Transforming Rural Healthcare: The Role of Dr. Good Deed Clinic and the Future of Telemedicine

Dr. Good Deed Clinic is to provide high-quality, affordable healthcare to underserved populations across India and potentially beyond.

Since 2017, the Dr. Good Deed Foundation has been at the forefront of transforming rural healthcare in India, with a mission to provide essential medical services to underserved communities. Each milestone strengthens their resolve to make a difference, and the foundation is committed to creating a healthier future for all. In an exclusive interview with MidDay, Dr. Chandril Chugh, Senior Neurologist and Director of Dr. Good Deed Clinic, discusses the evolving healthcare landscape in India, the role of telemedicine, and their future plans.

1. What motivated you to establish the Dr. Good Deed Clinic in rural Bihar, and how has the local response influenced your plans for healthcare expansion in underserved regions?
I founded the Dr. Good Deed Clinic in rural Bihar to address the stark healthcare disparities in underserved areas where specialist care and infrastructure are lacking. The positive response from the local population, who now have access to essential medical services close to home, reaffirmed my belief that healthcare is a basic right. This success has fuelled our ambition to expand into other underserved regions, ensuring affordable, high-quality care while also educating communities about their health.

2. Do you think telemedicine is a sustainable model for rural healthcare, or are there limitations that make traditional clinics more effective?
Telemedicine is a sustainable solution for rural healthcare, as it connects underserved areas with specialists, overcoming challenges such as travel barriers, financial limitations, and workforce shortages. However, limitations exist, including unreliable internet, power outages, and the lack of digital literacy. Moreover, physical exams and diagnostics, essential for conditions like neurological issues, cannot be done virtually. A hybrid model, combining telemedicine for routine care with traditional clinics for complex cases, offers a more comprehensive healthcare approach for rural populations.

3. You transitioned from telemedicine to a conventional clinic in 2021. Given the global emphasis on digital health solutions, was this transition a missed opportunity to innovate further in telemedicine, especially in remote areas?
The transition to a conventional clinic was a strategic evolution rather than a missed opportunity. Telemedicine remains essential, but the clinic addresses the limitations of virtual care, such as the need for physical examinations and complex diagnostics. This shift enables a hybrid healthcare model, combining hands-on treatment with telemedicine for consultations and follow-ups. This balanced approach ensures comprehensive care, particularly in underserved areas.

4. What are your long-term goals for Dr. Good Deed Clinic? With expansion plans, how do you intend to maintain quality and affordability as the network grows across regions with diverse healthcare needs?
Our long-term goal for Dr. Good Deed Clinic is to provide high-quality, affordable healthcare to underserved populations across India and potentially beyond. We aim to create a network of community-based clinics offering specialized care in areas like neurology, mental health, and preventive medicine, addressing each region’s unique needs.

Key strategies include:

1. Expanding into underserved regions, particularly rural and semi-urban areas, tailoring services to local needs.
2. Integrating telemedicine with in-person care, supporting remote areas while gradually building physical clinics.
3. Ensuring quality and affordability through standardized protocols, local workforce development, technology-enabled monitoring, and strategic partnerships.
4. Focusing on sustainability and scalability by using renewable energy, mobile health units, and efficient supply chains.

Our vision is to grow Dr. Good Deed into a national and global movement, providing specialized healthcare while maintaining quality and affordability.

5. Your clinics offer affordable healthcare with consultations priced at ₹100. How do you ensure that low-cost services do not compromise the quality of medical care, especially in specialized areas like neurology and gastroenterology?
Offering affordable healthcare while maintaining high quality, particularly in specialized fields like neurology and gastroenterology, is a critical aspect of the Dr. Good Deed Clinic’s mission. Pricing consultations at ₹100 is intentional and designed to make healthcare accessible to everyone, especially in underserved regions. However, this affordability does not come at the expense of care quality; several strategies have been implemented to ensure that high standards are maintained.

To ensure high-quality medical care at low costs, the Dr. Good Deed Clinic follows a few key strategies:

• Efficient Resource Use: Streamlined processes and centralized procurement reduce operational costs without compromising quality.
• Technology-Enabled Care: Telemedicine and digital tools enhance diagnostics and patient data management, cutting overheads while maintaining high standards.
• Preventive Focus: Emphasizing preventive care reduces the need for costly advanced interventions.
• Standardized Protocols: Evidence-based global best practices ensure consistent, high-quality care across specializations.
• Expert Partnerships: Collaborating with specialists who volunteer or accept lower compensation helps keep advanced care accessible.
• Community Involvement: We empower the community to help run the clinic, creating a sustainable and profitable model for affordable healthcare

6. Community outreach programmes and health camps are vital for raising awareness. How do you measure the long-term impact of these initiatives on health outcomes, given limited resources in rural areas?
Yes, outreach programmes and health camps are vital for awareness but we have always felt that they fall short in improving life at the grass root level. We have instead focused on reducing health care expenditure and providing employment. We employ local village people and due to our efficient clinic model we reduce their health care cost. We have retention of more than 86%. It is well known that once the economic standards improve and  health indices follow.

7. You’ve introduced a low-cost ambulance service to address patient mobility issues. How sustainable is this model in rural areas, and what hurdles have you faced in scaling it?
The low-cost ambulance service is sustainable with effective management and community involvement. We use fuel-efficient vehicles and partner with local drivers to reduce costs. However, challenges like poor road infrastructure, limited funding, and operational inefficiencies in rural areas have slowed scaling efforts. We're addressing these by introducing motorbike ambulances for remote regions, setting up local dispatch hubs, and expanding partnerships with healthcare providers and government programs.

8. Both you and Dr. Nivedita Pandey have extensive medical training in the USA. What cultural or operational challenges have you faced in adapting your expertise to rural India’s healthcare needs?
Adapting to rural India has been challenging due to cultural perceptions, mistrust of external doctors, and resource limitations. Traditional beliefs delay treatment for conditions like epilepsy or stroke. We've built trust by engaging the community and employing local health workers. Resource constraints have been tackled with mobile health units and telemedicine, while affordability remains a barrier that we continue to address through preventive care and local partnerships.

9. Your clinics are financially sustainable and replicable across India. However, healthcare franchises often face criticism for prioritizing profit over patient care. How do you ensure your model remains patient-centred as it scales?

• Financial Sustainability and Replication: Our clinics are designed for sustainability and can be replicated across India while ensuring affordable, high-quality healthcare.
• Mission-Centred Leadership: We will prioritise leadership focused on community health and social impact.
• Transparent Pricing:
• Fixed pricing will be a core principle.
• Regular audits will maintain consistency and fairness.
• Quality Standards:
• Strict quality standards will be enforced.
• We will incentivise quality care over patient volume.
• Patient-Centred Metrics: Performance will be guided by patient satisfaction and health outcomes.
• Selective Partnerships:
• We will choose investors who are impact-focused to avoid commercial pressures.
• Collaborations with governments and non-profits will help maintain affordability.
• Local Governance Boards: These boards will ensure our clinics align with community needs.
• Continuous Feedback:
• We will gather ongoing patient feedback and involve the community to maintain a focus on care rather than profit.
• Commitment to Mission: These measures will ensure our mission of providing affordable, high-quality care remains at the forefront as we expand

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