This report focuses on the innovative approaches adopted by one of the largest eye care services in the world which ultimately defeated barriers of distance, poverty and ignorance to create a self-sustaining system. In order to achieve this, the report outlines its effective use of scientific management and McDonaldization in providing high quality care available to masses at lowest possible cost. It finds that the all 4 elements of McDonaldization put forward by Ritzer were fundamental in the cooperation of a successful self-funding healthcare model. The report concludes with an update of how this system/Aravind…
Whilst we are solely dependent on our vision to live a life of independence, in developing countries there is a heavy burden of individuals with visual impairments. This puts them at huge risk with many below the poverty line and others with income levels that would place professional treatment far beyond their reach. In order to eliminate this barrier, Aravind Eye Care Hospital has eradicated comprehensive eye care systems to address the underprivileged in India, offering their services for free or at steeply subsidised prices. Ongoing research has reported the exponential growth of Aravind through the principle of McDonaldization to ensure a system of continuous improvement whilst ensuring innovative operating practices.
This report will therefore apply the principles of McDonaldisation to Aravind eye care to explain the ongoing efforts in providing highly successful medical interventions to break the destructive cycle of poverty that entraps the blind. First, I will introduce the concepts of scientific management and McDonaldization. A brief background of Aravind’s service and facilities will then follow. This will highlight the need of Aravind’s purpose to step in and meet the health needs of fast growing populations. Following this, I will discuss how McDonaldisation has been influential in ensuring Aravind’s efforts in maintaining consistency and efficiency in its delivery to low-income populations.
What is scientific management?
Fredrick W. Taylor was the originator of the ambitious and vigorous proponent of the “scientific management” principle which brought a revolution in shaping the early twentieth century factory system (Jaffee, D. 2001). He made one of the earliest attempts in applying science to the processes in management. His tremendous surge of affluence lifted the working masses away from inefficiency and ensured each motion of work was executed under maximum capacity of workers with an elaborate organisation and system to ensure maximum prosperity between all assets of the business (Caldari, K. 2007). On one hand this was “a complete mental revolution” whilst others criticised Taylor for introducing industrial action, monotonous jobs and negligence towards workers at the workplace (Ratnayake, C. and Ima. 2009).
George Ritzer’s concept of ‘McDonaldisation’ should also be explored which elicits McDonald’s as one of the most influential developments in contemporary society. The central thesis of McDonaldisation is that the fast-food restaurant has created dominant operations—efficiency, calculability, predictability, and control—and that this adaptation has engulfed more and more aspects of contemporary life in a globalized world. Efficiency is geared towards a managerial focus on utilising the optimum method to complete tasks. Calculability entails a focus on quantifiable objects (numbers and figures) rather than the evaluation of quality. The third component of predictability ensures a routinized production and service output which allows familiarity for consumers. Under control, employees become standardized to perform tasks in the same manner each time. All in all, this resounding success of McDonald’s has increasingly led other types of businesses adapting these same principles to their needs. Whilst these concepts have made important developments in the present moment, it has also evoked controversy with a considerable number of costs and risks (Kellner, D).
Aravind: Background Information
Aravind eye care began in 1976 from an 11-bed hospital to now standing as one of the largest eye care providers in the world with increasing attention from global outlets. With a mission to ‘eliminate needless blindness’ coupled with social responsibility, innovative marketing and an excellent delivering strategy, Aravind Eye Hospital was able to revolutionize the concept of efficient and sustainable eye care in the developing world. Since its inception, Aravind’s eye care facilities include 13 eye hospitals, 6 outpatient eye examination centres and 75 primary eye care facilities in South India making it a model for the rest of the world.
Dr. Venkataswamy (respectively known as Dr. V) had a specific mission to eliminate needless blindness in millions of poor people and this vision helped drive a successful execution of the Avarind Eye-Care system. Given the highly fragmented nature of its customer base and its need for scale, Aravind had to establish a low-cost business model whilst delivering exceptional quality (such as that of McDonalds) and thus, the integration of ‘McDonaldization’ was imperative. This service efficiency of McDonald’s fast food inspired Dr. V to emulate this whilst adapting it appropriately to the eye care system.
The first principle outlined in Ritzer’s McDonaldisation theory is efficiency or “the optimum method for getting from one point to another” (Ritzer, 1996). Aravind’s operational efficiency is highly noticeable; in 2001 they performed nearly 200,000 operations, mostly for cataract removal, more than the annual total number of cataract operations recorded for any entire European country (WHO, 2001). This clear productivity can be attributed to the superbly organised approach to “assembly-line” process: each theatre is managed by two surgeons with multiple sets of instruments and medical stuff. The support staff are trained to conduct key non-surgical tasks such as sterilizing the eye and administrating preoperative anaesthetic injections, allowing doctors to focus on core operations at high volume. This resulting partnership between well-trained surgical assistants and adequate staffing are vital in ensuring Avrind Eye Care enables a well-placed and routine fashion to optimise efficiency. Furthermore, this allows Aravind to cope with the increasing numbers of patients, in turn reducing waiting time between surgeries. All in all, Aravind’s efficiency has been the main principle in bringing the company to an elevated position opposed to other contenders in the health care market.
The next process outlined by Ritzer’s McDonaldisation theory is predictability which is the guarantee to uniformity of product and standardized outcomes. This was applied in Aravind through a rotating schedule for medical staff between the free and the paying wings. This systematic approach not only highlights Aravind’s respect to personal and unique needs of each patient but it gives them the satisfaction of consistency of care regardless of individual economic background. Moreover, this means the same quality of service can be applicable to all of its hospital branches.
The third process outlined in McDonaldisation theory is that of calculability which is the assessment of outcomes based on quantifiable rather than subjective criteria. Aravind strives to achieve productivity (quantity) without sacrificing quality. To maximise quality, several training programmes are in place to develop all human resources – ophthalmologists, paramedics, eye care managers aswell as local practitioners which are trained to become high-calibre surgeons. This continuing advancement in knowledge of eye care will not only satisfy the needs of the institution but also take care of the needs of the country. To maximise quantity, Aravind facilitates various community outreach programs, including mobile eye camps, in order to evaluate millions of patients at scale and keep demand flowing. However, it could be argued that Aravind could prioritise quantity to a greater extent as despite its efforts to provide eye care service to the doorstep of the community, it is yet to expand to other parts of India as well as globally to other developing markets which have large impoverished population.
The final process outlined in McDonaldisation theory is control. Aravind aggressively pursued opportunities to control their variable costs. In order to do this, Aravind set up a non-profit charitable trust after the name ‘Aurolab’ to manufacture intraocular lenses which were not pricing for the Indian market. Furthermore, to take care of fixed costs, Aravid is continually finding process to make patient-centric care more efficient. This can explain why surgeons can perform six to eight procedures per hour – an average of about 2,000 operations each year. Therefore, Aravind Eye Care System has philosophy of optimum utilisation of resources which allows control over cost.
In conclusion, at the core of Aravind’s management philosophy is the ability to standardize high-volume input, which together with the use of low-cost service and high productivity allows exceptional output which is also the idea shared by the leading fast food-chain McDonalds. This resulting use of McDonaldisation allows Aravind to exemplify a near-perfection industry market paradigm. The four core principles of efficiency, calculability, predictability, and control were applied in its business model and been a huge success. The scale of achievement has allowed Aravind to provide assistance to a breadth of eye hospitals which have seen extraordinary results – a double or nearly triple in their productivity. This clearly shows how the principles of McDonaldisation can be applied to various fields with necessary adaption to fit their local needs.
- Jaffee, D. 2001, ‘THE RISE OF THE FACTORY SYSTEM’, Organization theory: Tension and Change, McGraw Hill, Boston
- Caldari, K. 2007, ‘Alfred Marshall’s critical analysis of scientific managementכ ,‘The European Journal of the History of Economic Thought, vol. 14, no. 1, pp. 55-78, retrieved 29 March 2014, Taylor & Francis Group, Routhledge
- Ratnayake, C. and Ima. 2009, ‘Evolution of scientific management towards performance measurement and managing systems for sustainable performance in industrial assets: philosophical point of view’, Journal of technology management & innovation, vol. 4, no. 1, pp. 152-161, JOTMI Research Group
- Riter, 1996
- Mcdonalistion – https://en.wikipedia.org/wiki/McDonaldization
- Mcdonalistion efficiency- https://www.mcdonaldization.com/whatisit.shtml
- Mcdonalistion control- https://www.thoughtco.com/mcdonaldization-of-society-3026751