Healthcare, Court, and the regulatory authority
Dr. A J M Shafiul Alam Bhuiyan, Professorof Television, Film and Photography, Dhaka University : The recent directive of the High Court for the private health clinics to display all charges at public place s for the people has exposed a dirty secret of our healthcare system. There are two others requiring interventions: doctors’ lackluster care and the foul plays of the diagnosis centers. Will the healthcare service regulatory authority stand up to ensure quality care?
In terms of the ownership of the healthcare services, two types of service—public and private—operate in Bangladesh. The private healthcare services such as clinics and hospitals have turned health care into a commodity with ahigh exchange value but a lowuse value. In many of these private health facilities, people are trapped to buy services at exorbitant prices. Patients and their families discover many charges and fees during their stay for treatment and at the time of release. If the private healthcare facilities oblige to the High Court directive, people will know upfront about all the charges and will be able to decide whether they will seek the treatment or not. It will bring all hidden and unannounced charges to light. Charges and quality of services at the private clinics and hospitals vary based on their brand values. On the other hand, the public healthcare facilities including hospitals charge low but offer poor quality service. The number of patients at the public hospitals outpour the capacities of the capacities of doctors, nurses, and technicians. Many hospitals lack modern equipment for diagnosis and treatment while some have procured modern equipment without employing enough skilled technicians. Hygiene is also an area of grave concerns.The consequence is no service or a little service for patients.
If you get sick you are doubly unlucky. In addition to suffering from illness, you are at risk of suffering from mistreatment. It is an uphill tasktostay healthy all the time because of extreme weather, air and water pollution, unhygienic condition, and adulterated food.When you need to see a doctor, your ordeal begins. In the country, a patient can consult any doctor if they can afford it. In the West, access to specialist doctors is regulated by a referral system. Without the reference of a general physician, nobody can see a specialist doctor. This system is in practice to reserve specialist doctors for complicated patients. Given the open access system in our country, all of us prefer to see a renowned doctor, a doctor who has higher degrees and holds a senior rank in the profession. Dozens of people crowd a doctor’s private chamber for consultation every day. The doctor hardly has time to listen to patients and answer their questions. Many doctors prescribe medicines without properly listening to the complaints. Sometimes fatigue grips them as they are overworked. Many doctors either discourage questions or get annoyed to hear questions from the patients or their attendants. Many doctors recommend excess medicines and a lot of diagnostic tests. They never bother to explain why they prescribed particular drugs and tests. They have to part with a patient at a breakneck speed to deal with another patient waiting for advice. Rumor has it that many doctors love to recommend a large number of tests because they receive a commission for tests from diagnostic centers. The more they recommend the more they earn. Diagnostic tests are essential to diagnose diseases but irrelevant tests tax patients’ financial ability and may cause harm to them.Diagnostic centers have emerged as another trap where people get ripped off. There are also questions about the validity and reliability of the tests. The accuracy of a test hinges on the quality of the testing kits, technicians, and analysts. Unfortunately, a few of the diagnostic centers have credibility and can stand up their reports.
Given the poor services offered at the local hospitals and health care centers, the country loses a huge amount of money as hundreds of people leave the country everyday for neighboring India, Thailand or Singapore for treatment. Doctors over there have the reputation to give patients patient hearing and comfort them through psychological support and recommend appropriate tests and medicines. Is our healthcare regulatory authority aware of the outflow of Bangladeshi money to foreign countries for treatment? Will they take any measures to stop this?
It is a shame for the nation that we are yet to establish a credible healthcare system.Improvements in patient care, morality and quality of doctors, and the standard of diagnostic centers are a sine qua non to stop this outflow. [The writer is a Professor of Television, Film , and Media Studies at the University of Dhaka and the Executive Director of the Governance and Policy Research Foundation (GPRF).