Commercial pressures coming between patient and doctor

PUBLISHED : Wednesday, 13 March, 2002, 12:00am
UPDATED : Wednesday, 13 March, 2002, 12:00am

I refer to the letter from 'Name and Address Supplied' headlined 'Can elitist surgeons change their ways?' (South China Morning Post, March 5).

As a practising Hong Kong doctor, I agree with your correspondent that it is disgraceful for patients to be treated in an offhand manner in clinics and to have their emotional needs ignored.

He says this happens during private consultations for which presumably he is paying. Why does he therefore not change his doctor? There is no reason to persist with a surly doctor in the private sector. He should ask around and find a practice which prides itself on the medical care of people rather than just treating their diseases.

I wonder, however, if the true problem here is that your correspondent cannot change as he is enrolled in some form of contract medical scheme. Some, if not most, of these have reduced the payments to the doctor to such a derisory level that he cannot afford to spend enough time with each patient to provide the extra time for that human touch as well as providing diagnosis and treatment.

The dominance of these schemes, which has increased in the past few years, has seriously cut into the earnings of ordinary private doctors. Medical insurance companies and large employers keen to cut costs are now dictating lower and lower fees, often below an economically viable level. Commercial pressures are coming between the patient and the doctor, both of whom have become dependent on a third party whose first interest may not necessarily be the well-being of its clients.

Some years ago the Medical Council forbade doctors from associating with insurance companies. Perhaps this provision should be reconsidered and reinstated in the council's 'red book' (code of conduct) warning notice to practising doctors.