The Health Ministry, under the Private Health Sector Regulatory Council, has issued guidelines stating that doctors should spend more time with patients in diagnosing, and at the conclusion of surgery.
According to the Secretary to the Ministry of Health, Nutrition and Indigenous Medicine, Anura Jayawickrema the requirement is that doctors spend at least 10 minutes with each patient during consultation, and one hour following surgery.
It is not a secret that the public is dissatisfied with doctors’ consultation attitudes, especially, in the private sector, and in view of such circumstances the introduction of such a regulation would be met with gusto. However, the question is, whether we have the necessary manpower to introduce such regulations.
Speaking to the Sunday Observer, media spokesperson of the Government Medical Officers’ Association (GMOA), Dr. Samantha Ananda, said, although they welcome such guidelines to provide quality patient care the practicality of implementing it is doubtful.
“This is a good decision, but it needs to be practical. When considering the current clinics setup in Sri Lankan hospitals, it may be difficult. In a medical clinic we get nearly 400 patients while some clinics get more, with only a few doctors. If you spend 10 minutes with each patient per hour, we can only see six patients. So, it would take six hours to see 36 patients. In a clinic with only 3 – 4 doctors you cannot do the math. More than two thirds of the patients would have to go without seeing the doctor. This is the practical situation that we face at present. It is important that decision makers take decisions in consultation with the relevant stakeholders.” Dr. Ananda said.
Director, Sri Lanka National Hospital (NHSL), Dr. Anil Jasinghe speaking to the Sunday Observer said, there are some units that can handle the workload, but others may not be able to adhere to this requirement.
Ten minutes
There may be places where it is difficult to implement it. But, certain units can handle it. Some clinics are overloaded where the work for NHSL should be distributed. However, there are many clinics where doctors can afford to spend ten minutes with a patient. Hence, this is a step in the right direction towards the enhancement of the health sector in the country.
The application of this directive has so far been to the private hospitals and not so much for government hospitals. It is the view of some doctors that any regulations and/or directives introduced to the health sector should apply equally, both, to private and government hospitals.
The GMOA, while emphasizing that they fully support the government in its endeavour to increase quality patient care, says, there are other needs and urgent decisions that should be prioritized. “We are not opposing proposals of this nature and always assist and encourage any decision to increase patient care. Currently, as doctors we play a major role in providing quality patient care. Our Health indices are maintained on par with that of developed countries. Maternity Child mortality vaccination percentages are really high and on par with developed countries. At the same time Sri Lanka has eradicated malaria, filaria and polio.
Misdiagnosed
We are the only country which has achieved this in South East Asia. They have been achieved with low health budgets compared to other developed countries. Therefore, decisions should be practical with implementable solutions by which the health sector will truly benefit and develop,” says Dr. Ananda.
In its final quarter, last year, a research done by the American College of Physicians shows: “physicians spent 27 percent of their office day on direct clinical face time with patients and spent 49.2 percent of their office day on Electronic Health Records (EHRs) and other desk work. When in the examination room with patients, physicians spent 52.9 percent of their time directly talking to patients and 37 percent of their time on EHR and other desk work.”
The need for doctors to spend more time with patients is crucial, in diagnosing them. In countries such as France and Germany, doctors spend nearly twenty minutes per patient during consultation.
Many consultants in the US have claimed that more time should be allocated for them to spend with patients as short durations are unsafe and puts the patient in the risk of being misdiagnosed and or mistakes pertaining to prescriptions. “If they really want to develop the health sector they should assemble ideas and suggestions from those running the show.
We are happy if doctors can spend 10 minutes with the patients. And our burden will be reduced. But patients will also be at a loss by these regulations,” the Director opined.