The Medical Store

From a Dispensary to a System

When I first joined MGIMS, our “medical store” was really a small dispensary. It sat quietly in a corner of the hospital, more functional than impressive. The shelves held loose tablets—aspirin, chlorpheniramine, Nilpyrine—and a few familiar mixtures: cough sedatives, expectorants, throat paints, ear drops, glycerine magsulf, zinc oxide ointment. If a doctor wanted something unusual, he usually had to write it outside. The dispensary ran on experience and memory, and it was managed by two dependable compounders, Sudhakar Mitkar and Ambulkar. They knew every bottle and every drawer by heart. When both retired in 2006, the dispensary lost its anchors. Within two years, it shut down for good.

What replaced it was not just a bigger pharmacy, but a different way of thinking—about medicines, money, and the dignity of patients who had to buy them.

A dispensary, not a pharmacy

In those early years, we stocked what we could and managed shortages the way small hospitals always do: by improvising. The concept of an organized inventory, batch tracking, expiry alerts, and systematic procurement was still far away. Most of us did not even imagine that a rural teaching hospital could run a modern pharmacy with discipline and transparency. We were too busy treating patients and adjusting to constraints.

The change began slowly in 2004 when C-DAC arrived with the larger plan of computerising hospital services. A year later, Ajay Gupta created a small part of the pharmacy module. At first, the system ran on two legs—paper and computer—because no one trusted the new method completely. The old registers stayed open, and the new screens flickered beside them, waiting to be believed.

When computers arrived, fear arrived too

The medical store staff had every reason to feel anxious. For years, their competence had been measured by how fast they could read a prescription, find the medicine, and keep accounts in thick registers. Suddenly, a machine arrived and demanded a new skill: clicking, typing, saving, searching.

Mr. Chhagani—who later became our chief pharmacist—still remembers those early days with a smile. He says he was so intimidated that he didn’t even have the courage to touch the mouse. It looked harmless, but it represented something larger: the fear of making mistakes in public, the fear of slowing down the queue, the fear of being judged by younger people who seemed to learn faster.

Chhagani and the first brave click

What makes Chhagani’s story memorable is not that he was afraid. It is that he refused to remain afraid.

Over time, the man who couldn’t touch a mouse became the man who could run an entire electronic pharmacy. Today, he manages and tracks an inventory of nearly 2,500 items—tablets, capsules, injections, syrups, sutures, stents, implants—moving in and out every day with the speed of a railway junction. He speaks with quiet pride about what the system made possible.

“In the past, we used to feel overwhelmed while tallying accounts manually,” he told me once. “Now we track expiry dates easily, prepare comparative statements, and award tenders to the lowest bidder. We work with confidence.”

That word—confidence—is the real story. Computers didn’t just improve efficiency. They restored self-belief.

Maha Shivratri and the FoxPro-to-Oracle shift

Ritesh, who joined the medical store as a clerk in 2007, describes the older procurement system like a slow-moving file in a government office. Doctors recommended branded drugs. The medical store had to write letters to companies and send them by post. The companies forwarded lists to distributors. Distributors took their time. Supplies arrived late, or not at all. Stock-outs were common, and patients paid the price.

When C-DAC began computerising hospital services, the medical store saw a chance to upgrade properly. We decided to migrate from the old FoxPro program to the newer Oracle-based system. That shift happened on a day I still remember clearly—not because it was dramatic, but because it was symbolic.

It was Maha Shivratri, Monday, February 23, 2009. While others were celebrating, the pharmacy staff worked through the day, migrating every item of inventory from FoxPro into Oracle. The next morning, the store opened with the new software. It was not just a technical switch. It was a declaration that we were done with half-measures.

Bhavana’s role in this transition remains one of my favourite ironies. She had helped create and run the FoxPro system earlier. Yet she was the one who insisted we replace it with the C-DAC module and integrate it fully with the hospital’s electronic ecosystem. She approached it the way a good cook approaches change: she was willing to retire her own best dish if she believed the new one would serve people better.

Tenders, generics, and the real meaning of “affordable”

Technology improved tracking, but the real revolution came from a deeper question: What medicines should we stock—and at what price?

Between 2007 and 2011, we had a Drug and Therapeutic Committee meant to recommend rational and evidence-based drugs. On paper, it sounded ideal. In practice, it didn’t work well. People were busy, opinions differed, and decisions often remained stuck between “what is best” and “what is familiar.”

So we changed the approach. We formed a new drug committee chaired by Dr. Poonam Varma Shivkumar, with department heads, the administrative officer, chief accountant, and chief pharmacist. It met annually, and it worked with a seriousness that matched the stakes.

In 2009, the medical store got another boost when Dr. Rajnish Joshi joined as medical officer. He had already played a key role in building our HIS, and he brought the same clarity to the pharmacy. The store expanded its range, procurement became systematic, and tenders and quotations helped bring down prices sharply. Later, Dr. Ramesh Pande took over and carried the work forward for almost a decade, improving it year after year.

In February 2010, we made a decisive shift: we focused on generic and branded-generic medicines, and we digitised the tender process end-to-end—requirements, tender drafting, bid submission, evaluation, contract award, delivery, and payment. We also changed the pricing method. Earlier, like many hospitals, we used to deduct a percentage from MRP. But MRP itself can be a fantasy number, designed more for marketing than for honesty. We moved instead to a simple model: procurement cost + 20%.

It made medicines truly affordable, and it made pricing transparent.

I often think of the ordinary patient with multiple chronic diseases—heart disease, diabetes, hypertension, high cholesterol—who needs several tablets every day. Earlier, such a patient could bleed money slowly, month after month, until treatment became a burden. With the new system, many of them could buy their daily set of medicines for around five rupees a day. In India, that is less than what many people spend on tea without thinking twice.

Even auditors were stunned. Some would stare at the price list and ask, half-suspicious and half-amused, “How can you sell this for ₹24 when the MRP is ₹100?” A few were so impressed that they bought medicines for their own parents and requested three-month refills. That was not part of our plan, but I took it as an unintended certificate of credibility.

Heena and the Digital Turn

Heena joined the medical store as a pharmacist in 2010, and she took to the work like a duck to water. “I still remember those days,” she told me. “We prepared purchase orders by hand, and it would take forever to make even one. Even the comparative statements were done manually.”

By 2011, things had changed. The team began using the digital system to procure everything—from tablets and syrups to injections, ointments, syringes, masks, gloves, bandages, IV fluids, sutures, mesh, staples, stents, balloons, orthopaedic and dental implants, even physiotherapy supplies. The entire tender process became end-to-end digital: estimating requirements, drafting and publishing the tender, receiving and evaluating bids, awarding contracts, and finally tracking delivery and payment.

The counter where relief shows on faces

Over the years, the medical store shifted locations several times—like a restless tenant in its own hospital. It began near the entrance of the Obstetrics and Gynaecology wards, then moved to the area where the Surgery OPD once stood. Finally, in 2020, it found a proper home: a spacious, newly built main medical store inside the hospital building.

The new store runs like a small airport. There are separate counters for outpatients, inpatients, senior citizens, emergency, and dialysis patients. On an average day, it serves around 1,500 patients and generates nearly two lakh rupees in drug sales.

Not everyone welcomed the change. Some doctors—especially in dermatology, orthopaedics, and obstetrics—worried about the quality of generics and argued that brand-name drugs were always superior. We listened, we discussed, we improved quality checks. But we did not abandon the central idea: patients must not be punished for being poor.

The fall in prices over the years has been dramatic. Paclitaxel injection (260 mg), once priced at ₹13,500 per vial in 2015, now costs around ₹550. When such reductions happen, they do not look like “policy.” They look like survival.

And the most convincing evidence is not in a spreadsheet. It is at the counter. Patients stand in long queues, tired from travel, clutching prescriptions. Then they hear the amount. Their faces change—first disbelief, then relief, sometimes even a smile. Many look at the pharmacist as if he has performed a small miracle.

In those moments, I don’t see a pharmacy module or an inventory system. I see what a hospital is supposed to do: make treatment possible.

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