Thai Doctor Fears P4P Will Affect Patients

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Doctor fears P4P will affect patients
Kawintra Jaiseu,
Panyaporn Saithong,
Poungchompoo Prasert
The Nation



BANGKOK: -- Dr Niparat Sripai has decided to quit her job at the Ban Fang Hospital because she believes the recently introduced Pay for Performance (P4P) scheme in the public healthcare sector will destroy medical workers' caring attitude toward their patients.

"I am afraid that with performance-based pay, doctors will start looking at their patients as if they were products," she said.

The P4P will award extra wages to medical workers at state medical facilities based on their performance. The budget for the P4P comes from the fund that had long been reserved for doctors, pharmacists, dentists and nurses working in rural or remote areas.

Over the past year, Niparat has worked diligently in Khon Kaen's rural zone. She was there as a general-medicine practitioner under the One Doctor, One District project (Odod). According to the Rural Doctors Society, participants in this project receive grants for studying medicine and once they graduate, they have to serve at state hospitals or the equivalent for 12 years and return Bt2 million to the project.

Since the amount of money involved is quite large, participants usually stay till the end.

"But now, at least two participants have decided to quit," the society's president Kriengsak Vacharanukulkiet said.

One of them is Niparat. "I think I had better resign now and apply for a job at a private hospital," the young doctor said. "I will need to find money to pay back the project".

She said she was not happy with the P4P concept because it would shake doctors' ethics and ideology.

"As I was born in Ban Fang, I want to return and work for the people here. When I work, my priority is not money," she said.

Niparat said she believed that the special allowance for rural doctors were enough to cover her living expenses, but P4P was going to change that.

"If all medical workers focus on performance, there is a risk that they will become less caring. The ethics of good teamwork may be gone. I don't want to see this happen. We have voiced our concerns but the government simply does not listen," Niparat said. She submitted her resignation Tuesday, one day after P4P came into effect.

Meanwhile, medical staff and personnel at Somdet Phra Yupparat Kuchinarai Hospital in Kalasin yesterday wore a black ribbon and put up signs objecting to the P4P concept. Deputy director Dr Sirichai Namthassanee said the black-ribbon campaign was to call for the Public Health Ministry to review this policy as rural hospitals were already suffering from manpower shortages. He said the previous model of paying hardship allowance actually helped attract many doctors and specialists to work in rural hospitals over the past four or five years, hence benefiting the people.


-- The Nation 2013-04-04

[JetsetBkk]

"I am afraid that with performance-based pay, doctors will start looking at their patients as if they were products," she said.

Says more about her than her fellow doctors.

[Johnnie99]

"I am afraid that with performance-based pay, doctors will start looking at their patients as if they were products," she said.

Says more about her than her fellow doctors.

I am not quite sure how this will change the current situation

[thaicbr]

How i see it is the Rural doctors have a lighter workload but generally are burdened with extra paperwork and sometimes adverse working conditions (facility's etc)

As she was part of Odod she has to pay back 2 million baht to them so she is paying to work after (i presume) a free education. Then the Ministry take away that facility to earn the extra money required.

Not good. There are many, many diligent doctors here with the correct patient doctor ethics. That may get eroded with this money fixes all method of PTT.

One of the numerous Education ministers once stated that teachers only work for the money.. How little he knew. Same with this Health minister..... It's not JUST about money.

[ZhouZhou]

does every moaner of this new system now get his own article?

[thaicbr]

does every moaner of this new system now get his own article?

If it is relevant then yes.. IT's called news information.. Many people do not know others affected by it.. but all rural folk may be affected by it in the future...

Do you think P4P is a good proposal?

[ZhouZhou]

does every moaner of this new system now get his own article?

If it is relevant then yes.. IT's called news information.. Many people do not know others affected by it.. but all rural folk may be affected by it in the future...

Do you think P4P is a good proposal?

the new system has also good sides. Edited April 4, 2013 by ZhouZhou

[thaicbr]

does every moaner of this new system now get his own article? If it is relevant then yes.. IT's called news information.. Many people do not know others affected by it.. but all rural folk may be affected by it in the future... Do you think P4P is a good proposal?the new system has also good sides.

Any examples? By the way the Rural doctors association have stated that for some hospitals in large cities the P4P may work.

Sent from my i-mobile i-STYLE Q6

[ZhouZhou]

i wrote about my opinion on the p4p sytem in one of the 23 other topics to this subject.

btw. did you know that the p4p idea was conceived a few moons ago by the then democrats lead administration?

[thaicbr]

i wrote about my opinion on the p4p sytem in one of the 23 other topics to this subject.

btw. did you know that the p4p idea was conceived a few moons ago by the then democrats lead administration?

No I didn't but it was not actually put into place was it!

Sent from my i-mobile i-STYLE Q6

[Joe Mamma]

Dr. Sawbones don't care no more!