Majority of communal doctors misdiagnose: study

The findings stem from
interviews and observation of 1,000 doctors working at 78 district-level
hospitals and 246 communal health stations. The Health Strategy and Policy
Institute (HSPI) under the Ministry of Health, which led the 2015 research,
randomly surveyed the doctors across six cities and provinces representative of
different regions of the country.

The one-year study, the
first of its kind in Vietnam striving to evaluate the quality of healthcare
staff in local facilities, showed that only three percent of doctors managed to
diagnose children’s diarrhea and pneumonia, tuberculosis, diabetes type 2 and
hypertension.

The rate, however,
rocketed to 36 and 48 percent, respectively, for doctors
who correctly diagnosed three and four of the five diseases. There were still
11 percent who could only diagnose two diseases and two percent for one
disease.

The researchers did not
explain the low rate of diagnosis but their findings nonetheless indicate some
of the problems involved.

They found that on average,
doctors in local fail to ask about half the questions
necessary to diagnose an illness. For example, they only asked patients three
out of eight questions needed to diagnose hypertension and diabetes, five of 13
for tuberculosis, five of 11 for diarrhea and one-third of the questions to
correctly identify pneumonia.

Doctors also only
performed about half the necessary examinations.

“A patient with
pneumonia is only asked whether he coughs, but is often not asked about phlegm
or breathing troubles,” said HSPI head Khuong Anh Tuan.

Tuan also warned about
inappropriate prescriptions resulting from this diagnosis failure.

“Nearly 48 percent of
doctors prescribed incorrectly for children with pneumonia,” he said.

Some doctors also
prescribed “harmful medicine”, according to the research, which showed that
some 70 percent of doctors decided to give corticosteroidal medicine for
pneumonia to children and approximately 34 and 47 percent to treat patients
with hypertension and diabetes.

Former head of the Bach
Mai Hospital Pediatrics Department, Dr Nguyen Tien Dung, said corticosteroids
are effective but have many side effects and “should be restricted”.

“Corticosteroidal
medicine gradually breaks down the children’s immune system while frequently
causing osteoporosis or rickets in the children,” Dung said.

Deputy Minister of
Health, Pham Le Tuan, acknowledged that the research clearly reflects the
quality of local health facilities.

“It was easy to see that
the healthcare services of local facilities are limited, resulting in a mass
influx of patients to central-level hospitals in big cities due to doubts over
their local health providers,” he said.

This, in turn, overloads
big hospitals and the Ministry of Health is still struggling to resolve the
problem, which many believe means improving the quality of local healthcare.

Earlier this month,
Prime Minister Nguyen Xuan Phuc approved a master plan for developing a strong
local-level healthcare system toward 2025, which will monitor the health of all
residents where they live.

But the ambitious plan
will take time to yield results. In the meantime, people will often have to
travel dozens of kilometres to get proper treatment. – VNA