Introduction

IITB Hospital is one of the most crucial institutions on campus, serving as a primary care centre that provides medical services to all students and staff. The various services offered include general OPD, specialist appointments, blood tests, sonography, admittance, psychiatric treatment, etc. An ambulance is available 24/7 to attend to students and staff across campus. Given that the IITB Hospital is responsible for the physical well-being of campus residents, it is essential that the patients feel satisfied with their hospital experience. To gauge students’ experiences with the hospital, Insight conducted a survey (which received 402 responses) and interviewed students to share their  experiences with the hospital. We also interviewed the current Chief Medical Officer (CMO), Dr Arvind Meshram, who has been a part of the IITB hospital for 29 years, to relay the queries and grievances (raised in the survey) to him and get his perspective about these issues. 

Hospital and Health Advisory Committee

The Hospital and Health Advisory Committee (HHAC) is an oversight body responsible for monitoring the functioning of the IITB hospital. Prof. Ashutosh Gandhi, the convenor, currently heads it, and also consists of a 15-member team including the Dean SA, Dean Faculty, Registrar, doctors from IITB hospital and some external hospitals, the GSHA (General Secretary of Hostel Affairs), ISHA (Institute Secretary of Hostel Affairs), and the Institute Girls nominee. 

The committee’s meetings are held quarterly regarding policy matters and rules & regulations that govern the hospital. The hospital staff may also consult the committee about individual appeals of students and reimbursement issues. Additionally, the convener is kept in the loop during the recruitment of doctors and staff. The committee also calls for the approval of impanelling any external hospital with IITB to refer the students outside for treatment.

IIT Bombay’s Medical Insurance Policy

IIT Bombay’s hospital provides medical insurance through the Dean SA’s office under an internal insurance policy called SAIF (Student Accidental Insurance Fund). This allows students to access medical coverage within the empanelled hospitals of IIT Bombay. According to the Chief Medical Officer (CMO), a new medical insurance policy is underway.

The SAIF policy is an internal policy of the institute, while other IITs use external insurance policies. While an internal policy allows students to receive treatment in exceptional cases even when specific policy requirements are unmet, a new comprehensive policy should address broader coverage needs. 

We believe that the policy should mention whether it provides nationwide accident coverage with a clearly defined insurance cap. Pre-hospitalization and post-hospitalization coverage provisions should be explicitly outlined, especially for prolonged diseases (defined as conditions lasting more than 30 days under the current SAIF policy). Including coverage for pre-existing conditions and extending benefits to postdoctoral students would further benefit the student community. Insight hopes that these key things are addressed in the new policy in case the current system of internal insurance is to be continued.

The Hospital Survey 

Disclaimer:
The findings presented in this article are based on a survey conducted within our institute. It is essential to note that the survey may not be representative of the entire population of the institute. Consequently, the results might not capture the views or experiences of all members. The data should be interpreted as reflective of the respondents’ perspectives, and caution is advised when generalising these findings to the broader institute community.

The hospital survey was filled out by 402 respondents, with the demographics being 69.9% male and 29.1% female. Further, 46.5% of respondents were bachelor’s students, while 19.2% were master’s students, and 25.4% were doctoral.

Fig 1

From the responses, only 23.1% of respondents always visit the hospital when they are sick, while 19.2% of respondents preferred to visit “during emergency conditions” only, and the majority (52.7%) would only drop by “sometimes”. 

Some of the reasons which made students hesitant to approach the hospital included:

Total respondents – 245. Responders could choose multiple options

Among the 245 responses of students, the primary reason for never/rarely visiting the hospital was that they felt that the doctor generally prescribed them the same treatment and medication on each visit. Another leading cause was the lack of positive peer reviews that deterred them from visiting. Similar issues were pointed out in the Hostel Affairs Mid-term GBM of 2024, where the audience reported misdiagnosis cases. The GSHA at that time took note of the grievances and remarked that a hospital committee, which included the deputy director, which was recently formed then, would address these challenges.

OPD, Consultation and Hygiene 

The current OPD services are from 8 am to 6 pm from Monday to Friday and from 8 am to 1 pm on weekends and holidays. The list of available doctors and their times can be seen on the website. An emergency doctor is also always present to assist students during non-OPD hours.

Students have been satisfied with hygiene practices overall, as can be seen from the above graph. 

However, a few respondents mentioned instances where the waiting times were over an hour or the waiting time was increased due to the doctor’s unavailability. Addressing these complaints, the CMO mentioned that the waiting time is subject to the number of doctors available in the OPD. Sometimes, the doctor may be busy in another ward or helping the specialists; hence, they may not always be in their room. If a person has a severe condition and needs to consult a doctor, they will be given priority. The doctors’ timings are fixed, but where they may be in the hospital during those times varies.

Total respondents – 375. Responders could choose multiple options.

A majority of respondents stated that they felt that the current OPD hours were insufficient and there is a need for extended OPD hours during weekdays or weekends to accommodate their schedules better.

‘ With OPD timings often overlapping with class timings, and with the long waiting times, it is hard to find time to slot in a hospital visit in the day.’
-anonymous respondent

“The doctor on the weekend may just say to come back on Monday which is of no help if you’re sick. Weekends are when people are free to go to the hospital.”

-anonymous respondent

Along with these, some students also raised concerns regarding doctors’ adherence to the schedule, with instances citing doctors not being present at the mentioned times.

In response to the above queries, the CMO stated,

 “The IITB hospital is not a full-fledged hospital, and we have our limitations. The timing increase of OPD is difficult, as the purpose is to provide only basic facilities. Currently, the doctors cover shifts in the morning, afternoon, evening, and then emergency hours. Without informing, the doctors on campus cannot leave, as they can be called anytime by the hospital in an emergency. Extending OPD hours remains a challenge due to the difficulty of calling doctors in the evenings because of the number of doctors. However, there are ongoing plans to upgrade and expand the hospital.”

The survey suggested separate waiting lines for students and staff, for which the CMO said, “This would be extremely difficult for us. We have segregated the staff and students counter to solve the space crunch and long waiting times. But we can’t have separate doctors for both, and the timings also overlap. The administration must take care of accommodating students’ classes and lab timings, and we are ready to help.”

“Doctors are impatient to listen to our problems…and immediately write medicines. So, a second opinion is needed as the diagnosis process is not reliable.“

-anonymous student

More than a quarter of the students opined that the doctor prescribed them without sufficiently diagnosing them. To understand the procedure that doctors need to follow, the CMO told us, 

“There is a standard protocol which we learnt while studying which includes asking every information like BP, temperature, family history, allergies, etc. But while you are practicing, it doesn’t come into play. We also face issues due to students not bringing their medical files where this information and past medical history are mentioned.  We have a huge load of patients, so we have to be selective about the questions we ask the patients, and this comes with experience.”

One of the common reasons preventing people from approaching the hospital was that they felt doctors prescribed them common medications on each visit. The CMO remarked that 

“We recommend medicines based on initial symptoms for a few days and strongly suggest students follow up in case their condition hasn’t improved, and we can then further diagnose and treat the student better…We don’t prefer heavy medicines like external hospitals as antibiotic resistance can develop, and we will have to give higher doses every subsequent time. ”

Pharmacy

Regarding the medicine stock selection, the CMO explained that the stock of medicines is managed by a therapeutic and formulary committee (a body that oversees medication management in health systems), which annually reviews and decides the list of medicines based on their frequency of use and effectiveness.

The committee considers input from doctors, staff, and patients during this review process. Medicines are purchased in bulk, and while the hospital tries to ensure availability, it faces logistical challenges in urgently procuring specific or low-demand medicines, unlike external pharmacies. In cases where a medicine is unavailable, the hospital advises the external purchase of the medicine and has a policy to reimburse the cost incurred.

The CMO also informed us that only basic medicines for mental health and specialised prescriptions are available, but the hospital is working to address these concerns of availability.

Hospital Admittance experience

The following questions were asked only to the students who had been hospitalised at least once during their stay here at IITB.

Total respondents – 110

Overall, the student respondents were satisfied with the service to admitted patients, with mean scores of 3+.

Total respondents – 90. Responders could choose multiple options.

Respondents have shown a positive response, highlighting the care taken by the hospital to maintain hygiene. The food provided was majorly nutritious and adhered to the prescribed diet. The CMO mentioned that a diet plan is made with the help of the dietician to comply with the needs of patients.

Soft Skills

The result shows that doctors generally follow the basic protocols regarding students’ privacy while examining them.

Total respondents – 402

The soft skills of the hospital staff, doctors, and pharmacists are overall satisfactory based on the survey results. Through interviews of survey respondents, however, we found out that there were some instances when the patient found the doctor’s or nurse’s behaviour ill-mannered. Regarding this, the CMO said, 

“Clinical services training (aka CNE) has been arranged for the doctors, nurses, and other staff members for medical purposes in different hospitals like Jupiter or Godrej. However, for soft skills, the institute is trying to develop initiatives to teach staff skills like speaking, listening, etc. If the patient has any dispute with the doctor, nurse, or receptionist, they are free to contact me. I listen to both sides of the story separately, and most of the time, discussions clear misunderstandings.”

Specialist Appointment

Currently, the receptionist schedules specialist appointments manually. Once the patient gets a referral from an OPD doctor, they approach the receptionist and get the day of the specialist’s arrival. On the day of the specialist appointment, the patients are given a token number based on their earliest arrival. 

The students also feel the following issues regarding the specialist appointments:

Total respondents – 168. Responders could choose multiple options.

We can see that there are prevailing issues like not getting a specialist appointment on an urgent basis and delays in the doctor’s arrival time. We also got to know that the specialists’ timing clashes with the classes. About these complaints, the CMO remarked, “The specialist arrives from outside and is generally working in some other hospital too. We have to look at their schedule while making the appointments. However, if required, the specialists can be called from outside based on the emergency and the students can be sent to empanelled hospitals (hospitals which IITB has a tie-up with) for treatment. On Sundays, all the hospitals are generally closed, and there are only a few doctors, but the doctors on campus can be called based on their needs.” 

“I had a severe toothache and was told that an emergency appointment with the dentist couldn’t be scheduled. I was willing to wait after a few patients but was informed that a patient’s list had already been submitted and that I should come after 2 days.”

-anonymous respondent

Like the above-stated experience, there have been similar anecdotes when people couldn’t schedule a specialist appointment on short notice. A possible solution could be having free slots, which would allow emergency patients also to consult the doctor and prevent the aggravation of their problems.

The CMO acknowledged that specialist availability is limited, with specialists visiting only twice a week, and efforts are underway to increase the hours of current ones and bring in new specialists like dermatologists. However, space constraints in the hospital and housing constraints for full-time doctors and employees remain challenging.

Pink Slip

Some other grievances that respondents had shared include:

 Pink slip is a medical certificate issued by the hospital, which serves as an official proof to compensate for missed classes and labs, on account of illness. It is issued by the Medical Officer to the students only after examining and assessing the need for rest and merely attending the OPD does not make a student eligible for a medical certificate.

“I fell sick in my hometown and had to be hospitalised there. They didn’t listen to my case. I have suffered academically because of this trouble from IITB Hospital..they just said if I never came to IITB Hospital, that means I was never sick at all.”

-anonymous respondent

Upon discussing this with the Chief Medical Officer (CMO), it was clarified that much of the confusion regarding the issuance of pink slips stems from a lack of awareness among both students and faculty regarding the rules for pink slip issuance. While these rules were shared via webmail on 7th November 2024, the key points are summarised below:

• Visiting the OPD does not automatically qualify a student for a pink slip.
• Pink slips cannot be issued for visits to external doctors without IITB doctors’ reference.
• Students are supposed to stay on campus (with few exceptions) during the rest period.

The CMO emphasised that, like students, faculty members must also be familiar with these guidelines. The Medical folder/OPD paper signed by the hospital can be used as proof of the student visiting the hospital for treatment and can also be shown to the authorities. If there is any confusion from the professor’s side, they can email the CMO and get clarification about the patient’s condition. 

Concerning medical certificates issued by external hospitals, the IIT hospital can’t give a pink slip validating the same, as they haven’t treated the student and cannot verify another medical professional’s treatment or practice. In such cases, it is at the faculty’s discretion to accept or reject certificates issued externally. 

“I don’t have a medical file yet, so I wasn’t given a pink slip despite being admitted to the hospital for 6 days”

-anonymous respondent

The CMO informed us that treatment for the patient would be done regardless of whether the student has their medical file. However, to issue a pink slip, it is necessary to have the medical file, and the student can collect their pink slip afterwards for record purposes.

The CMO also assured that there is no daily limit to the number of pink slips that can be issued, contrary to the respondents’ experience. He further clarified that pink slips are not issued for menstrual cramps or allergic conditions as those are very subjective matters, but exceptions can be made. He added that during the exam timings, the doctors remain slightly more cautious about handing out pink slips, but the standard protocols remain the same.

Pink slips continue to be a topic of debate and murkiness, where there remain students who fake their illness to get a pass to reattempt their lab or exams but also genuine cases of students who don’t get them. It is unsure whether the administration could design a robust mechanism as this remains a highly subjective issue

Out of the 387 respondents to the above question, 57.4% (222) of the students are not aware of the reimbursement process for their medical bills. The current process entails filling out the reimbursement form, which is available on the website with the bills attached and the doctor’s prescription along it. In case any tests are done outside the hospital, the signature of the CMO is also required. Then, one has to go to the hospital reimbursement section and submit the necessary documents along with proofs attached.

The responses showed that  33.3% (83) of students would only apply for reimbursement if there is a large amount involved, and 26.1% (65) don’t apply for reimbursement. The underlying reason can be the effort required to apply and the duration of the process.

Optional question for those who have availed/ tried to avail reimbursement: Total respondents – 98, responders could choose multiple options

Regarding the delays in reimbursement, the CMO ensured that soon, a new hospital website would be up, and all documents could be uploaded there to streamline the process. This would reduce the delays significantly.

Answering a common question of students regarding the maximum amount that could be reimbursed, the CMO said there is no cap on the reimbursement per incident or year, and the students will be given the funds if required. Even for chronic diseases, reimbursement for medicines can be claimed.

Digitisation

Total respondents – 311. Responders could choose multiple options.

The survey highlights strong support for digitalisation, with respondents favouring online medical records, as well as digitalised doctor availability and appointment scheduling.

The CMO informed us that they are looking for a new external party to develop the IITB hospital website. Every facility will be digitalised in the long term, including patient records, appointments, medical files, prescriptions, test reports, and diagnoses. The CMO didn’t confirm the current timeline of the whole digitisation process. Regarding a suggestion to have a token system to avoid long queues, the CMO mentioned a new information system in the pipeline. It will enable students to book appointments without being physically present at the hospital, thereby addressing issues related to long waiting times and managing the crowd more efficiently.

The digital infrastructure will primarily focus on automation, where manual intervention is unnecessary, like in generating medical reports. At present, the website is maintained by ASC, and the hospital provides them with all necessary information like doctors’ availability, contacts and rules & regulations. “Due to coordination with the ASC, there are delays in updating the website with timely information”.

Total respondents – 301. Responders could choose multiple options

The CMO ensured us that the confidentiality of the documents would be of utmost importance, with standard data protection and privacy norms followed. Access can be granted to entities like the administration or parents only through the student’s authority and for a limited time. The director has mostly decided on the details of the complete process, but they have not been finalised yet. 

The next phase is training doctors to use computers and make them comfortable with the technology. 

Another parallel initiative by the admin is a complaints portal, which will be released in the future.

Conclusion

The hospital handles a large number of students and campus residents on a daily basis.

While the hospital delivers commendable services in multiple areas like hygiene, patient admittance, and pharmacy accessibility, there remain gaps that must be addressed. The issues of limited OPD timings, doctor-patient communication, pink slip issuance, and specialist availability reflect systemic challenges. The hospital administration, led by the CMO and supported by the HHAC, is aware of these challenges and intends to resolve them through initiatives such as digitalisation, infrastructure upgrades, and soft skills training for staff. Some limitations, such as space and specialist schedules, remain challenging to control or mitigate, but efforts are being made to improve the hospital in multiple ways. We further urge students to approach the IIT Bombay Hospital in case of any health issues. The hospital is always available 24/7 for medical assistance, and you can report to the CMO with any queries, complaints, or grievances.

Editorial Credits: Adarsh Prajapati, Shubham Agarwal, Tanvi Sharma, Pratyush Panda

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