Delaying a visit to the doctor
In some countries, the economic downturn means that patients are accessing healthcare less frequently. In Ireland, those without Medical Cards are increasingly putting off making an appointment, which can have an impact on early diagnosis and the treatment of long-term conditions. Requests for telephone consultations are on the rise, and with them the risks of potential missed diagnosis.
Failure to diagnose is a common cause of a complaint or a claim, so it is important to have a low threshold to invite the patient in for a review. Dr Brian Charles, Emergency Physician and MPS Consultant, based in Barbados, says: “A particularly worrying trend has been patients ‘waiting to get better’ before seeking medical care, particularly those with medical insurance who have to pay upfront and wait for reimbursement later. This has resulted in patients presenting to primary care physicians later in the course of their illness, with more complications.”
It is important to have a low threshold to invite the patient in for a review
Despite the impact of the recession being less marked in Hong Kong, Malaysia and Singapore, which generally have more private practices and less welfare spending, Dr Teoh says: “Recession has had an impact in the public sector, reducing the number of consultations, as patients are less likely to take time off work to seek healthcare. They cannot afford the time, rather than they cannot afford the cost of healthcare itself.”
A reduction in patient numbers has also led to many doctors in private practice resorting to longer opening hours, more practice promotion activities and more turf battles between doctors. The respective Medical Councils do not permit doctors to promote their practice or advertise or canvass for patients, and so doctors may find themselves in murky medicolegal waters if they do try to seek new patients in this way. They are advised to consult and seek legal advice if unsure.