Where are the specialists going to come from to be present in all hospitals? Who is going to pay them? How are the specialists going to get patients everyday morning and evening? Hence having specialists in all hospitals would not be feasible practically and financially.
The doctors for the common branches will be there in most hospitals, but a specialist would often share their time with 2-4 hospitals unless they are in a premier center for the district or state wherein they would be enough patients every day that would justify the resources spent on them. The best way forward would be to assess the supply and demand ration, work out the logistics and tailor the appointment and availability based on the regional needs.
Unfortunately, this is going to get worse due to the shortage of specialists in various departments.
'Idhuvum Kadandhu Pogum "
Even this challenging situation would ease
That is why such institutions only prosper in private sector but unfortunately, they charge so high that lower or poor class can not afford it.
This is a funny situation and it is natural that we can not have the facilities of both the worlds.
The only solution is either improving the situation in Govt sector or decreasing the rates of treatment in the private and both the options are equally difficult in our setup and systems.
Knowledge is power.
There is Red Tape System, the biggest drawback for any government institutions. From the gate keeper to the highest level & along with us are all aware of this but not able to do anything. Lack of facilities like the latest machineries along with the proper staff are not available.
For a Cardiology department, the hospital needs cardiologists.These specialists are further grouped into Non-interventional cardiologist and Interventional cardiologists (putting in stents, dilating blockages etc). ECG and blood tests will be done by the routine staff.
So for an OPD to function, you need at least one cardiologist, a junior doctor(registrar), a nurse and the technician who can do or co-ordinate echo cardiograms and stress/treadmill tests.
Staffing logistics and the cost of running specific departments is a concern in any hospital that wants to have specialists. As far as I understand, there would be eligible centers in larger Government hospitals or approved units in specific places but there would be some travel involved.