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PROJECT OF A NEW HOSPITAL IN BARIPADA, ORISSA

We found out that the people of Baripada are not getting adequate,
appropriate health care. That’s why we are building a hospital to satisfy
their basic needs in a most appropriate way.

LOCATION:

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PROJ E
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PAL B
H
AU
IC
RS
T
L
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SWOT ANALYSIS:-

Strengths:-
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• Cost advantage
• Innovation
• Strong management team
• Pricing
• 1:4-Nurse-patient ratio
Weaknesses:-

• Cash bond
• New in the market
Opportunities:-
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• Acquisitions
• Financial markets (raise money through debt, etc)
• Innovation
• local and international partnership
• supported by government
Threats:-

• Competition
• Economic slowdown
• Lower cost competitors or imports
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• Government policies

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PROBLEM TREE

Spending huge
money but not
satisfied

People are died by


HDF SCHOOL OF MANAGEMENT,
not getting the CUTTACK People PROJECT MANAGEMENT
lost faith
health facility on on doctors
time
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Poor people and lower


middle class people are
not getting good health
care facility

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Poor operation Unethical nexus


High charges of
of Govt. between the Govt.
private hospitals
hospitals doctor and private
hospital
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Ratio of doctor and Unavailability of


attain dent to latest medical
patient is very low equipments

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TARGET GROUPS:-

• Local people

• Lower middle class people

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GOALS INDICATOR ASSUMPTIONS

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• Provide • 99% cureness of • More number of


knowledgeable the patients Patients should
staff in numbers come to our
sufficient to hospital.
provide an
appropriate level
of care and
frequency of visits
in the home.
• Provide high
quality health care
services
HDF SCHOOL in a cost-
OF MANAGEMENT, CUTTACK PROJECT MANAGEMENT
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PURPOSE INDICATOR ASSUMPTIONS

• To improve health • Satisfaction of • Good doctors


care facilities in Patients after the remain with the
Baripada. treatment. hospital.

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INPUTS INDICATOR ASSUMPTIONS

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• Experienced • Sanction of geting a land in


doctors bankloans appropriate place.
• Funds for hospital • Equipments are
• Advanced comparable with
technology & the best hospitals
medical
equipments
• Good
infrastructure.

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OUTPUTS INDICATOR ASSUMPTIONS

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• Percentage of • 95% of treatment Increase of loyal


cureness has successfully Customer
increased done
• Updation of the
doctors with the
latest way of
treatment

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ACTIVITIES INDICATOR ASSUMPTIONS

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• Undertake
seminars for the
doctors. Daily maintains of Trustworthiness of the
• Routine wise duty records employees.
of doctors and
attendants.
• Maintaining
cleanness internal
as well as external
medical
environment
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Some information about the financial feasibily:-


• Providing 5 types of service:- doctor fees-Rs. 200, check up fees- Rs. 100,
bedding charge- Rs. 1000(100 bed available at the time of 2002-2003 some
bed increased), operation, other testing.

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• Depreciation charge:- 5% every fixed assets, in straight line method

• 2002-2003 furniture & fixture and medical equipments increased Rs. 20,000
& Rs. 30,000 respectively in first month.

• Interest charge 10% in every loan.

• Other Loan paid in 2000-2001 and 2001-2002 was Rs. 75,00000 and
remaining respectively.

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• Long term loan paid 2002-2003 and 2003-2004 was Rs. 20000000 and
remaining respectively.

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BALACE SHEET
1999- 2000- 2001- 2002-
particulars 2000 2001 2002 2003
furniture 5000000 4750000 4500000 4350000
motor
car(ambulance) 5000000 4750000 4500000 4250000
land 10000000 9500000 9000000 8500000
building 50000000 47500000 45000000 42500000
computer 5000000 4750000 4500000 4250000
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medical
equipement 10000000 9500000 9000000 8500000
other assets:-
license 2500000 2500000 2500000 2500000
advertisement 1000000 1000000 1000000 1000000
Miscillenious:-
expenditure 4000000 4000000 4000000 4000000
cash in hand 7500000 25750000 44000000 51600000
10000000 13605000
total asset 0 114000000 128000000 0

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Liblities:-
11610000
equity+np 60000000 73500000 91700000 0
long term loan 30000000 33000000 36300000 19950000
N
other loan 10000000 7500000 il
10000000 13605000
total liblities 0 114000000 128000000 0
INCOME STATEMENT
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2000- 2001- 2002- 2003- 2004-


particulars 2001 2002 2003 2004 2005
revenue
1000000 130000 1500000
outdoor fees 0 13000000 15000000 00 0
500000
check up 4000000 5000000 6000000 0 7000000
3600000 400000 3500000
bedding 0 36000000 40000000 00 0
150000 2000000
operation charge 9000000 14000000 16000000 00 0
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200000
other testing 1000000 2000000 3000000 0 3000000
6000000 750000 8000000
Total 0 70000000 80000000 00 0
expenditure
200000
electric & water 1000000 1500000 2500000 0 2600000
200000
oil 500000 1000000 1500000 0 2000000
2000000 250000 2600000
doctor salary 0 22000000 23000000 00 0
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1000000 150000 1500000


other employee sal. 0 12000000 13000000 00 0
455000
dep. 4250000 4250000 4550000 0 4550000
199500
interest 4000000 4050000 3650000 0 Nil
254500
other exp. 1750000 2000000 2400000 0 2500000
500000
tax 5000000 5000000 5000000 0 5000000
profit 1350000 18200000 24400000 169100 2235000
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0 00 0
6000000 750000 8000000
Total 0 70000000 80000000 00 0
CASH FLOW
2000- 2002- 2003- 2004-
particulars 2001 2001-2002 2003 2004 2005
operating activity
6000000 750000
cash reciept 0 70000000 80000000 00 80000000
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- -
3325000 465450
cash paid 0 -38500000 -42400000 00 -48100000
cash incured before 2675000 284550
tax 0 31500000 37600000 00 31900000
-
- 500000
less-tax 5000000 -5000000 -5000000 0 -5000000
cash generated from 2175000 234550
op act. 0 26500000 32600000 00 26900000
investing activity
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new asset purchase Nil nil -5000000 nil nil

cash generated from


inv. Act. 27600000
fin. Activity
-
- 219450
loan paid 3500000 -8250000 -20000000 00 nil

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cash generated from 1825000 151000


fin. Act. 0 18250000 7600000 0 26900000
516000
add-opening cash 7500000 25750000 44000000 00 53110000
2575000 531100
closing cash 0 44000000 51600000 00 80010000

PROJECT BUDGET

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1. SOURCE OF BUDGET:- owners fund, bank loan, borrowing money from friend
& relatives, other short-term loan from outsiders

2. UTILISATION OF BUDGET:- infrastructure, equipments, license, other


expenditure etc.

BREAK EVEN ANALYSIS OF 2000-2001


Fixed assets= Rs. 80750000

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Variable cost= Rs. 33250000

Sales= Rs. 60000000

Contribution= sales-variable cost

Rs. 26750000

PV RATIO:-
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Cont./ sales=0.4458

Break Even Point:-


F.C./ P.V. ratio=Rs.181135

PROJECT FINANCING-
Debt: long term loan, other loan

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Equity: owners fund

Marketing feasibility

• Type of service: Outdoor facility - @Rs. 200,

• Check up facility - @Rs. 100,

• Bedding facility- @Rs. 1000(100 bed available at a time)

• Operation facility
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• Other testing facility

Pricing strategy:

• Fixed pricing strategy

• Discount price strategy (only for poor)

Promotional strategy:

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Advertisement by

• radio,

• television,

• news paper

• Hoarding on the Bus stand, in the important squares & in the rush Traffic
areas.

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• Local TV channels- Blue Sky

• Free health check up

• Free awareness camp in different areas

Distribution strategy

Direct service provided to the patient, there is no need of any middle man

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Competitor analysis:

Arya hospital, jeevandan hospital, Lebmbhuduguda hospital in Baripada is our


competitors.

Industry Analysis:

The hospital industry is growing largely due to the growing diseases due to different
diseases.
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The Technical Feasibility Study assesses the details of how you will deliver a product
or service (i.e., materials, labor, transportation, where your business will be located,
technology needed, etc.). Think of the technical feasibility study as the logistical or
tactical plan of how your business will produce, store, deliver, and track its products
or services.

Process

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Legal requirements

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There is a set procedure following a death and there are certain legal requirements and
forms to be filled in which have to be complied with, such as registering the death. Today
many people die in hospital, where there will be more people to assist with the formalities
but it may be worth thinking who could help a bereaved person go through the formalities if
they need some support.

If the death occurs in hospital;

• The hospital staff will contact the next of kin (relative or friend)
• The hospital mortuary will keep the body until the executor (personal representative)
makes arrangements to have it taken away

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• The next of kin or nearest relative should collect the dead person's belongings
• The Death Certificate will be automatically completed by a doctor
• The health authority may give the Death Certificate to the registrar who attends the
hospital, but someone must still go to the registration office. The one which covers
the area of the hospital may be different to that of the deceased's place of residence.
• If the deceased is to be cremated then the hospital can also arrange the completion
of forms B and C.

If the death occurs in a residential or nursing home, then they may also complete most of
the formalities above. They may also have arrangements with a funeral director to transfer
the body to a mortuary or Chapel of Rest, however you do not have to use this funeral

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director for the funeral and they should not press for your business.

If the death occurs at home;

• Contact your local GP - in cases of terminal illness, the GP will be well aware of the
situation and may well have been calling at the house regularly.
• The GP will need to certify the cause of death and will issue two forms. A Medical or
Death Certificate showing the cause of death will be addressed to the registrar. A
Formal Notice confirms that the doctor has signed the Medical Certificate and gives
details about registering the death.

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• Depending on your religion and immediate wishes about how long you wish the
deceased to stay in the house, you will need to contact a funeral director (unless an
alternative funeral is planned)
• The death certificate will need to be taken to the local registrar (address in your local
telephone directory) so that the death can be registered.
• Deaths must be registered at the Registrar of Births and Deaths normally within five
days of the death.
• Copies of the Death Certificate cost 300 rupees and several copies may be needed
for legal reasons such as grant of probate or letters of administration.

If the death occurs abroad;

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• Register the death as required in the country and obtain a local death certificate.
• Either arrange a burial or cremation in the country of death or repatriate the body to
the INDIA. Advice regarding repatriation can be obtained from funeral directors and
there are a number of firms that specialise in this area.
• Authority to move the body will be required from the country of death, as well as a
translation of the foreign death certificate.

Coroner

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• If the death is sudden, other than an obvious accident such as a road traffic accident,
and a doctor has not seen the deceased during the last 14 days, then a Coroner may
need to be involved. The Coroner will decide whether to hold a post mortem
examination or an inquest, although this should not delay the funeral arrangements
and the Coroner's Office will keep the next of kin informed about what to do.
• The Coroner will issue an Order for Burial or cremation.

Registrar
The Registrar of Births and Deaths needs either the Death Certificate or notification from the
Coroner to register the death. They will require the following details;

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• Full name of the deceased (including maiden surname if a married woman)


• Date and place of birth
• Recent occupation
• National Health Service number (if known) and medical card if available

The Registrar will issue an Order for Burial or cremation, which is a green certificate. This
can be given to the funeral director or sent to the cemetery or crematorium.
As soon as the death has been certified, then plans for the funeral can go ahead and
provisional bookings can be made at either a cemetery or crematorium, once the attendance
of a minister (if required) has been arranged.

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Forms Required for cremation


Three forms are needed, which can be obtained from the crematorium;

• Form A - Application for cremation - to be completed by the next of kin or an


executor and needs countersigning by a householder who knows the person
completing the form
• Medical Forms B & C - statutory forms completed by the doctor who attended the
deceased before death and the doctor who confirmed the cause of death (for which
there will be a charge of about £82)

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• Notice of cremation - gives notice of the cremation and details of the deceased and
information about the service. It forms a binding contract concerning the payment of
fees to the cremation authority.

Forms Required for Burial


A Notice of Burial must be delivered to the cemetery authority as soon as a funeral booking
is confirmed. This is a formal notification and forms a binding contract regarding the work
and costs involved. The form should be accompanied by the Registrars green certificate or
the Coroner's Order for Burial.

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Environmental Concerns in the Hospital

Hospitals, like many other buildings, have many sources of contaminants. Here is a list of some
of the potential problems:
Mercury. Mercury is a heavy metal used in several products in the hospital, like thermometers,
batteries and fluorescent lamps. The metal can be toxic to the nervous system, and cause
problems with memory, information processing, attention, language, and fine motor skills.
Patients are not very likely to experience a direct exposure to mercury in the hospital. Instead,
mercury is more likely to end up in the medical waste stream and emitted into the air during
incineration of the waste. The airborne mercury can settle into nearby waterways or seep into the
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ground water supply. According to the organization Health Care Without Harm, hospitals
generate up to 50 times more mercury in medical waste than found in municipal waste.
Dioxin. Dioxins are toxic chemical compounds formed during the burning of hospital waste. The
chemicals are also found in products with PVC (polyvinyl chloride, a plastic polymer). Dioxins
don't easily degrade in the environment and eventually increase in concentration. Exposure can
occur through the surrounding air and in the food supply (the compounds are also taken in by
animals used for food). Dioxin has been linked to the development of several kinds of cancer. In
humans, dioxin exposure may cause changes in the immune system and in the levels of some
hormones.

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DEHP. DEHP, or Di (2-ethylhexyl) phthalate, is a plasticizer added to PVC products to soften


and increase flexibility of some medical devices (like IV bags and tubing). It doesn't bind well
with the PVC and can leach out of the product and into the body. DEHP may be toxic to the
liver, lungs and developing male reproductive system.
Volatile Organic Compounds. Volatile Organic Compounds (VOCs) are chemicals emitted as
gases from liquid or solid products. Some of the most common types of VOCs are formaldehyde
(found in some types of building materials, permanent press drapes and clothing, glues,
adhesives and some paints), pesticides, solvents and cleaning agents. Exposure may cause
irritation of the eyes, nose or throat, breathing problems, headache and nausea. VOCs may be
toxic to the liver, kidneys and central nervous system. Some VOCs may also be linked to cancer.
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Glutaraldehyde. Glutaraldehyde is a colorless, oily liquid used to cold sterilize some types of
hospital equipment. It is also used in labs and in the processing of X-ray films. Exposure can
irritate the airways and cause breathing problems, nosebleed, burning of the eyes, headache or
nausea. Contact with the skin can lead to a rash or hives.
Building an Environmentally Friendly ("Green") Hospital
Some hospital administrators are taking steps to make their facilities more environmentally
friendly. The Sarkis and Siran Gabrellian Women's and Children's Pavilion at the Hackensack
University Medical Center has won a design award as one of the Top 10 Green Hospitals in the
U.S. During construction of the Pavillion, designers and builders worked to avoid use of
materials containing harmful chemicals. Cabinets are made with wheat board instead of particle-
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board. Toys, floors and wall-coverings are made of PVC-free materials. The hospital instituted a
"Greening the Cleaning®" program to eliminate, when possible, toxic chemicals and replace
them with products containing natural or naturally-derived products.
The hospital also incorporated several other changes that contribute to an overall "green"
building. Flooring is made of rubber rather than vinyl. Instead of fiberglass to insulate the walls,
builders used recycled cotton denim. Whenever possible, left-over building materials that would
normally be discarded were recycled.
The move to a green hospital was an important choice for hospital administrators. Deirdre Imus,
Environmental Center Founder at Hackensack, says hospitals are supposed to be places of

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healing. So it doesn't make sense to expose sick patients to potentially harmful chemicals and
gases.

EQUIPEMENT

NAME UNIT PRICE NO. OF UNIT

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Anesthesia instruments 1,00,000 4

Ultrasound machine 2,00,000 5

Chemotherapy machine 3,00,000 5

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CT scan machine 2,00,000 5

X-ray machine 2,00,000 5

Spine Surgery 3,50,000 4

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Mini fragments 2,00,000 5

Other 35,00,000

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LAYOUT

BEDS(NO BEDS(A/
OT
N A/C) C)
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CANTEEN

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GARDEN
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RECEPTIO
N MEDICIN
E STORE

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MEDICINE EYE
CARDIOLOGIST ORTHOPEDCISTS
SPECIALIST SPECIALIST

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LEGAL REQUIREMENTS

1956 (102 of 1956), the Medical Council of India, with the previous approval of the Central
Government, hereby makes the following regulations relating to the Professional Conduct,
Etiquette and Ethics for registered medical practitioners, namely:-

Short Title and Commencement:

1. These Regulations may be called the Indian Medical Council (Professional conduct,
Etiquette and Ethics) Regulations, 2002.
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2. They shall come into force on the date of their publication in the Official Gazette.

1. CODE OF MEDICAL ETHICS

A. Declaration:

Each applicant, at the time of making an application for registration under the provisions of the
Act, shall be provided a copy of the declaration and shall submit a duly signed Declaration . The
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applicant shall also certify that he/she had read and agreed to abide by the same.

B. Duties and responsibilities of the Physician in general:

Character of Physician (Doctors with qualification of MBBS or MBBS with post graduate
degree/ diploma or with equivalent qualification in any medical discipline):

A physician shall uphold the dignity and honour of his profession.

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The prime object of the medical profession is to render service to humanity; reward or financial
gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the obligation
to conduct him in accordance with its ideals. A physician should be an upright man, instructed in
the art of healings. He shall keep himself pure in character and be diligent in caring for the sick;
he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting
himself with propriety in his profession and in all the actions of his life.

No person other than a doctor having qualification recognized by Medical Council of India and
registered with Medical Council of India/State Medical Council (s) is allowed to practice Modern
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system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine
is not allowed to practice Modern system of Medicine in any form.

Maintaining good medical practice:

The Principal objective of the medical profession is to render service to humanity with full
respect for the dignity of profession and man. Physicians should merit the confidence of patients
entrusted to their care, rendering to each a full measure of service and devotion. Physicians
should try continuously to improve medical knowledge and skills and should make available to
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their patients and colleagues the benefits of their professional attainments. The physician should
practice methods of healing founded on scientific basis and should not associate professionally
with anyone who violates this principle. The honored ideals of the medical profession imply that
the responsibilities of the physician extend not only to individuals but also to society.

Membership in Medical Society: For the advancement of his profession, a physician should
affiliate with associations and societies of allopathic medical professions and involve actively in
the functioning of such bodies.

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A Physician should participate in professional meetings as part of Continuing Medical Education


programmers, for at least 30 hours every five years, organized by reputed professional academic
bodies or any other authorized organisations. The compliance of this requirement shall be
informed regularly to Medical Council of India or the State Medical Councils as the case may be.

Maintenance of medical records:

Every physician shall maintain the medical records pertaining to his / her indoor patients for a
period of 3 years from the date of commencement of the treatment in a standard reformat laid
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down by the Medical Council of India

If any request is made for medical records either by the patients / authorised attendant or legal
authorities involved, the same may be duly acknowledged and documents shall be issued within
the period of 72 hours.

A Registered medical practitioner shall maintain a Register of Medical Certificates giving full
details of certificates issued. When issuing a medical certificate he / she shall always enter the
identification marks of the patient and keep a copy of the certificate. He / She shall not omit to
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record the signature and/or thumb mark, address and at least one identification mark of the
patient on the medical certificates or report.

Efforts shall be made to computerize medical records for quick retrieval.

Display of registration numbers:

Every physician shall display the registration number accorded to him by the State Medical
Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money
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receipts given to his patients.

Physicians shall display as suffix to their names only recognized medical degrees or such
certificates/diplomas and memberships/honors which confer professional knowledge or
recognizes any exemplary qualification/achievements.

Use of Generic names of drugs: Every physician should, as far as possible, prescribe drugs with
generic names and he / she shall ensure that there is a rational prescription and use of drugs.
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Highest Quality Assurance in patient care: Every physician should aid in safeguarding the
profession against admission to it of those who are deficient in moral character or education.
Physician shall not employ in connection with his professional practice any attendant who is
neither registered nor enlisted under the Medical Acts in force and shall not permit such persons
to attend, treat or perform operations upon patients wherever professional discretion or skill is
required.

Exposure of Unethical Conduct: A Physician should expose, without fear or favour,


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incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.

Payment of Professional Services: The physician, engaged in the practice of medicine shall
give priority to the interests of patients. The personal financial interests of a physician should not
conflict with the medical interests of patients. A physician should announce his fees before
rendering service and not after the operation or treatment is under way. Remuneration received
for such services should be in the form and amount specifically announced to the patient at the
time the service is rendered. It is unethical to enter into a contract of "no cure no payment".
Physician rendering service on behalf of the state shall refrain from anticipating or accepting any
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consideration.

Evasion of Legal Restrictions: The physician shall observe the laws of the country in regulating
the practice of medicine and shall also not assist others to evade such laws. He should be
cooperative in observance and enforcement of sanitary laws and regulations in the interest of
public health. A physician should observe the provisions of the State Acts like Drugs and
Cosmetics Act, 1940; Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act,
1985; Medical Termination of Pregnancy Act, 1971; Transplantation of Human Organ Act, 1994;
Mental Health Act, 1987; Environmental Protection Act, 1986; Pre–natal Sex Determination Test
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Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with
Disabilities (Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical Waste
(Management and Handling) Rules, 1998 and such other Acts, Rules, Regulations made by the
Central/State Governments or local Administrative Bodies or any other relevant Act relating to
the protection and promotion of public health.

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ORGA NIZA TIO


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Informational
Services

Physi
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Measure activity

Lo L1

Feasibility study • Financial feasibility

• Technical feasibility

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Land Acquisition Proper land selection

Building construction Different departments

License

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Doctors and staffs


recruitment

Treatment of patients

Discharge of patients

Stake holders analysis

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PARAMETE Govt. Investor Patients Local Employee Suppliers


R People Staff

Areas of high Low high high high high


interest

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contributio moderate High high low high Low


ns

power high High high moderate high Low

strategy Manage Keep Manage Keep Manage Keep


closly satisfaction closly satisfaction closly informal

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Risk management
LIST OF RISK DEGREE OF DEGREE OF Mitigation
OCCURENCE EFFECT

Political Risk Very Low Very High Good contact


with the Govt.
officials

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Net Getting local very low Very High Some CSR


activity
Support

Competitor Risk very low Very Low Up to date


information

Inexperienced moderate Very High Good training to


the doctors
Doctor

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MIS system of Hospital

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ADVANTAGES
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