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In Conversation with
In recent times healthcare sector has been witnessing major changes. Application of technology in the form of artificial intelligence is making things real ‘Smart’. Now we have smart wrist watch that can keep an eye on heart rate, body temperature, blood pressure, ECG, oxygen saturation in blood and can warn early if any of the parameters is abnormal. Real advantage of this technology is early diagnosis and treatment within the ‘Golden Hour’ (period of time during which there is the highest likelihood that prompt medical and surgical treatment will prevent death), thereby reducing chances of death, complications etc. Many more devices based on AI are in pipeline. In near future we may see ultra-sonography being done using mobile phones. Other novelties include robotic surgeries, artificial organs, nano technology. Application of technology in medical fraternity is changing the face of healthcare industry.
2.As a person knowledgeable with India’s healthcare infrastructure is it possible to distribute any Covid-19 vaccine (eg: Pfizer, Serum Institute etc) on a national scale? What would be the major hurdles in your opinion?
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COVID 19 vaccine is something that the world is waiting for. Considering population of our country it is a herculean task to make the vaccine available across the country in sufficient quantity. Major hurdle in the distribution of vaccine will be maintaining the cold chain. Vaccine developed by Pfizer, which will be available in near future, needs to be stored below – 70C. Even in developed countries it is difficult to have such storage facilities in all hospitals, health centers with sufficient capacity. Transporting vaccine from one place to another while maintaining the cold chain is also difficult. The Government will need to build logistic support and storage facilities in very short period of time across the country. But I am hopeful that necessary arrangements will be made by the Government.
3.What is the scope for Telehealth in India?
Telehealth/ telemedicine is witnessing boom after the world is hit by COVID 19 pandemic. During lockdown patients who were suffering from conditions other than COVID 19 were extensively dependant on it. However, we need to understand the importance of visiting a doctor as well. Whenever a doctor treats a patient, before treating the doctor talks to the patient, sees medical reports and also conducts clinical examinations which are very important to reach to a diagnosis. In telehealth set up the doctor cannot perform any of the clinical tests. Hence it is better, if a patient can personally visit the doctor at least at the first time and then uses Telehealth for the follow up visits. However in India, Telehealth will need some more time to get general acceptance due to one other reason – mind set of patients. Many patients feel relaxed or get psychological support when they personally meet the doctor. Hence, Telemedicine will be more popular as and when the patients will come out of the mind set and can see practical benefits of Telehealth. But Telehealth setups cannot completely replace clinics and OPDs. In India, Telehealth system can be a boon to strengthen rural healthcare system. As number of specialists and super specialist doctors is limited and these experts are mainly saturated in big cities and metros, patients living in small cities and rural areas are deprived of their expertise. This can be overcome by connecting doctors practicing in rural areas and their patients with specialists in cities through Telehealth. So doctor and the patient in a small town can take opinion from specialist practicing in any part of the world. On Field doctor can perform clinical tests, investigations as suggested by the specialist and can also carry out the treatment. This system can have positive impact on healthcare status in rural parts.
4.We have been facing new strains of diseases over the past decade. Allopathy has been the most agile stream of medical profession to respond to the new diseases. Do you think that in future, allopathy might make other disciplines such as homeopathy or ayurveda redundant?
Ayurveda, Yoga, Unani, Siddha and Homepathy (AYUSH) system of medicine was the mainstream medicine before the emergence of modern medicine and according to WHO, 65 to 80% people still use traditional medicine. Advances in science have undoubtedly made modern medicine as mainstream in healthcare system, but it cannot make AYUSH system redundant. Currently no healthcare system is complete to cater all the aspects of human health. While modern medicine has no alternative in treatment of emergency conditions, infections, in long term management of diseases such as Diabetes, Hypertension, arthritis etc. there is scope for AYUSH system due to side effects of modern medicines. Advantage of AYUSH system is use of predominantly herbal (non chemical) medicines which don’t have side effects. AYUSH is time tested healthcare system based on oriental ways of scientific thinking. If these oriental principles in AYUSH system are blended with
modern research tools our country can give one of the best integrated healthcare system to the world. Hence integrated healthcare system is the need of the day and AYUSH systems have major role to play in it.
5. During Covid-19, we saw a surge in demand for traditional immunity boosting medicines and tonics. Were these products as helpful as they were being marketed to be?
In a chaotic situation of COVID 19 pandemic, initially there was no clue for treatment or prevention of Corona virus. Hence in initial days all healthcare systems had to treat the patients based on their experiences in treating similar diseases in past. With multiple research projects, clinical experiences some line of treatment is decided and is being followed. Similar thing happened for traditional immune boosters. Hence, there was demand for medicines which are known to have positive effect on immunity, such as Giloy, Haldi, Chyavanprash. These medicines are already researched extensively for their immunity boosting effect and the data is also available in form of scientific publications. In current COVID 19 pandemic, central and state Governments, pharmaceutical companies, NGOs have conducted/ sponsored many research projects to quantify the effects of these medicines in boosting immunity. The reports of these studies are getting published in scientific journals and claim to have beneficial effects. Metaanalysis of these research articles will help in finding precisely which immune booster medicines have helped in the current pandemic. Ministry of AYUSH, Govt of India has also launched a mobile app – AYUSH Sanjivani, to collect data about use of AYUSH medicines in COVID 19 and its effect. Results of the data collected through app are awaited.
At Parul University, Vadodara, Gujarat we have conducted two projects to see preventive effect of Ayurvedic medicines. A major multi-centric study among these was to see preventive effect of famous Ayurvedic medicine Chyavanprash in preventing COVID 19. Initial analysis is showing promising results. Another study was to see effect of a combination of Ayurvedic medicines in preventing COVID 19 and respiratory infections in security guards. It has also shown promising results and participants consuming these medicines were not infected with COVID 19. Results of these studies will soon be published.
6.Do you expect Covid-19 to have a significant
impact on medical education in India, and why? The pandemic of COVID 19 has highlighted importance of adequate number of doctors per population The Economic Survey 2019-20 says that the doctor-population ratio in India is 1:1456 against the WHO recommendation of 1:1000. The Government has set up premier institutes like All India Institute of Medical Sciences (AIIMS) in different parts of country. Private education institutes/ universities are planning to set up medical or AYUSH colleges. So number of seats for medical education will surely increase and also the number of students opting for it. Medical education includes postings in hospital wards which are very important to gain practical knowledge and acquire different skills. As colleges suspended in campus activities during the pandemic, medical students were deprived of the practical knowledge. Especially final year students who have at least one ward posting a day are at considerable loss. Some colleges/ universities postponed examinations. But it will have short term impact and students will have to find ways to compensate the loss of knowledge.
Dr. Shaliesh V. Deshpande M.D Ayuveda Professor, Department of Ayurvedic Medicine
1.What’s new in Healthcare Tech?
Healthcare has been witnessing a lot of innovations and technological advancements. Telemedicine and Robotic surgeries. Robotic surgeries help doctors perform complex procedures with more flexibility, precision and control what is possible with the conventional techniques present. It is usually associated with minimally invasive surgery which is procedures performed through tiny incisions.
2.Which company do you think is making a name for itself recently in pharma/health industry and why so?
Due to the outbreak of COVID 19, the companies which are in news in pharmaceutical industry are majorly related to the vaccine. Pfizer, BioNTech, Zydus Cadila.
3.As a person knowledgeable with India’s healthcare infrastructure is it possible to distribute any Covid-19 vaccine (eg: Pfizer, Serum Institute etc) on a national scale? What would be the major hurdles in your opinion?
In my opinion it is possible to distribute Covid-19 vaccine utilizing the current healthcare systems and the new additions which are being made to the distribution channels will in turn make is feasible for widespread distribution. Major hurdles in this would be-
a. Maintaining cold chain b. Avoiding black marketing c. Arranging professionals d. Rate control and standardization
e. Matching demand and supply
4.What is the scope for Telehealth in India?
Telehealth is boon to the country like India. It is still very difficult to avail good health advice at village levels and with the rapid penetration of internet, Telehealth can be a way to reach people residing in remote areas. It can be cost effective, time saving and very handy. Having said that it can’t be a perfect substitute for a hospital.
5.Major changes that you have seen in patient behavior due to covid.
Major change observed in patient behaviour is acceptability to telemedicine, online consultation and health awareness.
over the past decade. Allopathy has been the most agile stream of medical profession to respond to the new diseases. Do you think that in future, allopathy might make other disciplines such as homeopathy or ayurveda redundant?
Allopathy is most advanced stream in medical science but Ayurveda/ Homeopathy are our heritage science. To make the optimum use of medical knowledge and innovation, there science should also be utilized in therapy along with allopathy in the constructive way for benefit of humanity
7.Do you expect Covid-19 to have a significant impact on medical education in India, and why?
We have lost many colleagues in the pandemic. This has also opened our eyes for the need of more healthcare infrastructure and personnel.
8.Can we expect some Ayurvedic medicine as well for Covid-19? What would be the major differences between cure finding procedures under different medical disciplines?
Yes, we can expect but the acceptability and standardization of the product is a big query in our country. Major difference in the cure finding procedure is the scientific approach of different medical disciplines.
