Turkey's family doctor system gets bad bill of health
ISTANBUL - Hürriyet Daily News | 2/22/2011 12:00:00 AM |
The 'family doctor' system in Istanbul is disorganized and has left doctors overworked and patients underserved, members of the Istanbul Medical Chamber have said.
The “family doctor” system introduced in Istanbul in November is disorganized and has left doctors overworked and patients underserved, members of the Istanbul Medical Chamber have said.
When the Health Ministry introduced the system, it said each family doctor would be responsible for 3,500 Istanbul residents, but a board member of the chamber said that figure had doubled or tripled, leaving doctors tired and overwhelmed by their new workloads.
“The fact that some 200 physicians and 50 nurses have resigned from the family doctor system since the first quarter of its application is a clear indicator that health personnel are not happy with the new system,” Mustafa Sülkü, a member of the Istanbul branch of the Practicing Physicians Association, said at a press conference where chamber members analyzed the system’s performance during its first three months.
The chamber members stressed that the burden of the system’s failures had mostly been carried by the city’s poorest neighborhoods, drawing attention to the increase of measles cases from two to 19 in these areas in just two months.
Another concern raised in the meeting was the fact that emergency teams are short-staffed due to the transfer of their team physicians to the family doctor system.
“There is a tendency by the Health Ministry to be completely ‘hands-off’ from this first stage of receiving health services,” the chamber’s Fethi Bozçalı told the Hürriyet Daily News & Economic Review on Tuesday following the press conference.
“The state has [created] enterprises, believing that it only needs to plan and monitor the system,” he said, adding that the first stage of health services has to be totally managed by public authorities. He said other countries that had instituted the family doctor system earlier, including Germany, Sweden and the United States, were now suffering from its failures.
The Health Ministry began the family doctor system in November, closing 552 health centers and setting up 808 private first-stage health facilities in their place. Under the new system, physicians are charged with the management of the whole center, including its maintenance, renovation, rent, cleaning, utility bills and nurses’ salaries.
“The system was introduced with a directive by the Health Ministry without making serious preparations [for the system’s infrastructure],” said Sülkü, adding that the system had been switched overnight from the old medical centers to the family doctor ones.
According to Sülkü, the annual contracts that physicians sign with the Health Ministry strip them of their job security. “They have been forced to sign the contracts, under time periods defined unilaterally by the health directorate,” he said. Sülkü also claimed physicians were worried about having too many patients to see, especially taking into account the other duties, such as data processing and other administrative functions, they have to perform.