Your father needs a set of diagnostic tests to be done. Your child is prone to allergic coughs. You need a second opinion before you go in for a treatment. You have a sore throat and you want to be sure it is not a serious virus attack. Who can you check with?

Paramedicals explaining the Anyuta scheme. Pic courtesy: Anyuta Trust.

What you need is a ‘Family Physician’ or a ‘General Practitioner’. Someone who can provide primary and preventive healthcare, as well as advice and educate you to make an informed choice. Unfortunately, the concept of a family physician is not very common nowadays.

The Anyuta Trust is a rare example that provides access to a network of family physicians. "Mounting medical expenses are one of the causes of concern for the common man. Frequent viral attack news makes it tricky to ignore even something as general as a common cold. Also, new age specialisations make it difficult for the patients to make an informed choice." expounds Dr Ravindra Shetty, an orthopaedic surgeon and a founder member of Anyuta Trust.

The Prototype

Anyuta model of Managed health care was launched in 2001 by Shetty . Their tagline is "In a crisis, you are not alone". It is modelled on the National Health Service – NHS in the UK and the Health Maintenance Organization (HMO) in the US. It comprises of a network of doctors and residents of a locality. Three or more doctors of one area form the family physician group and those doctors are available around the clock.

Any individual can join with a one-time registration fee of Rs 100. The monthly fee is Rs 50 per person that includes free multiple consultations.

Implementation

Typically, in an emergency situation, the member calls Anyuta and he or she is provided with medical advice over the phone, or directed to the nearest local primary physician or a specialist, as required. If it is a routine check up, as in case of hypertension or diabetic patients, the Anyuta Family Physicians can be consulted. They will refer the member to a specialist, if needed. The members can call the doctors anytime. "In simple words, we are trying to integrate the services in health care sector", explains Dr Shetty.

The network embraces diagnostic centres, nursing homes and hospitals. Partners include Elbit Diagnostics, Bangalore Hospital, Ramesh Piles Hospital, Baptist Hospital, to name a few. The discounts given by the diagnostic centres are directly passed on to the members.

Shankar Narayana Rao, DGM of VT Corp, aged about 64 and a member of the scheme, says "This is like an insurance scheme for out-patients, which may be the first one in India. I am a member for the past 5 months. I must have come for about 6-8 consultations so far. This scheme is working out great for me in the area of preventive healthcare."

Subsidised Insurance

Busy day at Anyuta’s centre. Pic courtesy: Anyuta trust.

Anyuta also runs a Third Party Administrator (TPA) service for insurance companies. It handles the paperwork for claims of health care schemes made through LIC and New India Assurance. It tries to educate low income citizens about health insurance schemes available at subsidised premium. Another such subsidised scheme is the scholarship policy by LIC. About 2000 people have signed up under these insurance schemes. At times, it is the Anyuta members who sponsor the policy for their domestic help.

The network assists the patient in times of emergency, hospitalisation and claim processing. Under the policy, hospitalisation charges up to Rs 30,000 can be claimed from government or private hospitals.

Challenges in reaching out

Started first in Hebbal, the doctor-patient network is also functional at Banashankari now. The concept would be launched next at Chikkamagalur. "Ideally, there should be one network in each neighbourhood. Anyuta will help setting up of similar schemes in other localities if the hospitals come forward" offers Subba Rao, a retired advocate and the member of the advisory council of Anyuta. Each network is expected to grow to 4000 members to reach a sustainable mode.

There are about 70 doctors, including specialists and General Practitioners in the network. All over India, nearly 6000 hospitals have signed up. The network has currently about 600 members in Bangalore.

Why is this number low? "We rely on word of mouth advertising. We are not into branding and marketing our concept. Perhaps it’s because people hesitate to enrol, thinking that this sounds too good to be true."

Given the demographic variants like immigrants and floating labour population, it is a significant challenge to implement Anyuta’s doctor-patient network in urban areas, is the opinion of Dr. Bobby Joseph, Professor, Community Health Cell of St. John’s Medical College. "This would work best in smaller cities or communities where the people are bound by some factor."

Joseph further illustrates how typically, in a coffee or tea plantation area, for every 3-5 thousand workers, they have a General Physician. Perceptibly, medical history records are well maintained. "Having such a physician-people network is a very great idea. I sincerely hope there is more market study and analysis done and Anyuta works around the challenges", is his optimistic view.

"This people oriented, win-win model could be applied at state or national level", feels Dr Shetty. If the Anyuta concept spreads and becomes successful, it can prove to be a pioneering model for public healthcare in Bangalore and elsewhere. ⊕