CMC started as a small hospital of 40 beds, aimed solely at treating India's destitute. As the Christian medical college expanded, it faced a serious problem. It was unable to continue to treat the poor of India on donations alone, and needed to raise funds another way. They had already become a world renowned charitable organization, but now needed to draw in patients who were able to pay for their care, and fund the care of poor patients.
In order to attract these patients, they kept up with the times, and maintained an advanced hospital with state of the art diagnostic and therapeutic equipment.
In the early 1980s, the CMC board worried that their new advanced hospital was attracting too many patients who could afford care, making it more difficult for the poor patients to access the system. They had already established the community health and development center, to address the rural population near vellore, and in 1983 they established the Low Cost Effective Care Unit to treat the poor urban population of vellore, with the purpose of continuing to focusing on CMCs initial mission.
They established a small hospital and clinic, and out front they placed the original arch leading into Ida Scudders first hospital, named after Mary taber shell, the deceased wife of the banker that provided her startup funds.
While the inpatient/outpatient experience is interesting, Moriah and I spent most of our time with a social work named augustine, who has been incredibly helpful.
Whereas the rural hospital relies on community representatives to provide information on patients' ability to pay for care, the denser urban environment makes this system less useful, and instead social workers are deployed to patients homes to determine to what extent they can pay for their care.
We met one man, a tailor, who had been in a serious motorcycle accident several months prior, and suffered a fracture of his proximal humerus. At the time he was evaluated by an orthopedist, but refused surgery and instead consulted a local ayurvedic doctor, who managed his pain with herbs and attempted to set the fracture using the bandage seen in the picture. Several months later he had very limited range of motion and had been unable to return to work.
When he could work as a tailor, he could make about Rs 100 per day, and his wife could take home another Rs 50 or so working as a housekeeper, meaning this family of five was making about 3 dollars a day, and lived in a one room hut 1/3 of the size of our studio appartment. However, now that he was unable to work, they had only his wife's income.
He had already spent Rs1500 on his medical evaluations, and had been reevaluated by an orthopedist who wanted to perform an open reduction and internal fixation with pins to set the fracture properly. The total cost of the procedure would be Rs 55000, which at just over $1000 doesn't sound so bad in america, but even if he were working it would take over a month for he and his wife to earn that amount, and that's without the cost of their rent or food.
The orthopedic surgeon sent the patient to the social workers to determine how much the patient would be able to pay for his care, and we went with him on a home visit to see if the patient didn't have other ways of paying for the procedure.
His living conditions were indeed as he described, and the social worker did believe the patient was telling the truth. In fact, a significant portion of the interview was spent trying to convince the patient not to sell his wife's wedding ring to help pay. As Augustine explained to us, the gold might net only about Rs5000, not enough to make a significant dent in the cost of the procedure, but enough to cause his family significant distress.
The man did have a golden earring which did not have signifiant emotional value, and probably worth less than $20, which he offered to sell. The social worker agreed, and filed a recommendation that the man be charged the Rs 1000 for the procedure.
Dave
In order to attract these patients, they kept up with the times, and maintained an advanced hospital with state of the art diagnostic and therapeutic equipment.
They established a small hospital and clinic, and out front they placed the original arch leading into Ida Scudders first hospital, named after Mary taber shell, the deceased wife of the banker that provided her startup funds.
While the inpatient/outpatient experience is interesting, Moriah and I spent most of our time with a social work named augustine, who has been incredibly helpful.
Whereas the rural hospital relies on community representatives to provide information on patients' ability to pay for care, the denser urban environment makes this system less useful, and instead social workers are deployed to patients homes to determine to what extent they can pay for their care.
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| A splint from an ayurvedic doctor |
When he could work as a tailor, he could make about Rs 100 per day, and his wife could take home another Rs 50 or so working as a housekeeper, meaning this family of five was making about 3 dollars a day, and lived in a one room hut 1/3 of the size of our studio appartment. However, now that he was unable to work, they had only his wife's income.
He had already spent Rs1500 on his medical evaluations, and had been reevaluated by an orthopedist who wanted to perform an open reduction and internal fixation with pins to set the fracture properly. The total cost of the procedure would be Rs 55000, which at just over $1000 doesn't sound so bad in america, but even if he were working it would take over a month for he and his wife to earn that amount, and that's without the cost of their rent or food.
The orthopedic surgeon sent the patient to the social workers to determine how much the patient would be able to pay for his care, and we went with him on a home visit to see if the patient didn't have other ways of paying for the procedure.
His living conditions were indeed as he described, and the social worker did believe the patient was telling the truth. In fact, a significant portion of the interview was spent trying to convince the patient not to sell his wife's wedding ring to help pay. As Augustine explained to us, the gold might net only about Rs5000, not enough to make a significant dent in the cost of the procedure, but enough to cause his family significant distress.
The man did have a golden earring which did not have signifiant emotional value, and probably worth less than $20, which he offered to sell. The social worker agreed, and filed a recommendation that the man be charged the Rs 1000 for the procedure.
Dave
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