 1000 population which is less than the World Health Organisation standard. As per Medical Council of India, there were a total 10, 22,859 allopathic doctors registered with the state medical councils or Medical Council of India as on March 31, 2017.”Assuming 80 per cent availability, it is estimated that around 8.18 lakh doctors may actually be available for active service. It gives a doctor-population ratio of 0.62:1000 as per current population which is estimated to be of around 1.33 billion.
The WHO prescribes a doctor population ratio of 1:1000.The doctor-population ratios of the some of the countries are:
Australia – 3.374:1000, Brazil – 1.852:1000,
China – 1.49:1000, France – 3.227:1000,
Germany – 4.125:1000, Russia – 3.306:1000,
USA – 2.554:1000, Afghanistan – 0.304:1000,
Bangladesh – 0.389:1000, Pakistan – 0.806:1000
- There is shift from communicable disease to lifestyle disease due to sedentary life style. Most lifestyle disease are caused by high cholesterol, high blood pressure, obesity, poor diet, smoking and alcohol
- Hospitals and pharmacy chains are expanding to tier II to III markets.
- Telemedicine is emerging fast in India. Appollo, AIIMS and Narayana Hrudayalaya have already entered into telemarketing services. Telemedicine can bridge the rural-urban divide in terms of medical facilities, extending low-cost consultation and diagnosis facilities to the remotest of areas via high-speed internet and telecommunication.
- Healthcare insurance is gaining ground in India. The trend will benefit both the individual and healthcare providers.
- Digital initiatives like Electronic Medical Record, Electronic Health Record, and Hospital Management Information System, Cashless transaction system are gaining quick ground.
- Advance technologies in pathology, home collection of samples are driving better diagnostics and health check-up than ever.
Adapted from CRM in Pharmaceuticals and Healthcare Marketing by Shailendra Tripathi