The Aravind Eye Hospital is an organisation in Madurai, India; it provides a low cost high quality solution to people who suffer from unnecessary and preventableblindness that can be treated with corrective glasses,simple cataract or other surgery.
Annually, doctors at the hospital perform over 200,000 cataract operations, of which, over 60% of the patients are treated at no cost, while approximately 40% pay for treatments and surgeries ranging from $50 to $300. The Aravind Eye Hospital was able to deliver in excess of 60% of itsservices for free of charge due to McDonaldization, which is a low cost high quality business strategy mainly used in the fast food industry. It is when workers havehighly focused compartmentalized jobs that are repetitive and routinized (Crossman, 2017). Henry Ford was the pioneer of McDonaldization, with his vision of an assembly line for improving the production of automobiles. His revolutionary idea dramatically changed how many automobiles could be produced and was very efficient (McDonaldization, 2000). Converselyanother theory that could have been implemented by the Aravind Eye hospital to help it expand would be the Human Capital theory. This theory is similar to the McDonaldization theory yet it is still very different as it focusses on humans as capitals. The Human capital theory focuses on the employee and job performance, and how an individual’s knowledge, skills, abilities and other characteristics (KSAOs) can contribute to organisational-level capabilities (CIPD, 2017)Dr G.
Venkataswamy established The Aravind Eye Hospital in 1976, following his retirement at the age of 58. Dr Venkataswamy also known as Dr V. was concerned by the issue of avoidable blindness that was increasing rapidly in India at the time and consequently led him to establish the Aravind Eye Hospital, a not-for-profit institution dedicated to provide high quality eye care all patients who visited the hospital (Aravind Eye Care System, 2015). The idea of starting the AravindEye Hospital came into Dr V.’s mind after he had visited a McDonald’s restaurant for the first time, two years prior his retirement. Dr V. was inspired by the fast food chain’s business model and had a vision to eliminate avoidable blindness, so he decided he was going to ‘sell’ (Diep, 2017) people good eyesight the same way McDonald’s sold burgers.
Dr V. said “If Coca-Cola can sell billions of sodas and McDonald’s can sell billions of burgers, why can’t Aravind sell millions of sight-restoring operations, and, eventually, the belief in human perfection?” and as a result he started the hospital with just 20 beds and the only two surgeons alongside him were his sister and her husband, Dr G. Natchiar and Dr P. Namperumalswamy. Dr V.
believed that the hospital will someday become one of the largest eye hospitals in the world foreseeing the potentials of what it has become today.The concept of McDonaldization was introduced by George Ritzer, and according to him McDonaldization of society is when institutions and organisation within a society adapt to the same characteristics that are found in fast food chains (Crossman, 2017). Ritzer’s four main principles of McDonaldization are: predictability, calculability, efficiency and control; which are all characteristics of McDonald and other similar fast food restaurants (Long-Crowell, no date). Ritzer sees predictability in McDonald’s in the way customers can predict the menu and are able to find the same food in all their restaurants, the size of the burgers are the same for everyone and even the design and layout of the buildings are usually the same. According to Ritzer, calculability in McDonald’s is in the way they always emphasizes on quantity over quality, bigger is better with very low prices for their burgers which always appeals to customers as they will get a lot for the money.
McDonald’s takes pride in the efficiency of its operations for example when a customer orders something; it is normally already prepared and has been kept warm prior to the order being placed. Also each employee is tasked with a particular role, this allows McDonald’s to operate efficiently as speed is considered extremely important and sometimes comes at the cost of quality.According to Ritzer, control within McDonald’s is achieved through the substitution of non-human for human technology and by making tasks repetitive for their employees, employers like McDonalds can maintain a tighter control over those who work for them. While the fast food industry was already using the McDonaldization theory other industries such as shopping districts, education, healthcare were slowly changing and implementing the same techniques (Long-Crowell, no date).
The Aravind Eye Care System is a key example of how McDonaldization helped the hospital expand as it has now become the largest eye care facility in the world. When the 20 bed Aravind Eye Hospital opened in 1976, it performed all types of eye surgery, with the aim of offering quality eye care at areasonable price and in order to achieve this Dr V.applied Ritzer’s McDonaldization theory to the hospital and in 1977 a 30 bed new building was opened to accommodate patients recovering post-surgery. However it was not until 1978 that a 70 bed free hospital was opened to provide the poor with free eye care.
The Aravind Eye Hospital boosted its efficiency and had expanded from two to seven times; a 20 bed hospital had become a 70 bed hospital in the space of just two years, which is significant. By 1981 Dr V. had opened the main hospital which was for paying patients; it had 250 beds, was comprised of five floors and was well-equipped with modern, imported equipment to provide the finest eye care for its patients.
In 1984, the new 350 bed, free hospital was opened and it was also comprised of five floors. Doctors and nurses were posted in rotation so that they served both the free and the main hospital so to ensure that non-paying andpaying patients all received the same quality of eye care. (Rangan, 2009) Dr V. used the McDonaldization theory throughout the hospital which helped in calculability, efficiency and control. The Aravind Eye Hospital had developed standardized processes for key operations, so as to ensure consistent and efficient delivery. The doctors at the hospital were able toperform over 2000 surgeries in a year compared to the average of 400 surgeries in India and 150-200 for most Asian economies. This significantly higher productivity is obtained by adopting an assembly line approach to surgery (Krishnan, 2015). Each operating roomcomprised of one surgeon, a minimum of two operating tables, multiple sets of equipment and multiple nursing teams to carry out basic non-surgical tasks such aspreparing the patient and administering the anaesthetic.
This unique layout enabled surgeons to complete a surgery, turn around and start the next surgery on another patient who has been pre-prepared. This procedure enables the doctor to perform six to eight procedures per hour as opposed to usual norm of one surgery per hour. Human capital refers to the knowledge, skill sets and motivation that people have and that not everyone has the same skill sets or knowledge. Quality of work can be improved by investing in people’s education (Nickolas, no date). Although human capital affects economic growth and can help to develop an economy through the knowledge and skills of people it wasn’t the appropriatetheory that would have helped the Aravind Eye Hospital because as it focusses on each employee as capital for making money for a company and in order to help eliminate blindness Dr V. did not require many skilled or knowledgeable employee to make what he had imagined come true.
He only required his employees to have the basic knowledge in what they were supposedto do, for example clerks and nurses. As for doctors he made sure they were trained especially in their field of work for example his sister Dr G. Natchiar; and her husband, Dr P. Namperumalswamy were qualified doctors.
In conclusion, The Aravind Eye Hospital has used McDonaldization in a very clever manner thus boostingits efficiency from two to seven times and expanding from one hospital to five. The assembly line process avoids process inefficiency to achieve the faster (6-8 surgeries/hour) model (Krishnan, 2015) which is whythere are now 5 hospitals within Tamil Nadu currently offering 4000 beds, the majority of which are free. Due to the achievement of the hospital, The Aravind Eye Care System has managed to not only focus on cataract surgeries but it has also been able to explore other areas such as education, lens manufacturing, research and development and many other activities with the aimof improving sight and access to treatment. Dr V.’s idea of selling people good eyesight the same way McDonald’s sold burgers, led to the use of McDonaldization in the healthcare industry. This also allowed the Aravind hospital to be able to concentrate on other things such as manufacturing their own lens; an in-house manufacturing facility meant that they can keep their costs low.