Ailing people, who come from across the country to the capital in the hopes of getting better consultants services, get advice and treatment from junior doctors in most of the hospitals. Doctors at the district, sub-regional and even regional level hospitals send patients to capital for consultant services after they are unable to cure ailments. The health system of the country is also based on referral system.[break]
"How can junior doctors cure the ailments that senior doctors and consultants at district and regional hospitals failed to treat?" Director of Bir Hospital Dr Bulanda Thapa said. There are many senior doctors and consultants serving in district and regional hospitals. Most of the posts of senior level doctors at major hospitals in the capital are vacant.
The Ministry of Health and Population (MoHP) has neither created additional posts for doctors since past 18 years nor fulfilled the vacant posts. The hospital development committees have recruited only junior doctors of late.
Dr Thapa conceded that the referral cases are seen by junior doctors at government hospitals including at Bir.
The hospital administration informed that senior doctors and consultants do not remain at the hospital until their duty hours. Director Thapa said he has himself often marked with red the attandance of the doctors who flee to private clinics and nursing home before the end of their duty hours. "I tried different methods to curb such practices, but without success," he said, adding, "Juniors have to see the patients in absence of senior doctors."
In outdoor patient departments (OPD), mostly junior doctors see the patients. Patients hardly inquire whether the doctors they speak to are senior or not. "Sometimes patients complain that the doctors at the hospitals in the capital prescribe same medicines as given by health workers of district hospital," he said. The patients are compelled to take the same medicines that failed to cure their ailments.
Only the patients who get admitted to the hospital are able to see the consultants. Dr Thapa said that he will issue a written directive to all the department chiefs asking them to develop a system under which all referral cases are seen by consultants only.
Meanwhile, at Sukraraj Tropical & Infectious Disease Hospital in Teku, there are only two doctors of 10th and 11th level including director.
Of the 12 posts for medical officers, the hospital has only three. While two medical officers have taken leave for study, the ministry has not sent doctors to fill the vacant posts of senior doctors. A doctor at the hospital said, "Specialists do not stay long to see patients at OPD and juniors handle the cases."
He said most patients return home frustrated by the lack of improvement in their health conditions. Those who can afford go to the private hospitals. He said that the ministries as well as the hospital administrations are aware of the problems but they simply overlook it.
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