Tuesday, July 17, 2018

Extending OPD timings to 12 hours: Will this mean a shift to better health care?

The union health ministry is contemplating a 12-hour OPD from 8am to 8pm. Safdarjung Hospital will be the first amongst all hospitals run by the Central govt. to start this, although no timeline for the execution of this project has not yet been defined. If successful, this could be replicated in other hospitals run by the central govt., reports TOI. Presently, OPD timings are 8am-1pm, with specialty clinics like Diabetes in the afternoon.

The Right of Children to Free and Compulsory Education Act or Right to Education Act was enacted by the Parliament in 2009. To fulfill this right, there must be increased access to education, which could mean a need to increase the number of schools. Shift schools were started to increase the number of schools. This reduces the infrastructure costs to an extent, but requires planning for efficient and effective operations. There are differing viewpoints on this too; there is a concern that shift schools will reduce quality of education.

I believe that there are several ways by which the govt. can think of providing accessible health care.

The govt. can enlist the help of private doctors, for example, in Mohalla Clinics, who can then be reimbursed on per case basis.

Hospitals should be hospitals and OPDs should be just that, OPDs. This means that hospitals (inpatients) and OPDs should be separate. Doctors should be posted either in OPDs or in wards, of course for a defined period of time. This is one way by which a 12-hour OPD can be realized.

In a move to address delay in surgeries and to reduce backlog, last year, the Delhi Govt. had announced that some selected private hospitals would perform free surgeries if the waiting period in govt. hospitals was more than 30 days. These private hospitals would be reimbursed at CGHS rates for the complete treatment. Something similar can be worked out for govt. OPDs. Many patients are given long dates due to long waiting queues at the OPDs. Such patients can be referred to private hospitals and they can then be reimbursed by the govt.

A double shift in OPDs, PHCs and hospital OPDs can help as long as each doctor maintains the required 8-hour shift.

Long working hours will disturb the work-life balance … a tired doctor is more likely to make medical errors.

Extending OPD hours is a good idea provided this does not lead to exploitation of doctors.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

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