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Tuesday, June 15, 2021

Lack of medical experts: Dhanvantari Covid Care hospital turns to telemedicine, visiting consultants to meet shortage

Officials have cited lack of medical staff and experts, along with shortage of medical oxygen, as roadblocks to run the centre to its full capacity.

Written by Ritu Sharma | Ahmedabad |
Updated: May 10, 2021 11:21:42 pm
Lack of medical experts: Dhanvantari Covid Care hospital in Ahmedabad turns to telemedicine, visiting consultants to meet shortageUntil May 10, the hospital has been able to expand its operational bed capacity to only 560 despite having a total 900-bed capacity which can be expanded by an additional 500 beds. (Express Photo by Nirmal Harindran)

TWO WEEKS since it began operations, the Dhanvantari Covid Care Hospital in Ahmedabad has turned to telemedicine and hired visiting doctors on hourly basis to deal with the shortage of medical experts, including specialists for Covid patients.

The Covid care hospital, set up jointly by the Defence Research and Development Organisation (DRDO), Gujarat University and the state government at Gujarat University Convention and Exhibition Centre in Ahmedabad, started operations on April 25 with just 40 Covid-19 patients.

Until May 10, the facility has been able to expand its operational bed capacity to only 560 despite having a total 900-bed capacity which can be expanded by an additional 500 beds. Officials have cited lack of medical staff and experts, along with shortage of medical oxygen, as roadblocks to run the centre to its full capacity.

On Monday, sources told The Indian Express that a telemedicine service was launched last week with about 16 private practitioners, include specialists like nephrologists, gastrologists, and neurologists among senior doctors in general medicine, besides 12 private superspecialists, who have been roped in as visiting doctors from this week.

Dealing with nearly 50 calls per day, as on Monday, the telemedicine service operates in three time slots designated to respective consultants. During the duty hours, the resident medical officer guides the medical officer for identification of patients, who require consultations from physicians, pulmonologist or any specialist doctor.

Identification of patients is done every morning between 9 am and 1 pm, the time slot between 1 pm and 3 pm is fixed for scheduling, following which consultations start with calls for the super-speciality reference with the doctors on roll between 3 pm and 7 pm.

The consultations cover treatment plan at the time of admission, change of treatment plan during reassessment, deciding the time of discharge, decision on treatment or advice in selected cases, and even emergency or special situation that may arise in ICU or ward.

“There is no harm in getting consultants’ services through telemedicine which is an easy access to expert doctors and it help doctors to closely monitor patients. Though telemedicine cannot be a solution to all the problems but considering the ongoing Covid pandemic, it can surely help decrease the burden of the healthcare system to a large extent and boost the morale of the patients,” principal secretary education Anju Sharma, who is managing the hospital, told The Indian Express.

Declining to share the “remuneration” given to consultants, Sharma said they are paid as per their services and experience on an hourly basis.

The hospital had invited applicants through walk-in interviews for posts, including staff nurse to MDs, with salary ranging between Rs 20,000 and Rs 3 lakh per month. The hospital increased the Rs 1.3-2 lakh salary offered for the posts of physicians and anaesthetists in its walk-in interview advertisement on April 19 to Rs 2.5-3 lakh per month on April 28. On May 3, the hospital again made call for medical staff, including 14 supervisors for the hospital ward at a salary of Rs 40,000 per month for a 12-hour shift.

The April 28 advertisement was for recruiting five physician pulmonary chest (EMD) along with 10 anaesthetists and intensivists at Rs 2.5-3 lakh per month salary. The advertisement said there was a requirement for 20 medical officers at a salary of 1.25-1.5 lakh per month, 55 staff nurses at Rs 35,000-45,000 and 50 medical officers intern at Rs 75,000 per month.

To meet the shortage, third year MBBS students of BJ Medical College and Hospital in Ahmedabad, who had just taken their exams, were also roped in by the state government on April 28.

Currently, the 900-bed Covid care hospital has staffers from at least 10 public and private agencies, including DRDO, Gujarat University, the state government, all three defence forces — Army, Navy and Air Force, Border Security Force (BSF), Central Reserve Police Force (CRPF), and Sashastra Seema Bal (SSB) among others.

It also has around six full-time specialists and super-specialists, a dozen anaesthetists, about 45 medical officers (MBBS), eight senior resident doctors along with paramedical staff.

Further, the hospital authorities are planning to rope in more medical experts affiliated to the Ahmedabad Hospitals and Nursing Homes Association (AHNA) and the Ahmedabad Medical Association (AMA). “Discussions are on for these services and something is expected to be materialised soon,” AHNA president Dr Bharat Gadhavi said.

The state government, in an affidavit submitted to the Gujarat High Court, had also stressed on the lack of skilled staff “causing constraints in immediately achieving full operability” of the hospital.

“However, of the staff available from various agencies, the number of skilled nurses is only 45 and specialists are only 11 causing, constraints in immediately achieving full operability. Due to tremendous pressure on the health infrastructure at present there are severe constraints in getting additional nurses and specialists to reach full capacity utilisation,” the affidavit had stated.

Referring to the shortage of medical oxygen, the state government affidavit stated, “For activating all the 900 beds at the hospital a minimum 25 metric tonnes of oxygen supply is required on a daily basis.

However, the hospital currently has a limited daily supply of oxygen of about 15 MT allocated by the state government. Additionally, the constraint on the availability of medical and paramedical staff also has impeded the ramp up of hospital capacity swiftly. Hence in view of this, hospitals utilised bed capacity has, so far, reached 558 beds.”

The hospital, meanwhile, has also engaged 130 nursing students to assist the functions of the hospital. The Centre has also been urged for extend support to the hospital by mobilising additional manpower through the armed forces.

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