Editor’s note: Ong Kian Soon, a Singaporean doctor living in Vietnam, provides his take on complaints by another reader about his health check-up with local doctors.
Dear Tuoi Tre News,
I am a Singaporean doctor and enjoy reading Tuoi Tre News very much. Congratulations on the launch of your new website last week. The interface has improved significantly and looks great on my phone browser now.
I read with much interest a recent article published on Tuoi Tre News about a patient's frustration on a health check experience which was unsatisfactory to the patient. Having performed and received numerous health examinations myself, I can well understand the patient's frustrations and feeling that such an exercise was a waste of time (and money). Although it was not mentioned in the article, I also can empathize with the doctor who had performed the health check on the other end. I can only guess at the doctor's helplessness when he/she, pressed for time, asked the patient "Are your limbs normal?" and stamped the word "normal" into the examination results.
The bigger issue here is that health examinations in Vietnam (and indeed in many other parts of the world) have become commoditized. When companies look for a provider for such health checks, their mindset is not in terms of looking for quality, but for the lowest possible price. As more and more clinics compete for such health check contracts, it is a race to the bottom as clinics compete on price with little regard for quality.
These days, the capital required to open a "phong kham da khoa" or polyclinic in Vietnam (which owns the licence to do health checks) is substantial and hence, most of the polyclinics are owned by businessmen rather than doctors. Hence, such establishments are less about providing a good quality of care than about making the highest possible return to the shareholders. In such a situation, many of the doctors are in a helpless situation. While they want to provide a good quality of care, they cannot, as the clinic owners push the prices lower and lower in order to get more business, reducing the doctor's position to that of an assembly line worker.
The patient ultimately has the most to lose, because if the patient really has a serious illness, such a perfunctory health check will not be able to detect it.
In Singapore, such health checks are decentralized and not only polyclinics but Family Medicine clinics (owned and operated by one doctor or a group of doctors) can also perform such checks. As most of these clinics are owned by doctors and not businessmen, it is less likely that such Family Medicine clinics compete on price alone at the expense of clinical quality. As the clinic owners are also doctors, they know well that they are ultimately responsible for the results of the health check.
As another layer of check and balance, the government in Singapore also sets strict regulations on what tests or specific examinations need to be done. For example, the pre-employment check for a person who works in an oil rig would be very different from another person who is working in the hospital. Other types of examinations like the annual health check up, the company simply provides the employee with a fixed budget and the employee decides which doctor or clinic he/she wants to give the business to. As one can imagine, the employee will likely not only choose based on price but also on quality.
To my mind, it is good that the author of the article, Mr Dai Duong, brings up this issue that very few people talk about as it gives us the opportunity to start a conversation on how we can make health care in Vietnam better for everyone in the future.
Dr Ong Kian Soon