Exclusive Q&A With : Dr Ashok Seth Chairman of Fortis Escorts Heart Institute, New Delhi & Head, Cardiology Council
Updated on: 29 Jun 2016
The government should be encouraged to create manufacturing and research ecosystems to give the best advantages to those interested, shares Dr Ashok Seth, Chairman of Fortis Escorts Heart Institute, New Delhi and Head, Cardiology Council of Fortis Group of Hospitals in an exclusive interview with Kusum Kumari and Jaya Lakshmi of Elets News Network (ENN)
Sir, with your wide experience as a super specialist, you have witnessed all kind of advancements. So, now that we are in the stage where gene therapy and robotic surgery are coming to India, what are your observations?
In the last 30 to 40 years, the science and technology advancements, especially in the medical field and more so in the cardiology field, have been massive. Science and technology has progressed like never before in the last 2,000 centuries, as in the 20th century. Medical science has grown in the last 50 years. In brief, we have transformed 'care' in the last 30 years, offering 'more treatment of disorders'; however, we have, ofcourse, not found 'cure for disorders, rather have found only palliations'. Overall, we have succeeded in ensuring 'longer lives'. However, we still have not found how to absolutely say that I have treated you and you will never have coronary heart disease or develop blockage again.
In another 1,000 years, we might conquer many of these challenges; in this century for certain we are not going to conquer many diseases, but only have better therapies. As such, 'treatment' has improved significantly, such as minimally invasive surgery, and we now have loads of equipment, which is phenomenal.
In the last 15 years, I have been the core part of numerous pioneering technologies, such as replacement of valve of the heart without cutting the heart open through catheters, which was for the first time ever done in Fortis Escorts Heart Institute in the world in 2014. It subsequently became an established procedure worldwide, with 150,000 implants conducted so far. Therefore, things that were unimaginable in 2000 have now become the standard care practice in 2016. The time span of innovation is reducing because people know that innovation actually helps to save lives. However, medical expertise still cannot be replaced, which is the vital aspect. Therefore, clinical acumen, compassion, ethics, expertise and focus of the medical profession combined with any of these advancements of technologies is what delivers the best for the patients. As such, technology will assist in improving the results, make procedures less painful (less of cuts, rapid recovery and more minimally invasive) and ensure costeffective quality care.
Quality care by the way relates to providing very cost-effective healthcare and not necessary high technology.
Gene therapy, which changes chromosomes and therefore transforms the disease process can have a great impact, but the cost involved is huge. Any therapy besides being useful should also be cost-effective.
What are your key concerns and recommendations for the Indian healthcare? The opportunities in India are phenomenal, as obviously we have got 1.2 billion people to treat. We cannot have innovations for the few who are rich and can pay for it. Every time a new technology comes to me or I pioneer a new technology which costs twice, supposing it's a new stent, such as I was integral part of the creation and putting into research and practice of dissolvable stents, and my biggest concern was that if it is going to be available only to few rich people at the twice the cost of a normal stent, then I don't think I have done justice to healthcare, because at the end of the day it is only valuable if it is transferred down, not necessarily to all the people but at least to a significant portion of the people at a highly subsidised cost. Therefore, everything which we have to think of in terms of healthcare has to be cost-effective. This is the reason I love the idea of start-ups. For me, the value of a start-up is that its offerings should be applicable and capable of altering the life of a large number of people.
My biggest problem is that we still have not built up ways to promote innovation in terms of funding. Research and science should start in the medical colleges. Our medical colleges have no curriculum about research and science. That's sad because minds should start working around healthcare delivery in an appropriate manner through innovation right from the beginning. It needs to be in-built in the system and encouraged. This will make people think much ahead. We should have more of innovation centres. It's only in the last 5 years that we have seen innovation incubators. More number of people should be able to access these incubators. Innovation should become the agenda of the country and a habit. Youngsters should create and innovate not just for the sake of livelihood and financial rewards, but for the sake of ensuring benefits to a large number of people.
Key Takeaways Science and technology progressed like never before in the 20th century Reduction in the time span of innovation Medical expertise is irreplaceable Technology to assist in improving results and making less-painful procedures Ensure 'cost-effective quality care' Innovation need to be the agenda of the country and a habit
We see a lot of start-ups offering software-driven Internet platforms, as they overcome technical manufacturing issues. However, innovations in hardware are less. But, remember it's the hardware also that treat heart disease; therefore, it needs to be researched, created, developed and finally got to be implemented. A lot of hardware is required when we go for super specialised care, but when we go for preventive and commentary care a lot of m-health and e-health platforms are required.
Please throw light on the procedures initiated by you that have been institutionalised in the medical fraternity.