Other dysfunctional foundations of our health care system need attention. A primary care system should consist of a physician, internist or family practitioner, assigned to or chosen by the patient to follow his or her care, schedule routine follow-up visits, recommend screening tests in due time, and, when indicated, provide referrals to either a specialist or a medical center for further care. In our reality, matters are quite different. Due to an excessive workload and time constraints, our clinic practitioners rarely follow their patients and are often unable to request certain basic diagnostic tests typically part of the armamentarium of such providers. Backed by the flagrant inequalities between Kuwaiti and non-Kuwaiti patients, this results in a generalized loss of confidence in the primary care system, inappropriate referrals to emergency departments, either by the patient’s request or the inaptitude of providers, and mismanagement of illnesses. This in turn creates a bottleneck effect in our hospitals where absurd numbers of patients present unnecessarily to our emergency departments requesting primary care services thereby diluting the true emergencies. Combined with inappropriate staffing, lack of specific expertise and a rigid administration, this creates a detrimental effect on patient care.
This brings us to another major malfunction: public health, or the lack thereof. This is the area that focuses on educational programs, disease prevention, risk factor analysis, and determination of disease prevalence within a population. As highlighted in previous articles, Read the rest of this entry »
