Health care welfare is not only a human right for all people but a greater advantage to have as an availability for people living in disadvantaged and poor areas. These people usually do not have enough funds to pay for their health care bills, transportation to get to health care facilities and other health expenses. There are also disadvantages of long wait times, rushed appointments, old facilities, and poor disease control and prevention (Private vs Public health sector in SA, 2016).
Now what happens when even with the convenience they can get, patients still feel incovenienced with a clinical setting’s running/scheduling? It is a common known factor that we cannot always get what we want and things do not go according to our convenience and preference. Health care facilities focus on a number of people who’s needs requires to be met at all times, well and accordingly.
In outpatient settings there are much more difficulties that patients from poor communities face; financial constraints including travelling costs. At my present placement, I encountered a patient who had an incovenience with his appointment dates and as well as financial constraints to provide the necessary required documents. A 34 year old male, booked in for Physiotherapy appointment with a painful hip came into the department for his therapy session. The patient had applied for disability grant and needed the doctor’s signature to finalise his documents. Mr X informs me that he stays quite far from the clinic and has another appointment with the doctor in a week’s time, but he feels like that is incoveniencing, since he is already at the clinic he feels like why can he not just jump in and see the doctor today instead.
Mr X states that his hip gets too painful for him to walk long distances and is struggling financially to take transport as he is still awaiting disability grant. He then goes on to plead with me to get the doctor to see him on this day of his physiotherapy appointment so that he does not have to struggle again next week with a painful hip that leads him to limp as well as transport money to get to the clinic. Mr X then went on to inform me that he still requires to photocopy his documents for the disability grant and requested I provide him with R2.00 so he can be able to make those copies and present them. I am now in a dilemma of empathizing with a patient who is seems to be struggling and rules and schedules of a clinical setting. I had chosen this field of study because I love working with people as well as helping them. But, did this passion mean that I can compromise to go out of my scope of practise.
I knew I could not speak to anyone about this because they will not discern it the same way I do. Someone else will not feel the empathy I am feeling as they did not directly speak to him, also they will approach the situation in a professional ethics way instead of a struggling patient. Another dilemma is helping the patient then he gets used and thinks he can do this perpetually. I took a decision which I deemed right and told him I cannot help him in any way, next time he should try and have his appointments on the same day if possible.
As health care professionals, I think it would be beneficial if we would consider certain factors when booking patients for appointments. They might forget when you make it for them, but it would be considerate to take on the responsibility to ask if patients have any preferred days or rather have any other upcoming appointments in the setting to avoid such incidences. It would be beneficial for patients to know that they will struggle once in a month with an attendance, knowing that they will however cover all their appointments in one day.
REFERENCES
- Young, Montgomery, “Private vs. Public Healthcare in South Africa” (2016). Honors Theses. Paper 2741.
- La Puma, J., Schiedermayer, D.L. (1989). Outpatient clinical ethics. Journal of Internal Medicine. 4:5 (413-420).
3 thoughts on “Oupatient’s convenience”
Hi Lusanda.
I really enjoyed reading this as we often forget all the other aspects in a patients life when booking appointments that suit us and our schedule, but at the same time also have our restrictions of time. There is a clear link with the coursework in the welfare and patient rights.
I think defining health care welfare or identifying the rights affected would really add to the piece as well as adding more references that can contribute to current situation of many outpatient clinics, such as the patient to health professional ratio as many clinics are overcrowded with limited staff. You could also maybe elaborate on the limits we have as physiotherapists with regard to ethics when it comes to patients requests for help outside of our profession such as the doctors appointments or giving money for photocopies. This could add some depth and understanding of where the line is for us as health care workers.
The argument is a little unclear. I see how you covered the right of patients to health care and how they struggle to get to appointments due to outside factors but is is realistic to accommodate all patients with grouping appointment. Elaborating on the ideal vs what actually happens in outpatient clinics could clear it up.
You could maybe add a picture to add to your piece that captures the attention of the reader and gives additional contexts to draw from.
There are a few grammar mistakes throughout but otherwise it flows really well and is easy to understand. Paragraph 2 has ‘factor’ instead of ‘fact’. In paragraph 3 ‘ much more difficulties’ may flow better as ‘ additional struggles/ difficulties’. Paragraph 5 ‘agreed to understand’ could be changed to ‘seemed’or ‘appeared’.
I enjoyed the piece and think the conclusion really captures the message and gives us a lot to think about when booking patients.
Hi Lusanda, Thank you for sharing.
Your piece brings up an issue that I’m sure all of us have experienced in the clinical setting. A strong sense of empathy and a desire to help those in need is often what leads people to persue a career in healthcare. Although these qualities are what make these people suited to care for others it also leaves us with a moral dilemma when the system we work for fails those whose care we are charged with. So often the broken system we work in ties our hands behind our backs yet still expects favourable outcomes. Your case was heart wrenching but I feel you took a while to bring up the central message of your piece and then did not focus much on the ethics and background behind it. Ideally your case study should not form the majority of the discussion. It would be nice to hear more of your own discussion regarding the issue in more broad and less case specific terms. Bringing in literature regarding the challenges that cannot be solved, just because the clinic is free doesn’t mean there aren’t still obstacles to receiving that “free”health care. Taking more time to discuss a “But is it really free?” topic and structuring it in a way that each paragraph tackles a different obstacle might help the piece to have more flow. Starting with and introduction that explains your topic and then bring a more summarised case study in followed by your views on the issues raised in the case study as well as literature pertaining to those issues might be a nice addition to your piece.
The grammar and syntax needs to be reviewed and has been addressed in Carla Lentz’comment.
Over all I appreciated the issue being raised and would love to read this again with a little more of your own thoughts in it. I hope my advice can help guide you.
all the best for the rest of the year,
regards Brynn
Hi Lusanda. I really think that you’ve chosen a good topic that is very relevant, especially in South Africa where our health system is so stretched.
Maybe if you open up with defining a health care system, or by trying to find some literature on what is expected in terms of wait times at a CHC/ hospital in south africa and compare it to the reality (not sure how difficult it will be to find this). I also agree with Carla as she says maybe try to find a number or ratio of healthcare workers to patients on average at health acre centres around south africa, as that might really help to paint a good picture of the issue that you are trying to address.
I must also agree to what Carla commented on as the argument that you are setting forward is a little blurry, and as I have said previously with regards to finding literature on what healthcare waiting time is supposed to be vs the actual reality of what people go through might be a good argument to base your writing piece on.
Otherwise good job, I think you’ve managed to choose a good topic.