Chiefs tackle clinic doctors' heavy workload

PUBLISHED : Wednesday, 26 December, 2007, 12:00am
UPDATED : Wednesday, 26 December, 2007, 12:00am

Nurses and pharmacists will have to pick up the slack at outpatients'

Plans are afoot to relieve the workload of public clinic doctors who complain of having an average of only 5.6 minutes for each consultation, a Hospital Authority source said.

The move comes after the Public Doctors' Association, representing about 300 doctors working at 74 public outpatient clinics, condemned the authority for providing 'second class' services to the public. The doctors said the heavy workload meant they could offer only short consultations even to chronically ill patients. They wrote to the authority earlier this month demanding at least eight minutes per patient, as recommended by the College of Family Physicians.

An authority source said public clinics were facing a dilemma.

'We are under pressure in that if we cut the number of patients a clinic can see in a day, it means some patients have to wait longer for an appointment. There is always pressure from the local community including the district councils to cut the waiting time.

'The problem does not have an easy solution. We have to bring in people from different disciplines to share our doctors' burden.'

The source said the authority planned to have nurses and pharmacists take up more duties such as health and drug education.

'We are also thinking of posting clinical psychologists at clinics so they can be the first point of contact for patients with mood problems,' the source said, adding that in the long run, public patients should be encouraged to use private doctors.

The Policy Address by the chief executive announced a plan to sponsor chronically ill patients in Tin Shui Wai for 10 consultations at private doctors in the district, because public medical services are inadequate in the area.

'The Tin Shui Wai programme will run as a new model for us. If it is successful, we can expand it to other areas so more patients will see private doctors,' the source said.

The authority will also train more doctors in family medicine.

College of Family Physicians past president Donald Li Kwok-tung said consultation times were not the only factor in patient satisfaction.

'The college recommends eight minutes for a new case, but whether five or eight minutes is enough very much depends on doctor-patient relations,' Dr Li said.

'If a patient is not willing to talk, the doctor should not drag it on and can arrange an early follow-up consultation.'

Psychiatrists at public hospitals have complained they could only average seven minutes per patient.

'Of course, seven minutes is not enough, but what can we do?' said one psychiatrist who wished to remain unnamed. 'There is a long queue waiting outside the consultation room, and if we spend more time on the first patient, the time on the second patient will be cut.'

Public Doctors' Association vice-president Ho Pak-leung said the union would conduct a survey of 300 public general outpatient clinic doctors on their workloads and occupational illnesses. Dr Ho said doctors' morale was low. 'They sit in the room every day and the authority keeps adding to the number of patients they have to see. Apparently, the authority wants to make up some nice figures, but doctors are frustrated that they have to provide such a poor service. Some complain of neck and back pain because they sit and look at the computer for a long time every day.'

In a letter to the authority on December 10, the Public Doctors Association said computerisation had also put pressure on doctors. 'Many patients have complained that doctors no longer look at them as they have their eyes glued to the computer screen.'

Short medical consultations are a common problem in Hong Kong.

Clinical performance

The number of attendances at public outpatient clinics in the 2006/07 financial year was: 4.84m


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