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Private hospitals overly cautious in Nepal, turn away patients
Publication Date : 01-03-2013
Sumitra Mishra was at the Bir Hospital in Kathmandu on Sunday after being referred there from the Nepalgunj Medical College in her hometown Nepalgunj, in Nepal's mid-west. Mishra, 18, had been vomiting for about a week when Bir Hospital doctors diagnosed her with conversion disorder.
Similarly, Suman Shrestha, 25, was brought unconscious to the Bir Hospital on Wednesday morning, after being referred from the Venus Hospital, also in the capital. The attendant emergency doctor immediately told Shrestha’s family that there was no hope. Later on, in an interview with this reporter, the doctor said Shrestha had already died at the hospital that had referred him. He had just been brought to Bir to be declared dead as the previous hospital had feared possible reprisal from family members, the doctor said.
Dr DP Singh, Chief of the Bir Hospital Emergency Department, said the government agency-funded hospital receives many patients like Mishra, who are referred by private hospitals, even for minor illnesses, and ‘only to confirm deaths.’ A week ago, a patient was referred from the Kathmandu Medical College due to a lack of beds in the Intensive Care Unit. According to one doctor, the patient had low creatinine levels, a symptom of renal failure which requires emergency dialysis and ICU internment. The patient was first taken to the Om Hospital, which refused to accept the patient. Family members tried a few other hospitals but to no avail. Eventually, the Lifecare Hospital in Sundhara accepted the patient.
According to doctors, there has been a massive rise in patients being referred from private hospitals to other private or government hospitals inside and outside the Kathmandu valley. Many attributed this trend to a fear of vandalism and assault from family members and relatives of patients who die.
Dr Ramesh Acharya, Chief of the Emergency department at the Tribhuvan University Teaching Hospital (TUTH), said that everyday they receive patients who are referred from other hospitals even for minor ailments, because professionals are too afraid that something might go wrong. According to him, TUTH receives around 30 patients a day, out of which around 10 per cent come in because they've been refused by other hospitals. “Through day-to-day observation, cases of poisoning, burns, patients who are already incubated at other hospitals and those with spinal injuries, are generally not accepted by many private hospitals,” said Dr Acharya.
According to the Nepal Medical Association, over 70 cases of hospital vandalism and assault on doctors were reported in the past five years. Just this week, the Patan Hospital and Kantipur Hospital in the Kathmandu valley were vandalised following the death of patients.
Many private hospital owners and hospital management committee members who spoke to the Post admitted that they could not risk treating patients “whose family members ask for a guarantee of the patient’s safety” or if they “sense danger from the patient’s relatives.”
This trend of referring patients has consequences for both patients and health facilities. Referring minor illnesses to other hospitals incurs great loss of money and unnecessary hassles for patients and is also a sign of doctors’ lack of confidence, said experts. “Also, private hospitals are more concerned about making profits rather than treating patients. Why else would they turn away patients?” said Dr Acharya.