Business and ethics must go hand in hand for private hospitals
Private hospitals and clinics in Bangladesh should ensure high-class service, maintain ethics and win the confidence of patients to take the country's burgeoning healthcare system to the next level, said a top representative of private hospitals.
Bangladesh's healthcare sector has made impressive strides in the last two three decades: diagnosis and advanced-level treatment such as bypass surgery, kidney transplant and liver operation are locally available, an improvement that was unimaginable even two decades ago.
Yet, the outflow of patients to India, Singapore and Thailand for treatment continues, reflecting a confidence crisis among the healthcare-seekers and raising a question of what to do for the sector to ensure world-class standard.
Proper training of doctors and nurses and a change in mentality are necessary to improve the overall healthcare standard in the country, said Md Mainul Ahasan, secretary general of the Bangladesh Private Clinic Diagnostic Owners Association.
"If we only think of profit after establishing hospitals, we will not be able to make it. We have to think of both service and profit. We should not run after too much profit -- at least in the health sector."
Business-only attitude will enable only a section of people who have the means to get medical care in Bangladesh, depriving others.
Additionally, modern hospitals need to be built. Otherwise, people will go abroad, said Ahasan, also a physician.
According to him, government support is also necessary. The government should have a good hospital in every upazila and district so that patients don't have to travel far for treatment.
"Healthcare facilities at the district and upazila levels should be expanded."
In an interview with The Daily Star, he reflected upon the progress made in the country's healthcare setup, particularly by the private sector.
"It is a big change and sometimes it is hard to believe."
Even 15-20 years ago, people going to India, Singapore and Thailand for treatment of cardiac problems such as bypass surgery was a common sight. Today, only the super-rich go abroad for such treatment.
"Development has been made in kidney transplant, bypass surgery, liver operation and cancer surgery, to name a few."
Advancement has been made also in case of investigation.
"A lot of investigation was unknown to us 20 years ago. Now, many of them take place here except for a few," he said, adding that the machinery that the healthcare sector has installed at their facilities are more improved.
Private hospital and clinics provide medicare to 62.5 per cent of the patients in Bangladesh, he said, citing the World Health Organisation (WHO) statistics.
And, because of advancement in healthcare, the flow of middle-class going abroad for treatment has slowed, he said.
But Ahasan acknowledged that confidence on the country's healthcare system is not cent per cent yet.
Because of pressure of patients, there are some doctors who see more patients than they should.
As a result, the doctors in many cases can't give adequate attention to patients for physical examination and investigations, which leads them to making wrong diagnosis and thus compelling many patients to seek treatment in other countries.
"Giving time to patient and counselling is very important to boost confidence. Many doctors don't talk to patients and provide counselling even though they have time. As a result, patients don't feel assured."
The practice of briefing and assuring patients is very important. This is absent among many doctors in Bangladesh.
Ahasan suggested regular supervision and monitoring by the government.
The Directorate General of Health Services should visit hospitals not only on an annual basis.
Rather, it should visit hospitals time to time to ensure quality care for patients, he said, citing reports of malpractices like surgeries done by juniors or ward boys.
The government should be liberal where it is necessary and tough when needed, he said, adding that all the ill practices will stop if the government sets one or two examples.
"We should be tough. It is not time to be soft as the sector has grown. It is time to be tough to elevate the healthcare sector to the international level."
According to Ahasan, the contribution of the government is little in the development of the private healthcare service.
In fact, it sometimes creates barrier in the name of procedures and formalities.
"If the government is liberal, it helps us. But it does not mean that clinics and diagnostic centres with no workforce or the required facilities should be given the permission."
But sometimes, positive reports are given by a section of health officials after they visit such facilities.
"The government should be firm to control this."
The healthcare sector is doing well and the government should waive all import tariffs, value-added tax and tax on the imports of diagnostic equipment.
The government should allocate land to establish hospitals in every locality to take the healthcare service to the country's vast population.
"Where do we establish hospitals if there is no land?"
Perhaps, a zone for healthcare can be dedicated.
Despite the progress, there is still a shortage of doctors and nurses at both the public and private hospitals, said Ahasan, also the managing director of Green Life Medical College & Hospital.
The country has one doctor for every 1,847 people, falling behind the WHO threshold of 23 doctors and nurses for every 10,000 people.
Except Bhutan, the doctor-patient ratio is higher in other south Asian countries than in Bangladesh.
In case of nurse-patient ratio, the country lags behind all South Asian neighbours save for Afghanistan.
Bangladesh has only 3.06 nurses for every 10,000 patients.
"At the same time, q caring attitude is a must. Becoming a doctor or a nurse is not enough. You have to have the mentality to serve," he said, adding that ethics should be a part of medical education.
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