Below is a kinda long but interesting write up by a friend of mine currently working in the medical field. It’s related to the “Kuwait to segregate medical care” post from last week:
Its not a sprint, its a marathon
We need help. Everyone can agree that healthcare in Kuwait should be paramount. We need to have a healthcare system we can be proud of and confident in. I need to feel proud of where I work and the job I do. The recent lobby towards segregated healthcare for none emergent cases is just one more example of a quick fix for many failed and saddening endeavours that we as a profession are at least partly responsible for.
From the outset I doubt that anyone working currently in Kuwaiti healthcare is evil or bad or totally and completely corrupt. In fact, I think many of us started our careers inspired and full of promise but were met by challenges that we cannot possibly overcome. At a healthcare system level, we need to refine our goals and find our way towards something more efficient and dare I say it welcoming to people.
How many people reading this have a family doctor?
I doubt many of you do. This may be because you are perfectly healthy but it’s probably because you show up at the emergency room if you need anything because you have no confidence in your local poly clinic or mustawsif. The fact of the matter is that I wouldn’t either.
We need to re-create the family doctors as the go to guy or girl for all things non emergency and as the primary referring physician (small bruises, vaccines, high blood pressure, diabetes control, breast and colon cancer screening). This will mean two big changes. The first is that one doctor or centre will have all your medical history and that from now on you won’t show up to the emergency room unless it is an actual emergency, otherwise the emergency department will refuse to see you (this is the norm in the US, Canada and the UK NHS, it is becoming the norm in many south east asian countries gradually as well). More importantly we need to equip our poly clinics and family doctors with information and facilities such as x-ray facilities, ultrasound and turn a rundown office into an actual treatment facility. We also need to mandate a minimum amount of courses to be taken by these doctors so that they remain up to date in their fields (this should be true for all doctors in general come to think of it)
Provided you’ve got a referral or are trying to see a specialist, how many of you see them on time?
The way things are now, if you live in Mishref, you go to specialists in Mubarak, if you live near Adan then you are sent there. This means that the areas with the highest population end up with the longest waiting times. We need a structured dynamic referral system. I’m sure that there is some sort of solution I’m just not sure what it is. Perhaps if there was a regular update of which areas had the shortest waiting time were made available to family practitioners on a daily basis (via email). It may mean that patients will get their appointments earlier.
The problem is that I doubt that a person living in Jahra would be happy coming to Amiri for his echocardiogram even if it meant he or she would get it quicker. Having referrals to different hospital for different things would mean that you need to have all the patients data accessible across different hospitals in a sort of a cloud. Lets face it people, I’m more likely to see a giant flying saucer deliver free red velvet cupcakes at 360 than I am to see the ministry of health manage a cloud based patient filing system.
Having exhausted all efforts to get an early appointment you decided to go private, how many of you see a physician in his private practice after trying to get an early appointment in his government funded one?
Many of us have a conflict of interest when we are employed in private and public healthcare. I know colleagues who completely neglect their public healthcare patients and I know others who have no interest in private healthcare. Regardless, clear guidelines have to be set so that a physician working in the private healthcare field does not neglect his or her public healthcare practice. A bill requiring all doctors working in private healthcare to have 50% of their practice as public or pro bono might be the best solution but it’ll also mean that you would be the most hated minister of health in the history of Kuwait. (Maybe if we start with 30%, doctors are less likely to revolt)