HYDERABAD: Dr Gullapalli N Rao, the founder of L V Prasad Eye Institute, made history as the first ophthalmologist working in India to deliver the prestigious Doyne lecture at the 106th Oxford Ophthalmological Congress in 2023, UK.
CE speaks with the stalwart of healthcare, where he shares what inspired him to establish the premier institute, his views on present healthcare conditions in India and what interventions can be made to improve them
Could you give a brief account of your journey?
The emphasis on rigour and quality care to patients in American medical institutions influenced me during my 12-year-long stay there and inspired me to replicate the same in India. In the last four-five years of my stay there, the idea took a concrete shape in the form of developing an academic eye centre along the lines of the best American centres.
My wife and I discussed and started working on the idea. In 1985, we started a foundation in the US and a charitable trust here with the idea of going ahead with the project by raising money in the US from family and friends, mainly for acquiring the equipment necessary for starting the institution. In India, we approached the then Chief Minister, NT Rama Rao, for some land at a concessional price from the government which we got in an area called Kismatpur near Himayat Sagar, where we have our other campus now.
About a year later in the summer of 1986, the son of LV Prasad, Ramesh Prasad said they would support us in our endeavour and also offered some money they had in their trust. At our very first meeting in Chennai, they also offered a piece of land in Banjara Hills for the project. We accepted it and in recognition of the large contribution, the board of our trust decided to name the institute after Shri LV Prasad, who was a legendary movie director and producer.
How to make eyecare accessible for all?
Our founding vision is actually to reconcile excellence with equity. We started with that simple vision, which most people felt was impossible to implement. The idea is to provide care to anybody who comes to us with any eye problem, whether they pay or don’t pay. In our experience over the past 36 years, there has never been a problem in achieving that. I believe very strongly if we want to do it, we can do it.
What is your assessment of the skill and training imparted to doctors at the national level?
If you look at the country’s situation, I don’t think the quality of training has gotten better. In fact, I think it got worse because we are proliferating training programs in medical colleges and this and that without paying attention to the quality of faculty. We can build buildings, we can buy equipment, but we can’t get faculty very easily. Nobody is paying attention to refining the faculty training.
Until we do that, and until we have a critical mass of faculty in our medical colleges, nursing colleges, and other institutions that train paramedical and other carders of high medical care, healthcare personnel will continue to have problems of quality and commitment. That is still the biggest challenge in our country and remains so. In my view, it got worse over the years.
What role does new-age technology play in providing healthcare?
I think technology has a role, but I believe it has a limited role, particularly in healthcare. You can only teach through technology, the theoretical element, imparting knowledge and skills becomes more difficult. It is possible, but it is more difficult. On top of that, how do you teach the care element? I’m not a strong believer in Artificial Intelligence. Artificial Intelligence should only be used as an aid to natural intelligence. If we become completely dependent on artificial intelligence, I personally believe we’ll get into trouble.
Where do you think we stand in terms of research?
I can’t talk of other fields as far as medical research is concerned, we are in a rudimentary stage in India. We hardly have anything to show for it. We have a long way to go. We have to first build the foundation for quality research and then build the superstructure on top of that. For that, the very idea of inquiry, inquiring minds, should start from the early days. It should start in schools, colleges, where we have no such exposure at all to the kids. Medical colleges have nearly zero research in our country. That is the current environment. There are individuals, a few departments in a few institutions doing well in terms of research, but otherwise, we are not leaders in medical research by any standard in the world.
What kind of interventions can be made to improve this situation?
Just like medical care, we have a few islands of excellence, but when we look at the uniform quality of care across the country, the basic minimum standards are also not met most of the time. So that is the key to achieving universal healthcare: to make sure that every doctor, healthcare professional, and healthcare organisation is following at least a basic minimum standard. That’s the first goal to achieve. I believe healthcare education, in parallel, has to receive a lot of focus. After we achieve that, I think the focus on research can be improved. The few outstanding individuals with exceptional talent can certainly find their way in blossoming and doing medical research.
How do you see the institute growing in times to come?
Our direct presence will be limited to three states: Orissa, Telangana, and Andhra Pradesh. We have come up with two strategic pillars on which our future will progress. One is to create Institutes of Excellence and Global Resource Centres in some niche areas, for example treating major causes of blindness, blindness in children and problems among the elderly, etc. We are going to intensify our focus on high-quality primary care for individuals living in remote, rural and tribal areas so that the need for them to travel to the cities for every problem is minimised.
What advice would you like to give to the younger generations taking up medicine as a profession?
As Atul Gawande says, medicine is a life of responsibility. They have to realise that when they are beginning to wear white coats. Without that, it is going to be a life of constant frustration. If you want to make money, there are so many other ways to do it. If you want to be a good doctor, you have to love the idea of service to people.