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Echo appointment, a no-go for off-hour clinic

The Board is not keen on having too many services which require payment

A proposal by the Department of Cardiology at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) to have echo and endoscopy appointment during the off-hour clinic was rejected by the Ministry of Health (MoH) and the Board of Directors.

Talking to Business Bhutan, a cardiologist at JDWNRH, Dr Mahesh Gurung, said that having echo during the off-hour clinic would decrease the work load at the department. He said that about 85% of the patients who come for echo during the regular hours have normal echo.

“Being focused on these cases delays echo appointments for the critical patients,” said Dr Mahesh Gurung. He also added that those who are willing to pay and do not want to wait can always avail off-hour clinic and the needy people can get faster and better services.

Dr Mahesh Gurung said that having echo during the off-hour time is a win-win situation. It would decrease the workload during the regular hours, cut down on waiting time, give more attention to critical patients and those willing to pay and not wanting to wait in queue can visit during off-hour clinic.

“Having it during off-hour would also mean emphasizing on standardizing the report,” said Dr Mahesh Gurung, pointing out that with limited number of patients coming for the off-hour, the cardiologist themselves can perform the echo procedures rather than having the echo technicians do it, which is currently the case.

The Medical Superintendent of JDWNRH, Dr Gosar Pemba said that the proposal was put up after some people who were willing to pay for the services recommended it. However, the Board disapproved the proposal because according to Dr Gosar Pemba, the MoH and the Board are not keen on charging a fee for too many services.

Dr Gosar Pemba also added that the Board has asked the MoH and JDWNRH to do a study on why there are backlog cases at the department.

According to data maintained by the Department, currently, patients cannot get appointments before June 22. The data also showed that a total of about 300 patients (adults) and about 150 pediatric patients come for echo every month.

On the other hand, excluding about 10 emergency cases every day, the department also receives about 14 adults and 10 pediatric patients daily.

Dr Gosar Pemba clarified that the increase in the backlog cases at the Cardiology Department is mainly because the echo procedure is performed only at JDWNRH. “All the cases that need echo appointments from across the country come to JDWNRH,” he said.

He also added that the other factor is that there are just two echo machines at the department: one for children and another for adults. Another reason is the time it takes to do echo. “For adult patients, it takes at least takes a minimum of 30 to 45 minutes, and it takes longer for pediatric patients,” said Dr Gosar Pemba.

“We don’t have plans to have echo appointment during the off-hour clinic,” confirmed Dr Gosar Pemba.

Off-hour clinic at JDWNRH was started in 2010.

Lucky Wangmo from Thimphu