The Aravind Eye Care System ( AECS ) epitomizes to near-splendid an industry market paradigm: high-class input paired with inexpensive consumables and high productivity keeps running costs low and grants quality output together with public desire. Prior to retiring in 1976 from the Government Medical College, Dr G. Venkataswamy decided to set up the Aravind Hospital whose headquarters are located in Madurai, India (Maurice, 2001). Aravind has some worthy of admiration facets such as growth: having started in a rented house with just ten beds and a passionate concern to deracinate needless blindness, Dr G. Venkataswamy managed to build up to today’s 11 hospitals and 40 vision centers jointly with a network of community outreach centers, research foundations and eye camps. This made it possible for Aravind to handle the volume of 3.8 million patients last year with each eye surgeon performing 2000 operations per year on average. The system’s ability to deliver highly subsidized benefits to so many people hinges on its efficiency, calculability, predictability and control. (Le et al., 2016). Aravind’s business strategy rests on integrating Taylorian management principles from none other than McDonald’s restaurants (Virmani and Lepineux, 2016).
McDonaldization is the most prominent and influential exemplar of rationalization in modern societies. The aforementioned sociological term was devised by George Ritzer in 1993 who reconceptualized Weber’s rationalization of bureaucratic organizations (Turner, 2003). Ever since the concept of McDonald’s has been brought forward by Ray Croc, McDonaldization has unveiled every indication of being an inexorable action, sweeping through seemingly impervious facilities such as Aravind Eye Hospital. The thesis is underpinned by 5 core principles: efficiency, predictability, calculability, control over uncertainty and “irrationality of rationality”. With globalization, this business notion has become a dimension in widespread sectors like banking, cruise tourism or franchises of all types (Weaver, 2005). The process of McDonaldization ushers to a society in which an utmost concern of accentuation is put on obtaining the optimum means to any given end (Ritzer, 1983).
Principles on which McDonald’s restaurants operate are often translated into other sectors owing to the fact that the idea behind it is the same: high and consistent quality provision and low cost which achieve desired end, profit. Thus, to ensure efficiency is attained, a set of rules has been appointed to employees, as well as, customers to follow. Customers are presumed to efficiently eat their food as quickly as they can or to take it home hence why the drive-through has been created (Ritzer, 2000). On the other hand, top employees are upskilled in McDonald’s Hamburger University (Ritzer, 1998), in order to teach junior employees the workflow to guarantee fewer deviations which hinder the whole process, cause delays and culminate to clientele dissatisfaction (Weaver, 2005). Equivalent tailoring skills can be seen in Aravind Health Care System. Aravind confides in paraprofessionals (mid-level ophthalmic staff and cataract counsellors) who execute greater part of perioperative clinical services maximizing the time 22 surgeons dedicate to performing surgeries. While one patient is undergoing surgery, paraprofessionals prepare other enabling surgeons to perform 6-7 operations hourly hence 2000 or more cataract operations annually (Le et al, 2016). Use of high-volume operating rooms and standardized employee training results in Aravind’s admirable efficiency. In fact, it offers free of charge surgeries to 70% of its patients making a profit from just 30% that chooses to pay. By paying $120 (direct and indirect costs), in opposition to $1500 in American and European hospitals, clients cover the cost of the rest. Total income of $6 million was enough to counterbalance its expenses of $3.1 million in the last financial year (Maurice, 2001).
According to Ritzer (2001), calculability is “the emphasis on quantity rather than quality”. In McDonald’s setting, it connotes the capability to curtail everything to a quantifiable degree (Dumbili, 2013). Relatedly, they praise the size of their product (Big Mac) more than the quality of it (it’s not called a Good Mac). The main concern is the number of processed customers, the velocity at which they are served and the produced profit which results in the stray of quality (Ritzer, 1983). Aravind, however, is striving to actualize profitability without sacrificing quality. It hires local practitioners and then instructs them to become top-drawer, high-calibre surgeons whose monthly salaries are a little above the average ones in government hospitals. The reoccurring issue is staff attrition as surgeons tend to open private practices in rummage of higher incomes (Maurice, 2001). What is more, during procedures surgeons do not routinely change gowns nor gloves to optimize their productivity (Le et al, 2016) which may prompt one to think that the system has been dehumanized and all of these irrationalities are just consequences of McDonaldization (Ritzer, 2010).
Another component of rationalization is predictability. It is an affirmation that both service and product will be homogeneous and foreseeable (Ritzer, 2000). With the purpose of assuring the aforesaid, the impetus must be put on discipline, routine, formalization, consistency and methodical operation (Ritzer, 1983). Surprises are not expected and the commodity is acquired by the customer. This standardized system is applicable everywhere including the Aravind facilities. The hospital staff follows a standardized routine: diagnosis is done by the clinical staff, nurses address pre-operation and post-operation care, doctors prescribe and surgeons operate alternately on two operating tables which logically boosts productivity (Virmani and Lepineux, 2016). Nonetheless, one may argue that staff formalization in an institution like a hospital can seem raw and emotionless (Ritzer, 2010). However, Dr G. Venkataswamy claims that his hospital is a mix of compassion, family and business built on spiritual grounds of Aurobindo’s philosophy of interconnectedness of human souls (Virmani and Lepinaux, 2016).
Finally, the necessity of control is crucial to ascertain good workflow amongst all of the core principles. It is reinforced by the technology used and the way the establishment is set up to bolster this ascendancy (Ritzer, 2010). Other than control over personnel, the rational systems are also concerned with controlling the consumers. For instance, the limited seating, absence of servers, the restaurant counter and the drive-through windows all tend to subconsciously lead customers the certain way (Ritzer, 1983). So how does Aravind manage to control millions of patients every year? Its community outreach activities notify people and sustain the demand flowing. Nowadays, even in remote places in India, information can be assessed through the use of television or the internet (Maurice, 2001). According to Ritzer (2001), due to the fact that human actions are the most unpredictable, control can be obtained by substituting human workforce with machines.
In this essay, I have attempted to elucidate the powerful force of McDonaldization and illustrate the global impact it has had on modern societies. The business enterprise that is Aravind Eye Care System, transferred this model and came up with an alternative method becoming that way the largest eye care facility in the world. With the emphasis being placed on efficiency, calculability, predictability and control, innumerable advantages have been introduced to the market. It has also brought some drawbacks too known as “irrationalities over rationality”. Having taken everything into consideration, what is needed is a greater control over the process to try and diminish aforementioned irrationalities. To conclude, rationalism is occurring virtually in every sector of today’s society and is a force to be reckoned with.