Pri­vate docs FOR US

J’cans shun pub­lic hos­pi­tals be­cause of time it takes to get treat­ment

Jamaica Gleaner - - FRONT PAGE - An­dré Poyser Staff Reporter

SIX OUT of 10 Ja­maicans say they head for to pri­vate doc­tors, rather than gov­ern­ment-owned hos­pi­tals and clin­ics, when they have health prob­lems.

But while poor med­i­cal ser­vice and the bad at­ti­tude of staff fig­ure among the causes Ja­maicans shun the pub­lic in­sti­tu­tions, the qual­ity of care is not their main rea­son. Rather, it’s the time it takes for them to get treat­ment – a prob­lem the Gov­ern­ment says it has be­gun to ad­dress by ex­tend­ing the open­ing hours at some clin­ics and in­creas­ing avail­able staff.

“We have ac­tu­ally started this ini­tia­tive in some hos­pi­tals and some health cen­tres that are close to hos­pi­tals,” says Dr Jac­que­line Bisasor-McKen­zie, di­rec­tor of emer­gency med­i­cal ser­vices in the Min­istry of Health. “We have cho­sen seven hos­pi­tals and we chose these hos­pi­tals based on the fact that they ac­counted for the high­est vol­umes of vis­its

per year to the emer­gency de­part­ments.”

Ac­cord­ing to a national sur­vey com­mis­sioned by The Gleaner that probed the per­cep­tions Ja­maicans hold of the is­land’s health-care in­sti­tu­tions and the peo­ple who work in them, only 37 per cent of adults (19 per cent clin­ics; 18 per cent hos­pi­tals) had these pub­lic in­sti­tu­tions as their first point of contact if they be­come ill.

When probed on their lack of con­fi­dence in fa­cil­i­ties, whose ser­vices are os­ten­si­bly free, by far the main rea­son (47 per cent) peo­ple gave was the long waits they have to en­dure. In fact, that con­cern was more than two and a half times worse than the 18 per cent who com­plained about per­ceived med­i­cal mis­takes/bad treat­ment, or the 17 per cent who com­plained about the at­ti­tude of em­ploy­ees. A mere five per cent specif­i­cally men­tioned short­age of med­i­ca­tion, while three per cent pointed to a short­age of, or mal­func­tion­ing, equip­ment.

By con­trast, of the 45 per cent who, in the Septem­ber sur­vey, de­clared hav­ing no prob­lem with these in­sti­tu­tions, the largest seg­ment (20 per cent) was be­cause they be­lieve they would re­ceive good treat­ment, while only 12 per pointed to their “good doc­tors”. Iron­i­cally, only 10 per cent of this group men­tioned among the rea­sons the fact they don’t have to pay.


Fur­ther, of the per­sons who have ei­ther been, or had a fam­ily mem­ber as a pa­tient in a pub­lic hos­pi­tal – the mean av­er­age pe­riod for ad­mis­sion at the time of the sur­vey was 19 months – 53 per cent were sat­is­fied with the ex­pe­ri­ence, with the main rea­son (45 per cent) be­ing the qual­ity of treat­ment.

Per­haps, para­dox­i­cally in the con­text of the those find­ings, only 15 per cent of Ja­maicans rated the treat­ment peo­ple re­ceived at pub­lic hos­pi­tals at ei­ther good or bet­ter, while 19 per cent said their ser­vice was av­er­age. Over­all, merely 34 per cent of Ja­maicans shared a some­what pos­i­tive view of pub­lic hos­pi­tals. This com­pared with a com­bined 54 per cent not be good or worse.

Given these at­ti­tudes, it is hardly sur­pris­ing that at on­set of ill­ness, 60 per cent of Ja­maicans say they seek out their pri­vate

doc­tors, and that 72 per cent of these have a spe­cific physi­cian to whom they go for treat­ment or ad­vice. Women (78 per cent) are more likely than men to have this kind of re­la­tion­ship with their doc­tors.

The vast ma­jor­ity of Ja­maicans are sat­is­fied with the qual­ity of ser­vice/treat­ment they re­ceive from their pri­vate doc­tors: 63 per cent say they are very good or world class and 13 per cent rate them as av­er­age. Only three per cent said their pri­vate doc­tors were no good. For those who rate these doc­tors av­er­age or below, their main com­plaint was that the physi­cians were too con­cerned with money or were too ex­pen­sive. Un­sur­pris­ingly, lower fees/costs emerged (among 22 per cent of re­spon­dents) as the ma­jor is­sue that they would like to see pri­vate doc­tors ad­dress. At the other end, peo­ple (33 per cent) praise the ex­cel­lence of the health care, and un­like in the pub­lic sec­tor, the speed (18 per cent) with which they re­ceived care. Pri­vate prac­ti­tion­ers, who note that it was the ma­jor­ity sen­ti­ment in the sur­vey, re­ject the idea of money-grab­bing doc­tors, say­ing they have to make a re­turn on their in­vest­ment in fa­cil­i­ties and equip­ment and be paid for the ser­vice they pro­vide. For uro­log­i­cal sur­geon and med­i­cal en­tre­pre­neur, Dr Devon Os­borne, while cost may be a con­cern, many Ja­maicans don’t mind pay­ing more be­cause of the qual­ity of care they re­ceive at a pri­vate physi­cian.

“Money is a fac­tor, but many per­sons would rather save and go to their pri­vate physi­cian than face the jug­ger­naut of a pub­lichealth sys­tem,” said Os­borne, who op­er­ates health-care fa­cil­i­ties in Port­more, St Cather­ine, and May Pen, Claren­don.

Added Dr Fitzroy Mallett, who prac­tises in the east­ern parish of St Thomas: “When you come to the pri­vate doc­tor, its quick, easy ac­cess and there’s a spe­cial re­la­tion­ship be­tween doc­tor and pa­tient.”

The pub­lic health-care fa­cil­i­ties may not be able to match the quick turn­around time of the pri­vate doc­tors and the spiffy med­i­cal cen­tres, but al­le­vi­at­ing, or at least eas­ing, the frus­tra­tions of long, some­times fruit­less waits is among the things the health min­istry’s Dr Bisas­orMcKen­zie hopes to achieve by hav­ing health clin­ics open till eight o’clock at night.

Says the health min­istry of­fi­cial: “I spoke to a pa­tient at Com­pre­hen­sive Health Cen­tre (in Kingston), and she said she went in the morn­ing and it was crowded. She was asked to come back in the even­ing and she said she was happy to go home and do her chores. When she came back, she got through quickly.”

Dr Jac­c­que­line Bisasor-McKen­zie

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