Appreciating our health system

With more patients visiting the hospital annually, the workload for doctors and staff at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) has been increasing.

The hospital recently launched its first annual report in which figures are supposed to make us aware of the increasing workload.

We are aware that our doctors and hospital staff have a heavy workload. We appreciate their efforts and value the work they put in, day and night.

Given the importance of their work, we don’t want them overworked or overburdened. We want them to know that they are appreciated; that we’re grateful for the free health system, and we hope they remain motivated and passionate.

However, given the increasing number of patients visiting not only JDWNRH, but other hospitals, it is hoped that we’re doing whatever we can to make the system as efficient as possible. Having the most efficient system in place, from a rational token system to orderly queues and less waiting time, means less frustrated patients, and therefore less stressed-out medical staff.

Simple improvements, like designating queue areas with the help of painted lines or other equipment, can help. Many express frustration with the token system which requires some to go and wait as early as 8am. If you require a blood test, some say that the wait can take several more hours.

We are relieved to know that efforts are underway to record all patient information electronically. It has taken several years, but we are hopeful that this initiative goes nationwide soon. This should definitely reduce waiting times and increase efficiency.

But there is room for improvement. The hospital needs to identify its weaknesses in management and address them.

But with the increasing number of patients, even an efficient system can get bogged down, especially one with doctors constantly leaving the service.

How do we retain doctors and specialists is a question that has not been answered.

If we have to pay our doctors more to prevent them from leaving, perhaps they should be de-linked from the system so that we can.

While private diagnostic clinics have been allowed, there is a need to begin outsourcing more services to reduce the burden on JDWNRH and other hospitals in Thimphu. Privatisation of medical services so that our health care system is not overburdened needs to receive serious consideration now. That is how we can acknowledge the efforts of our health fraternity and improve the system.

1 reply
  1. irfan
    irfan says:

    Long waiting lines of patients at a major referral hospital can be just a minor issue with management and administration system in place, or it can be the symptom of something even more serious in the overall health service deliveries.

    Privatisation of medical services at different levels is one aspect, while having the right public-private balance for the country’s ‘health care system’ is the lot broader theme to consider. Issues in health care services identified by the service receivers are usually a lot more different than challenges pointed out by our health care fraternity.

    A health care system must take into consideration the back end services that create the entire environment for medical and paramedical education and training. By simply privatising diagnostic clinical services will only create more pressure on the demands if we ignore the supply side that ensures adequate trained professionals for health service delivery. And no professional management system in place can improve things dramatically if the supply end is not optimised.

    But even bigger a challenge is the affordability of the medical as well as clinical equipment. An out and out free access to all here will load up the health care system somewhere else. It’s not easy to allow restrictions in the supply of medical professionals and paramedics. And then we have key parameters like doctor to nurses ratio for consideration in the system.

    But challenges don’t just end there for issues to be identified by a common service recipient. We have a doctor to beds ratio to maintain for a given standard. Our infrastructures are not enough without the right resources placed inside. A medical equipment is as important as the doctor or specialist himself. The first one here can drain the country’s financial resources big time and this is people’s money.

    So training at the job desk matters for the professionals in the field of medical and paramedical sciences. And we have our ‘Basic Health Units’ to run and maintain for the right purposes. A failure in effective service delivery here ultimately makes management and administrative issues at the head of the referral system. This is where the supply side problems develop.

    Privatisation of health services matters towards having a great quality system for health care. But privatisation demands business models at least for sustainability if not it’s profit from the beginning. To think, plan and act innovative here will be the key to a quality system. The more we can bundle vertically, the better it may get. And it demands mobility beyond just ambulance services.

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