THIRUVANANTHAPURAM: To streamline the functioning of medical college hospitals (MCHs) as tertiary care centres in the state, the health department plans to bring a better patient referral system. Health Minister Veena George said the department would come up with clear guidelines in this regard. If implemented, only patients requiring expert attention would be referred from general, district and taluk level hospitals to MCHs.
The decision was taken after doctors in MCHs complained of patient overload due to unnecessary referrals from peripheral hospitals. Veena said there will be a referral register in every hospital which should have details of treatment provided and the reason for referring the patient to a higher medical institution.
“The treatment facility of the hospital and condition of the patient should be criteria for referrals.
The referral register will be monitored at the district and state levels once in a month,” said Veena, during a meeting of the health department on Monday. Currently, the referral system is far from perfect. The doctors in government MCHs complain about unnecessary referrals creating excess workload that hinder their research activities.
MCH docs complain of workload
“A lot of patients who can be treated at the peripheral hospitals are referred to the emergency and outpatient sections at GMCHs. A majority of the accident cases which require only minor suture are now treated at MCHs. This should be avoided. Already, the doctors are overburdened due to patient load. A proper referral will enable the doctors to provide maximum care to patients,” said Dr Aravind C S, state secretary of Kerala Government Medical College Teachers Association.
The association also called for a back-referral system, where the patients who received treatment at MCHs can continue follow-up treatment at the hospital near their residences. The minister has also agreed to frame guidelines for back-referrals.
The decision to streamline referrals and back-referrals came at a time the government has started improving the super speciality treatments at the district-level hospitals. Currently, speciality treatments are available at taluk hospitals and upwards. Some general hospitals have started super speciality treatments such as heart and neuro surgeries.
The department had in January set up control rooms in all MCHs to enable referrals and back-referrals of patients. While shifting a patient from a peripheral centre to an MCH, the control rooms should be informed of the referral to ensure ICU or ventilator facilities there, said the statement from the minister.
However, the doctors under the Kerala Government Medical Officers’ Association (KGMOA) complained that the staff strength and facilities in the peripheral hospitals are not sufficient to implement the referral system in toto.
“The GMCHs still have PG students and senior residents to look after patients. But in peripheral hospitals, the staff strength is limited. If the patient load increases beyond the capacity, referral is the only option left. The posts of 128 specialist doctors have been lying vacant for several years,” said Dr TN Suresh, general secretary of KGMOA.