Docs from dists, taluks to be trainedto reduce private hospital surgeries

Bengaluru: Encouraged by the success of its strategies to get hip and knee replacement surgeries done in public institutions instead of private setups, the state govt is aggressively pursuing its plan of training doctors from district and taluk hospitals in the procedures.
Victoria Hospital's orthopaedics department will now train doctors in district and taluk hospitals in hip and knee replacement surgeries under a hub and spoke model that will kick off mid-Feb. This comes months after the Sanjay Gandhi Institute of Trauma & Orthopaedics in Jayanagar started the same process to address the high number of joint replacement surgeries going to private hospitals.
Data from Suvarna Arogya Suraksha Trust (SAST), which oversees disbursal of reimbursements under the Ayushman Bharat Arogya Karnataka (ABArK) scheme, shows 1,108 joint surgeries were performed in private hospitals and 611 in govt hospital during 2023-24.
A source from SAST said the health dept took cognisance of the fact that 65% of the joint surgeries were done in private hospitals and began looking at how to reverse the trend.
"On Oct 29, 2024, a modified system came into place that mandated surgery referrals to be passed through the SAST expert committee before being sent to private hospitals. Prior to that, the govt hospitals would directly refer patients to private hospitals," said the source.
The SAST data suggests that after the new system kicked in, the trend reversed. Of the 384 joint replacement surgeries performed between Oct 2024 and Jan 2025, 77% were done in govt setups.
The govt also noticed that there was the aspect of less experienced surgeons in govt setups that had to be addressed and came up with the plan to train doctors in district and taluk hospitals in joint surgeries.
The orthopaedics department of Victoria Hospital at Bangalore Medical College and Research Institute was declared a centre of excellence (COE) for joint replacements on Jan 9. As part of the new responsibility, Dr Ramesh Krishna K, dean and director, BMCRI, told TOI that doctors from district and taluk hospitals of the govt will be trained specifically to conduct joint replacement surgeries.
"At present, we have fellowships where postgraduates get trained in arthroplasty or joint replacement for a year and a half in our department. This is in association with RGUHS, and there is an entrance examination based on which applicants from across the country are selected," he said.
Regarding the current training that will come as part of the COE, Deepak S, medical superintendent, Victoria Hospital, said, "The surgeons that come to be trained will be made to assist every joint surgery at BMC for one or two months."
Dr Krishna added that they are looking to train about 50 orthopaedic surgeons from across the state in six months.
To address the issue of unnecessary surgeries, SAST set up a second opinion toll-free helpline 1800-4258330 on Nov 19, 2024. Since then, 92 calls have been received seeking a second opinion, said the source, adding that a team of nine orthopaedic surgeons were onboard for it.
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How trend reversed
- 65% of joint surgeries were conducted in private hospitals in 2023-24
- On Oct 29, 2024, a modified system came into place that mandated surgery referrals to be passed through the SAST expert committee before being sent to private hospitals
- SAST data shows that of the 384 joint replacement surgeries performed between Oct 2024 and Jan 2025, 77% were done in govt setups
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Quote
At present, we have fellowships where postgraduates get trained in arthroplasty or joint replacement for a year and a half in our department. This is in association with RGUHS, and there is an entrance examination based on which applicants from across the country are selected
- Dr Ramesh Krishna K, dean and director, BMCRI