HCMC hospitals: rip-offs or special "services'?

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Patients lie down outside a hospital room in Ho Chi Minh City

It has become common practice for doctors at a Ho Chi Minh City public hospital to make extra money using surgery rooms during working hours to operate on patients who pay more for better and faster services.

HCMC health authorities would investigate the problem at all of the city's public hospitals following a Vietweek exposé, a senior official has said.

Doctors and patients are familiar with the term "schedule surgeries" - referring to surgeries arranged according to the hospital's schedule and conducted during working hours, which cost less - and "service surgeries" which means that patients pay more so that they will not have to wait in a long line for their turn to undergo a surgery.

Normally, service surgeries are allowed if they are performed after the hospitals' set working hours (after 4-5 p.m.).

However, Vietweek reporters spent more than six months (between May 2011 and January 2012) investigating the development and found that doctors at the HCMC Traumatology and Orthopedics Hospital spend most of their time performing service surgeries.

But these service surgeries are conducted during working hours, which means the doctors are stealing time and facilities for their own profit.

According to the Vietweek investigation, doctors at the hospital usually stop performing schedule surgeries at around 2-3 p.m. to save time for service surgeries, which will last until 9-10 p.m.

In some departments, schedule surgeries are finished by 11 a.m. every day. The remaining time is used for service surgeries.

As a result, the number of patients for service surgeries is usually double or triple the number of patients undergoing schedule surgeries each day.

On average, there are 30 schedule surgeries and 50-80 service surgeries per day.

According to a hospital employee who requested anonymity, not only doctors but also the chiefs and deputies of surgical departments, and even hospital leaders, know about and even participate in service surgeries during working hours.

When a patient comes to the hospital for surgery, doctors will ask him or her to choose between the two kinds, and they do not forget to suggest that the patient would have to wait if they chose "schedule." They also do not fail to add that a service surgery would be easier and quicker.

Many poor families who do not have enough money to pay still chose service surgery at the doctors' suggestion.

The poor patients often take out loans to pay after doctors warn them that their condition will only get worse if they wait too long.

Big money

Dr. Tran Thanh My, director of the HCMC Traumatology and Orthopedics Hospital, told Vietweek that "service surgeries" help improve the low incomes of hospital employees doctors, nurses, and surgery team technicians.

He said the number of service surgeries conducted each day is high because most of the cases are simple. However, Vietweek observed many complicated surgeries performed outside working hours.

According to the hospital, a surgeon will be paid with 35-40 percent of a service surgery's total fees. With the average price of a surgery being VND1.5 million-5.5 million, a surgeon will earn VND500,000-2.2 million on average per surgery.

If a surgeon performs 10 service surgeries, he or she will pocket up to VND22 million per day.

The basic salary for a doctor at a public hospital ranges from VND1.2 million-4 million ($50-200) per month.

Vietweek also observed 12 anesthetic technicians who took part in 372 service surgeries received VND144 million in total payment for that work.

It works out that each technician earned VND2 million per day.

N.N.T., a street vendor from the southern province of Binh Phuoc, told Vietweek she was admitted to the HCMC Traumatology and Orthopedics Hospital to treat a broken arm.

She was alone at that time and was unable to clearly distinguish between "schedule surgeries" and "service surgeries."

"A nurse came to ask me if I would like to have a "˜service surgery' while I was in the surgery bed and I said yes.

"I would never have imagined they picked the expensive kind for me."

After the surgery, T. was told she would have to pay VND4.5 million for the surgery and more than VND1 million for other equipment.

T. had to borrow money from her neighbors, while she herself had to get by with free-of-charge meals taken from pagodas or other patients.

"If I had been informed, I would have chosen schedule surgery to save money, and I would have waited no matter how long.

"I don't know how I'll have enough money to live in the coming days, and to raise my kids," she said in tears.

Fixed prices to be set

On Tuesday (February 7), Dr. Pham Viet Thanh, director of the HCMC Health Department, admitted there were holes in the implementation of "service surgeries" at the HCMC Traumatology and Orthopedics Hospital.

"A team of inspectors from the department would be sent to the hospital to review the process of service surgeries at the hospital," he said.

He told Vietweek the department would inspect and review the services at all of the city's public hospitals as well.

According to Thanh, the Health Department is working on a plan to set fixed prices for service surgeries, because prices have for long varied at different hospitals.

Thanh added that the Health Ministry is planning to increase perks for doctors and nurses who work on shifts in an attempt to reduce wrongdoings and low performance at public hospitals.

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