Have you often wondered the meaning of posters like ‘we take good care of all our patients’ accompanied with pictures of smiling faces and friendly nurses that are plastered on the walls of some private hospitals?
Is this what people experience when they walk into a hospital, inquire at the counter or ask the nurse on duty as to when a consultant they have channelled will be available? Just like some consultants, they will mumble a reply without looking up, be indifferent or respond “Api danna (we don’t know when the consultant is coming).” One of our readers wittily commented, “They will give you a ‘GAL’ stare.”
Ever since private channelled practice entered the domain of the local health service some decades back, the service has provided a mix-bag to the public.
While the private hospital sector has grown by leaps and bounds, so has the cost of care, resulting in longer waiting times as doctors in demand resort to hospital-hopping (going from one hospital to another) resulting in patients having to wait for a long time.
In one peculiar case, patients who channeled a doctor and were told to come at a specific time were in for a shock when they arrived in time for their appointment. The doctor had come and gone as the first few patients didn’t turn up and instead of waiting for the others who were given prescribed times for their appointment, had left. Hospital staff looked on helplessly as patients let off their fury on the hospital. Now if patients can wait for hours for a ‘paid up’ service, why can’t doctors do the same?
The debate of the doctor versus the patient in private channeled practice will go on for years with the patient being at the mercy of the doctor and the hospital, with their ‘take-it-or-leave-it’ attitude.
A poll by the Business Times with its polls’ partner, Research Consultancy Bureau (RCB) this week on ‘channelled practice’ arising out of an interesting debate on this issue at the Sunday Times Business Club two weeks back, proved beyond doubt that the public is fed up with waiting time for doctors, the limited time and attention given by doctors and the attitude of the hospitals.
Results of the poll conducted by email and through a street survey are reported elsewhere in this newspaper but the message is clear: Channelled private practice has become a necessary evil and patients (big or small, rich or poor) are at mercy of doctors. Ironically patients are now spending almost the same amount of time at a private hospital they would otherwise spend at a government hospital to be examined by a doctor, one of the reasons why private hospitals proliferated. In fact a consultant would spend more time in a government hospital because he or she sees a limited number of patients while less time (at huge cost to patient) is spent with patients outside.Here are two comments that were received in this week’s survey:
*Patients should not be taken for granted. Doctors still behave as if society is at their mercy. The waiting time is unbearable for patients who need urgent attention. * Sometimes consultants don’t even look at the patient and write prescriptions in a jiffy while quickly calling in the next patient. Hospitals should insist that the consultants should spend at least 15 minutes for each patient thereby informing the consultant that he could see a specified number of patients within the time the consultant is in the hospital.
The other side of the coin is that due to the demand to see the best, some doctors are compelled to see as many patients as possible as everyone comes to them because of their skill, expertise and judgement.
Do patients have rights just like in any consumer society? Are patients able to complain to a hospital that they should not be kept waiting? A veteran, now retired, doctor says that one of the problems is that in
Sri Lanka there isn’t a culture where patients complain.
Private hospitals like the rest of the private sector get certification from all kinds of international and local bodies (Sri Lanka Standards). Some of them are International Organization for Standardization’s (ISO) 14001-2004 for environmental management or ISO: 15189 standard for quality and competence in medical laboratories.
Both are important like any other certification. However has any hospital got certified for ‘good and friendly’ service where patients are greeted by friendly staff at the counter, in the corridors and by the nurse who helps the consultant in question? The last-named, often a junior nurse or trainee is often indifferent, flippant, rude or curt while most patients are compelled to be ‘nice to her’. What a state of affairs!
Discussing private practice and the attitude of hospitals to patients is like opening a can of worms – so much to talk about but so little that can be done. The private hospital industry needs a wake-up call and tougher government regulations to be more patient-centric and caring. Otherwise there would be a time where people revert back to state hospitals if there are more paying wards like the Merchants Ward at the Colombo National Hospital providing a far better and more caring service