Social Affairs
Secluded at commune and ward health stations
The model of family doctoris chosen by the health sector as a fundamental solution to reduce the burden on hospitals and to attract patients to primary care clinics.
However, after 3 years of implementation, this model is still unfamiliar to the people. Medical experts expect that, over time, this model will bring efficiency, help people in medical examination and treatment.
People do not care
Only about one kilometer away from the family doctor clinic, but Nguyen Thi Mai (Tay Mo, Nam TuLiem, Hanoi) has not come to this clinic yet. Referring to the notion of family doctor, Mai was rather vague because she did not care. According to her way of thinking, family doctor is just a doctor opening a private clinic for overtime according to the needs of the people. In fact, few people of Hanoi City - one of the eight provinces and cities selected by the Ministry of Health to pilot the model of family doctor, know or discuss this model.
People do not care
Only about one kilometer away from the family doctor clinic, but Nguyen Thi Mai (Tay Mo, Nam TuLiem, Hanoi) has not come to this clinic yet. Referring to the notion of family doctor, Mai was rather vague because she did not care. According to her way of thinking, family doctor is just a doctor opening a private clinic for overtime according to the needs of the people. In fact, few people of Hanoi City - one of the eight provinces and cities selected by the Ministry of Health to pilot the model of family doctor, know or discuss this model.
Doctor's clinic at Chi Lang Commune Health Station, Que Vo District, Bac Ninh province.
In everyone's thoughts, when they are in illness, whether serious or mild, they all go to hospital or private clinic. Deputy Director of Hanoi Authority for Health Nguyen Van Dung admitted that until now, many people still did not know the family doctor model, even some people think that the family doctor is a doctor coming to patient home for examination and treatment. Therefore, the number of patients coming to the family doctor clinic is very small.
According to the statistics of Hanoi Authority for Health, there are 78 family doctor clinics in the city. Of which there are 68 clinics located in commune and ward health stations; 6 clinics are located in the hospitals of PhuXuyen, Dan Phuong, Ba Vi, Me Linh, Dong Anh, and St. Paul; 4 public clinics (Medelab, 395 Kim Ma, Family Doctor General Clinic at Me Tri Lake, Melatech Hospital) and a family doctor center. However, in the year of 2015, there were only 6.159 visits. It is estimated that the average number of patients per year was only 80 for each clinic. Meanwhile, according to the "norm" set by the Ministry of Health, each family doctor clinic will manage the health of 500 households, equivalent to about 1,000 to 1,500 patients.
Many obstacles
Commune and ward health stations are the most sought after places for the development of the model of family doctor, as they are the closest medical facilities, which is convenient for capturing the health status of people. However, this integration seems to be just pouring "old wine" into the "new bottle", because those clinicsare not attractive to patients who seek medical treatment. Moreover, people are not interested in free medical treatment at health stations, therefore, they show no interest at coming to the family doctor clinic having to pay medical fees.Doctor Nguyen ThiNham - Head of NguHiep Commune Health Station (Thanh Tri District, Hanoi) said that although NguHiep commune health station did not have a family doctor clinic, but if any, she would be in charge of the clinic as well, at that time the working volume would be larger.
Besides, Dung also said that the current family doctor model still had many problems. The clinics located at the commune and ward health stations lack medical equipment in accordance with the regulations of the Ministry of Health. Even, at some units, facilities have been degraded,rooms are too narrow so they should be paired with common rooms. On the other hand, the application of information technology is limited, there is no electronic medical record system, after referral for patients, many family doctor clinics have not received feedback from the higher level on the results of the examination and treatment for patients; therefore, the management of patients' health is not comprehensive.
Vital to overcome difficulties
Minister of Health Nguyen Thi Kim Tien asserted that the family doctor model was beneficial for the people, so even though it is difficult, we must try to overcome all difficulties, it is difficult because it is still at the beginning of the process. Mrs. Tien also said that in the family doctor clinics at the first time, medical staff were not be trained, doctors did not have knowledge of family medicine, propaganda was not made to people to understand immediate and long-term benefits of the model; therefore, there were many negative ideas. However, clinics now take care of such things as vaccination, maternal and newborn care, prevention and treatment for people with health insurance; therefore, it is able to combine recording, monitoring and managing the health of people in the area. In particular, in the coming time, patients coming to the family doctor clinicswill be covered by the Health Insurance, so it will attract patients.
Mr. Dung also said that in 2016, Hanoi health sector will intensify training to improve professional skills, improve medical ethics and communication skills for staffs at the clinics. At the same time, the Authority will advise the People's Committees at all levels to invest more in facilities and equipment and to set up suitable remedies to attract doctors to work at the clinics. Mr. Dung affirmed that bringing family doctors to the clinicswill create a big turning point in the medical examination and treatment, in which the biggest beneficiaries are the people. However, it takes time to consolidate and gradually overcome remaining difficulties.
According to the statistics of Hanoi Authority for Health, there are 78 family doctor clinics in the city. Of which there are 68 clinics located in commune and ward health stations; 6 clinics are located in the hospitals of PhuXuyen, Dan Phuong, Ba Vi, Me Linh, Dong Anh, and St. Paul; 4 public clinics (Medelab, 395 Kim Ma, Family Doctor General Clinic at Me Tri Lake, Melatech Hospital) and a family doctor center. However, in the year of 2015, there were only 6.159 visits. It is estimated that the average number of patients per year was only 80 for each clinic. Meanwhile, according to the "norm" set by the Ministry of Health, each family doctor clinic will manage the health of 500 households, equivalent to about 1,000 to 1,500 patients.
Many obstacles
Commune and ward health stations are the most sought after places for the development of the model of family doctor, as they are the closest medical facilities, which is convenient for capturing the health status of people. However, this integration seems to be just pouring "old wine" into the "new bottle", because those clinicsare not attractive to patients who seek medical treatment. Moreover, people are not interested in free medical treatment at health stations, therefore, they show no interest at coming to the family doctor clinic having to pay medical fees.Doctor Nguyen ThiNham - Head of NguHiep Commune Health Station (Thanh Tri District, Hanoi) said that although NguHiep commune health station did not have a family doctor clinic, but if any, she would be in charge of the clinic as well, at that time the working volume would be larger.
Besides, Dung also said that the current family doctor model still had many problems. The clinics located at the commune and ward health stations lack medical equipment in accordance with the regulations of the Ministry of Health. Even, at some units, facilities have been degraded,rooms are too narrow so they should be paired with common rooms. On the other hand, the application of information technology is limited, there is no electronic medical record system, after referral for patients, many family doctor clinics have not received feedback from the higher level on the results of the examination and treatment for patients; therefore, the management of patients' health is not comprehensive.
Vital to overcome difficulties
Minister of Health Nguyen Thi Kim Tien asserted that the family doctor model was beneficial for the people, so even though it is difficult, we must try to overcome all difficulties, it is difficult because it is still at the beginning of the process. Mrs. Tien also said that in the family doctor clinics at the first time, medical staff were not be trained, doctors did not have knowledge of family medicine, propaganda was not made to people to understand immediate and long-term benefits of the model; therefore, there were many negative ideas. However, clinics now take care of such things as vaccination, maternal and newborn care, prevention and treatment for people with health insurance; therefore, it is able to combine recording, monitoring and managing the health of people in the area. In particular, in the coming time, patients coming to the family doctor clinicswill be covered by the Health Insurance, so it will attract patients.
Mr. Dung also said that in 2016, Hanoi health sector will intensify training to improve professional skills, improve medical ethics and communication skills for staffs at the clinics. At the same time, the Authority will advise the People's Committees at all levels to invest more in facilities and equipment and to set up suitable remedies to attract doctors to work at the clinics. Mr. Dung affirmed that bringing family doctors to the clinicswill create a big turning point in the medical examination and treatment, in which the biggest beneficiaries are the people. However, it takes time to consolidate and gradually overcome remaining difficulties.
