FAIR OR UNFAIR?

Life is full of choices. Its your own decision to make. As for me I have a choice to stay in government service or join a private institution. Both has the pros and cons. But what I want to discuss now is not the pros and cons of working in a government institution or working in a private institution. This is about the care of patients in a government or private hospitals. Let me start in my specialty first, ie Radiology Department before we discuss about other departments.

In most private hospitals, there are usually one radiologist as compared to a government hospital in which there are at least 4 radiologists. The number of radiologist and the efficiency of the radiologist will usually determine the patient care.

1. Reporting.
In PH (Private Hospitals), reports are done fast, usually within hours after the examination was performed. In Government Hospital (GH), reports are usually late, taking up to 3 days. But usually, urgent cases are also reported within hours too. I usually try to finish all my reports within the same day too. Most of the time in PH, you can report comfortably and decisively. However sometimes, probably less than 5% of cases, you are not sure or undecided. You are pressed to release the report since both the patient and attending doctor are waiting. You don't have the luxury to discuss with other colleagues or to refer to reference books in a very short time. So do you release a vague report or you delay the report? In a GH, you will have the luxury to discuss with other colleagues or to refer to specific reference books. If you release a vague report, will the patient care be compromised? So in this case, will a GH patient get a better care than a PH patient?

2. Image Quality
In most PH, machines are usually cheaper than in GH, since profits are more important. You tend to get less quality images. This could be attributed to less quality machine or less trained radiographer. So, when reporting on these images, do you think you will give a good report? In cases with less trained radiographer, usually PH radiographer do multitasking. So they tend not to be very expert in all modality. In a GH, usually there is a radiographer who is expert in certain modality. This specialized radiographer usually tend to give you high quality images. If you get low quality images in GH, you will usually ask them to repeat and repeat it until you get one. Or if you still can't get a good image, you may postponed the study t the next day with a better sedation. In PH, when you get a poor quality images, sometimes you don't have the time to call your radiographer to repeat the study due to the bulk of films in front of you waiting to be reported. Even when you ask your radiographer t repeat it, you might not get what you want due to the less experience in doing the imaging. It might not be his or her fault. It could be due to lack of experience in doing that type of case. So in this case, will a GH patient get a better care than a PH patient?

3. Physician's feedback
In a GH, we usually have weekly radiological conferences. In these conferences we will update ourselves on the findings of our reports in comparison to the operative findings. We also discuss on what the physicians or surgeons want in the report. With this, there will be learning in both ways. In a PH there is rarely a conference or any discussion with the physicians or surgeons, unless you make your own effort to ask. Sometimes you don't have the time to do it. With this, you will never know whether your report is correct or not? And also you might not learn new things from the physician or surgeon. So, in this case, will a GH patient get a better care than a PH patient?

I will add somemore when I can think of something else.
Comment??