Facing a Medical Emergency? Walk into Rupee 1 Clinic
Mumbai’s Rupee 1 clinics promise emergency medical care during the critical golden hour and more, observes Vrushali Deshmukh.

What can you do with one rupee in your pocket? What can you offer in 100 sq ft of space? A lot more than you would imagine. As Healthcare pundits world over hotly debate accessibility, affordability and availability of quality healthcare, Mumbai’s doctor- entrepreneur brothers have paved the way to a unique healthcare delivery model.
A Personal Calling
Dr. Rahul Ghule was a young medical officer at the prestigious JJ hospital in Mumbai. The Government run hospital saw a very high volume of patients coming from the low socio economic strata. This made him restless and he wanted to do more for the people who needed medical attention but could not afford it. One of his friends offered help and a tiny space for a small clinic in the fishermen settlement around Colaba in South Mumbai. Dr Rahul started offering medical services to patients in the evenings from 5 to 8 pm and charged them a nominal fee of Rupee 1. Rupee 1 was just a token as he strongly believed that anything that is offered free is often not valued. Word by mouth got him a steady stream of patients.
The same idea got carried further when he along with his brother Dr Amol Ghule, started Mumbai’s first Rupee 1 clinic in collaboration with the Central Railways.

Fulfilling the Unmet Need
Mumbai is home to almost 22 million people. Public transport and local trains in particular are considered as Mumbai city’s lifeline. On an average there are 30,000 to 32,000 number of accidents recorded each year in the city that are attributable to train accidents. Most deaths occur while crossing railway tracks and falling off the overcrowded coaches. Immediate medical treatment is vital for survival and limiting disabilities. Unfortunately, lack of medical facilities has claimed the lives of several and permanently immobilized many.
Rupee 1 clinics fulfil this very need. The main objective of the clinic is to give primary medical treatment to commuters and accident victims.
The clinics are strategically located in close proximity to the railway stations in Mumbai. The stations were selected after a careful location analysis. Those which saw most crowds and most accidents were initially chosen. For example, approximately 2.11 lakh commuters use Dadar station every single day and the number of accidents is an average of 2 per day. Similarly, Thane station gets an average of 6.5 lakh commuters every day and accident victims average around 2–3 per day.

A Partnership Model
The Rupee 1 Clinic Model is an excellent example of a successful Public Private Partnership (PPP) model in healthcare. The Central Railways provides space free of cost along with water and electricity. Magicdil Health Pvt limited, a company set up by the Ghule brothers in October 2016 provides medical services at these select clinics. The company bears expenses of manpower, equipment and any other associated cost.

The Rupee 1 clinics serve as a middle way. Though the partnership is public and private, the system is neither public nor private. Doctor’s availability round the clock all through the week makes it easy to access services. The infrastructure includes free wi-fi, air-conditioned examination room and RO filtered water which gives these clinics a corporate feel.
The standard Rupee 1 is charged to all patients irrespective of their social class. This is to ensure that there is standardization of services. Drs. Rahul and Amol strongly believe that “patients should never feel that someone who pays more get better services compared to those who don’t.” There is no compromise on quality either. The clinics are manned by MBBS doctors who rotate in shifts. Most clinics have nurses, sisters and an administrative staff as well.
A Bouquet of Services
Apart from providing emergency help to railway accident victims in the golden hour, the clinic offers medical services 24×7 for patients with routine illness. While Rupee 1 is charged for a health check, other services such as MRI, CT scan, Pathology, X-ray, ECG, etc., are offered at a very reasonable price. For example, patients are charged only 50 paisa for ECG, 25 paisa for blood sugar and MRI costs around Rs.3000. The company has partnered with laboratories where they can get tests done at a discounted price. Pharmacies operated by the company are well stocked with generic drugs where patients can avail medicines at a discounted price.

Success in Numbers
The clinics on an average see around 100 patients across the 7 active locations. Of the 100, one-third are referred to pathology interventions and one-third to diagnostic tests. Routine checks account to an average of 20–25 per day per clinic.

Expansion on the Horizon
By the year end, 19 clinics will be operational around railways stations in Mumbai. The next step is to start clinics in Pune at Waked, Kothrud, Kondwa and Hadapsar and one in Patna, Bihar. Apart from focussing only on railway stations, the founders also want to start similar clinics around major bus stations/ junctions in the state of Maharashtra.
The administrative team is working hard to centralise all patient data. This will enable commuters to collect their reports from any station regardless of where they underwent their tests. Keeping up with the technology, the plan is to launch an app which will make it easy for patients to fix appointments as per their convenience.
Talks are in progress with the BMC with the aim to scale this successful model across the state of Maharashtra. The founders are also opening similar clinics in top five cities of India that include Delhi, Bengaluru, Kolkatta and Ahmedabad.
Bridging the Gap
In a country like India where there is a huge disparity between the demand and supply of doctors and healthcare facilities, clinics such as these offer the much needed respite. They bridge the gap between our public health systems which are inundated with large patient loads and private systems that continue to be beyond the reach of many sections of our society.
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