Doctor At Your Doorstep: Dr. Bishal Dhakal
For a long time we have followed the traditional way of visiting the doctors in hospitals even though the technology involved has progressed signi cantly. Often times we have heard that patients are unhappy with their doctor or the service they are provided with. We, the humans of the world depend on the medical eld to help us. Without them, who knows where we would be. We have been grateful for anyone that has dedicated their lives to help others. In that context, we talked to one man who has been doing the same. Health at home has been providing medical services to people by going to patient’s houses and lling the loop which has been going on in the industry. Dr. Bishal Dhakal is the pioneer in this eld of delivering medical services to patients in their houses. We had a chat with him in his of ce where we had the chance to talk with him and his lovely staff members who have been battling medical issues themselves as well.
HOW DID YOU PLAN TO BECOME A DOCTOR? WAS THERE ANY INSPIRATION BEHIND THE CHOICE?
For two things. Firstly, my grandfather always wanted to see me become a doctor. As I grew up, he always told
me that i was going to be a doctor even though my dad was a prominent lawyer. He would have loved me as a lawyer too, but my family was always supportive of what career i wanted to choose.
Second, when I was done with my higher secondary education in India, I had the chance to go to Russia. My cousins were there and being more spontaneous then, than I am now, I went to medical school. It was a spur of the moment sort of thing, but I’m sure my grandfather’s wishes had a lot to do with it.
YOU STARTED OUT AS A MEDICAL STUDENT LIKE ANYONE ELSE WHO WANTED TO BECOME A DOCTOR. DID YOU HAVE ANY IDEA THAT YOU WOULD DO WHAT YOU ARE DOING NOW. HOW DID IT ALL START?
Again, there are two parts to it. One is because of how I am as a person. I’ve always wanted to create something unique and something I can call my own. And I want what I do to contribute towards the society.
Also, I struggled a lot during my time as a resident doctor in Pakistan. While there, we would have critical patients who needed cardiac surgery. These surgeries rendered a 30% chance of mortality and a 40% chance that the patient would live the rest of their life with disabilities.
It was a lingering discomfort of these statistics that had me thinking constantly. Around the end of 2008, the concept of home health care came as an epiphany that would set me on the tracks of possibly doing something to eradicate this condition.
I looked at places I was familiar with, like India, Pakistan, Russia where, it turns out, the presence of a community care model was missing; which meant I would be pioneering into the sector.
The sad truth was, there was no after hospital care whatsoever. There were times when we would send patients off after surgery so they could die in their own bedroom. As a practicing doctor, I had fulfilled my duty after the treatment but as a person the entire concept pestered me.
I mean, who’s going to take care of them? Even if they might only have the next sunrise when they breathe their last, they need proper care, cleansing, medication, hygiene; basically a position to go in a dignified fashion. I was upset with this disfranchised manner of health care. So one day, 2 years into my academics as a surgeon, I walked up to my professor and just said, “Bye, I’m going.” It was as spontaneous as that because there was a higher calling that couldn’t be overlooked.
In 2009, we started our pilot model. It was based on a separate business entity I used to have. We started with subscription service for health at home, but it did not work out that well. We needed to do something different so we followed a much personal nursing care in which we just didn’t treat the patients for the sake of it but went an extra mile to make their time with us more comfortable. So, by 2010, we were clear about what we wanted to do. That’s how all this came into being what it is now.
HOW DOES IT WORK?
Most of the times the doctors directly call us and say that they have a patient who needs to be taken care of. The calls come into the call-center usually through word-of-mouth. We don’t have much support from proper referral agencies so most of our clients are people who have been sent our way by clients who we have already served. We have been able to build goodwill among our clients who
are willing to help us grow. We’re really proud of our high client satisfaction and I can’t think of any better way to justify it other than their repeated reference.
We have call-managers who process the call and track down which hospital, which bed and what case the patient has, plus what services they require.
We never ask our clients to come to us, we go to them. Our managers will go to them and evaluate, explain and give them the choices for nurses, labs, doctors, physios, anything they might need. Then we set up the people required, orient them and send them the patient’s way. We then receive daily update on the patient on how they are doing. Currently we’re using SMS services but we are developing a technology that will provide us with real time updates, like a virtual hospital of sorts. Then we respond accordingly, suppose the patient starts to suffer from fever, we send a doctor right a way. We bill the charges and we get money from its payment. Basically, our whole concept is based on the response we all have when our near and dear ones get sick.
WHAT ARE THE OBSTACLES THAT YOU HAVE COME ACROSS AND HOW DID YOU DEAL WITH THEM?
See, health care is a very complicated field because it lays the life of someone on your hands, the life of someone who is dear to someone. We are paid to deliver care for them. Now, our country has one of the highest number of holidays from being religiously and culturally diverse. We have Christmas, then New Year, followed by our New Year, then Maghe Sangranti and the list goes on, not to forget the massive amount of political strikes and bandhs..
The thing is, to operate this kind of business with all these holidays and strikes is an obstruction. My employees did not understand so I needed someone who could empathize with the need for proper medical attention. Fittingly, the backbone of our office are the people who are suffering from spinal injuries. They understand the issues because they have been through it.
Problems are always going to be there.. But the main question is, does one have the guts to tackle it and rise above. There will be problems and there will be solutions, all you have to do is look for it..
I’ve been to communities from all over the world and learned from them that problems are to be addressed by the people. For instance, today is a bandh, but my staff, despite being wheelchair bound, is the first to come into the office. She is the first one everyday and she comes here on her tricycle. Problems are there to be solved. If you are able to eliminate it, you’re golden.
And I have been able to do that in my life.
Over the years we have been awarded for what we do, but it didn’t come at an easy price or an easy way. I have faced defeat many times. However, I didn’t accept that and worked to the best of my abilities.
WHAT ARE YOUR PLANS FOR THE FUTURE?
Now, we have over 200 nurses and caretakers working for us with more than100 clients. Since we have started, other companies too have started replicating what we do with a model ditto to ours. Sure, that is competition, but the work they do, most of the credit goes to us because we started it.
The market size for this has gone from a small room to a platform where more than 3000 nurses have gotten dignified jobs; which our ministers have failed to create. Previously, nurses would be exploited and abused, but with us, we pay them for every hour they put in. As of today, we have given fifteen batches of women free training and we have plans on continuing it.
Like any good business, I want to expand. Currently we are in Nepal and doing very well. However, we want to be a global name and extend our services, starting with India. Some entrepreneurs have copied our concept in India, but like the others, have not fared so well. A model like ours has remained a concept for them, but by the fact that they have copied us means that they know of us, which pretty much means that our name is already out there.
Interviewed by : Shreya Sangroula
Words by: Nirveek PPJ Shah
Photos: Pritam Chhetri