Medicosnext
Per se, the word ‘health’ stands incomplete, odd, and under-described, until it’s paired with some other word. In order to make the word ‘health’ complete, sharp, and meaningful, this word has to be appended with another commanding word, ‘service’, so that the sense is endowed with more power. This pragmatic ground is enough in reflecting the reality that the service component has remained an inevitable and integral part of healthcare issues.
Since the dawn of the healthcare sector, it has never adopted the provider-centric philosophy. Rather, it has consistently and loudly adopted the user-centric philosophy. The health sector is never meant to instill abundance and prosperity to the provider side. Instead, it has always firmly stood with the objective of refilling abundance, charm, confidence, and prosperity to the ill people. It’s so apparent that healthcare is always a patient or public-centric phenomenon.
Answering the following simple yet practical questions would bring out more promising proof to the aforementioned reality. Did the existence of patients or disease come first, or did the existence of doctors, nurses, hospitals, Ministry of Health, or medical academics come first? Who are the providers and generators of the healthcare sector? The answer is, the patients, of course. It’s never true that there were hospitals and doctors so that people started getting sick to become their consumers. Just a reverse of that, hospitals were established, medical professionals were produced, and medicines and machines were manufactured just because there is the existence of those suffering from disease.
Thus, we cannot undermine the value of service component in the healthcare sector, and the question arises, “So, where do we stand in the ‘service’ part of health service?” In order to probe the magnitude of this question, one can visit, or imagine visiting, any house where one of the family members has fallen sick. The home we imagine can be of an affluent family or of one below the poverty line. The story there is never a white or polished story, the story we obtain is always a dark one. Falling sick invariably means falling down in money stock, confidence stock, and happiness stock.
The family is surrounded by confusion, hopelessness, and helplessness. The confusion starts from what to do next and where to take the patient to how to take the patient there, how to call the ambulance or vehicle, who is the supporter, how to manage money, how much money to manage, how to manage time, and who is the known doctor or staff in the hospital who can create comfort in that heavy crowd. Really, the scene in that home becomes chaotic. If they don’t have surplus in the locker, the story gets more complicated. If they forget to carry heavy bag of files and reports and plates, they get scared that they might be scolded by the service provider. Let’s imagine that the patient is taken to the hospital and they have crossed all steps of OPD or Emergency, and now they have to wait with fingers crossed to get a vacant bed. In the meantime, there is a constant pressure of managing money based on the reality that there is no culture of cost estimation. To summarize, there is confusion, hurdle, and pressure at every step, be it the phase of planning, transfer, connection, entry, processing, or follow up.
In this regard, we should not forget the reality of end users seeing only the front end; they are not bothered about the back end of the healthcare system. It means, patients are concerned with only the three ‘E’s—whether the service is easy, effective, and economic. They want cost-effective, less time-consuming, and politely-delivered service. This could be the reason that all standards and accreditation systems like ISO, JCI, NABH, NABL, etc. follow the service delivery and patient satisfaction parameter as an instrumental testing tool.
To connect this issue with our country’s reality, we can see a silver lining in the black cloud. Till a few years back, Nepal was concentrating just on making a recipe, not bothering about the menu and catering part. As such, we have now enough numbers of service providers. More than 500 hospitals of various levels, more than 20 medical colleges, many deemed medical universities in the pipeline, more than 26,000 doctors, with nearly 5000 specialists, including hundreds of DM and MCH levels, and thousands of para-medicals reflect that we are gradually heading towards numerical sufficiency in the case of providers.
Now, the issue is how to convert this number into a service blended with spices and taste of what patients look for. In order for this to happen, hospitals, diagnostics, and service providers have to start thinking differently. They should aim to reduce three things of the users, namely, time, cost, and effort. In the meantime, three things of the users have to be enhanced, that is, efficiency, outcome, and satisfaction. For this, Nepal should not delay in introducing strong regulation topped by add-on wings of service standards, quality assurance, and accreditation system. For sure all these can be carried through the vehicles of the three ‘I’s, that is, IT integration, insurance integration, and international reference.
In conclusion, we can only respect the health-related guarantee stated in the constitution by paying respect to the service component of the health sector.
