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HT debate of the week: Will PGI’s patient care mess ever get fixed?

For years, the Postgraduate Institute of Medical Education and Research at Chandigarh has been struggling to create a balance between its existing infrastructure and ever-increasing patient load, not only in OPDs and emergency wards but also in most of its other departments. The principal reason cited is the failure of states to provide quality patient care to their residents. Experts say there is an urgent need to expand healthcare facilities in the region so that pressure on institutions like PGI could be reduced.

chandigarh Updated: Apr 27, 2015 11:42 IST
Post graduate institute of Medical Education and Research,OPD fees,OPDs

For years, the Postgraduate Institute of Medical Education and Research at Chandigarh has been struggling to create a balance between its existing infrastructure and ever-increasing patient load, not only in OPDs and emergency wards but also in most of its other departments. The principal reason cited is the failure of states to provide quality patient care to their residents. Experts say there is an urgent need to expand healthcare facilities in the region so that pressure on institutions like PGI could be reduced.

City’s healthcare system needs a major overhaul
The healthcare system in the tricity should be streamlined as a lot of patients in the tricity continue to be deprived of proper medical treatment every day. There should be adequate number of beds at all hospitals and enough staff to attend to emergency patients. Those belonging to economically weaker sections cannot afford treatment at private hospitals, so more government run hospitals should be set up. Because of the heavy rush of patients at PGI, the referral system is the need of the hour. Patients who require primary and secondary care should be sent to GMCH-32 and GMSH-16 with only those needing specialised surgical intervention and tertiary care being referred to PGI. All city hospitals must be fully equipped in order to provide immediate treatment to accident victims.
Dr Shruti K Chawla, Chandigarh

Influx of local patients should be checked
Despite facing major problems PGI, Chandigarh still retains the distinction of being one of the top medical research centres in the country. If the institute’s administration is serious about maintaining its standards it should take steps to check the influx of local patients and should focus more on patients from adjoining states. Otherwise PGI with its limited resources will find it difficult to cope with the ever rising flood of patients.
TR Goyal, Manimajra

PGI has been reduced to the status of a civil hospital
It is unfortunate that PGI, which was set up to broaden the horizon of medical knowledge by intensive research in the field of health, has virtually been reduced to the status of a civil hospital. There has been an unprecedented rise in the number of patients coming to the institute every year from all over north India. This is due to the fact that it continues to provide good quality medical treatment while neighbouring states keep on reducing their budget for healthcare. To begin with, there should be a ban on treating patients not requiring tertiary care. Secondly, PGI can set fixed visiting hours for general patients and 24-hour services should be extended only to emergency patients with life-threatening diseases or those referred by other hospitals. Last but not the least, PGI can collaborate with nearby hospitals so that its reputed doctors are available at other hospitals too.
Surbhi Negi, Zirakpur

Introduce telemedicine services
PGI is catering to five states in northwestern India for all type of emergencies and tertiary healthcare. It is the responsibility of all state governments to provide emergency medical services to area residents. If they are unable to do so then states should introduce telemedicine and web conferencing services in collaboration with PGI. States should send their doctors for training at PGI. Also, free Wi-Fi should be introduced at PGI.
Prince Bhandula, Chandigarh

Top caliber hospitals should be set up in adjacent states
PGI is a premier medical institute in north India and, moreover, the only one in the northern region providing critical care. The behaviour of PGI doctors is really appreciable as compared to those in other hospitals even though the former have to deal with a large number of patients and have inadequate laboratories. Meanwhile, conditions at OPDs at the clinic have deteriorated steadily. The rising number of emergency cases and OPD patients has become a huge challenge. Keeping in view the increased burden, new hospitals of the highest caliber like PGI should be set up at different locations in north India.
Manjinder Pal Singh, SAS Nagar

PGI’s initial objectives should be restored
PGI should restore its initial aims and objectives as soon as possible. Converting a research organization to a general hospital has resulted in many problems. Moreover, it has led to waste of resources and loss of talent of highly qualified professionals. Doctors are assigned to examine patients and in the process their zeal for conducting research is suppressed. And the patients aren’t happy either as they have to stand in long queues and are often not treated properly.
Kamaljit Kaur, SAS Nagar

PGI must make optimal use of emergency infrastructure
There was a time when the PGI was neat and clean, well managed and providing efficient services because the number of patients were within its capacity. However, it’s evident today it is over stretched and both the staff and patients are suffering. Even the newly opened advanced trauma centre is overcrowded, with patients sitting in corridors and attendants holding glucose bottles. Among short-term measures that can be taken is limiting the number of OPD patients in accordance with the available capacity and staff. Simultaneously, PGI must expand its infrastructure to deal with more patients. Also, the hospital administration must be transparent and efficient.
Col RD Singh (retd), Ambala Cantt

Burden on PGI can be eased by setting up more hospitals in region
Since it was set up over five decades ago the rush of patients at PGI has increased manifold, making the premier institute more like a general hospital. The alarming increase of patients is a clear indication of deteriorating health conditions in our society. As many residents are not satisfied with the treatment provided in other hospitals they make a beeline for PGI. The positive side is that the functioning of the institute and the behaviour of its staff with patients is so good that its reputation has spread throughout the length and breadth of the region. This state of affairs reveals the inefficiency and unpopularity of other hospitals.
Paras R Kalotra, SAS Nagar

Rush of patients affects doctors’ performance
The PGI was established with the aim of providing quality treatment to patients and for medical research and was initially conceived as a referral hospital. But due to the poor healthcare infrastructure in adjacent states, this premier institute has been reduced to the level of a general hospital like any other in the country. The average number of OPD patients exceeds 8,000 on a given day. This rush of patients adversely affects the performance of doctors and patients are deprived of the best treatment. However, the institute is doing its best to cope with the burden.
DP Gautam, via email

OPDs in govt run hospitals, dispensaries should be upgraded
The PGI should continue intensive research in the field of medical care. The PGI authorities should also encourage city residents to attend civil hospitals and government dispensaries for routine checkups and treatment for common ailments. Also, the UT administration should upgrade OPDs in government hospitals and appoint more specialist doctors in every department. This can relieve the burden on PGI to an extent.
Sukhpal Singh, via email

Non-critical patients should be diverted to other hospitals
Chandigarh is one of the few cities in the country where quality medical treatment is being provided to patients. However, over the years the quality has suffered with the growing influx of patients. At PGI the number of patients visiting the hospital every day has swelled from 18,000 to 72,000 over the past two decades. Only “serious” patients should be treated at PGI and “normal” patients should be diverted to other city hospitals.
Upendra Bhatnagar, Zirakpur

OPD workload should be reduced
Doctors of government hospitals routinely refer patients to PGI to pass on their responsibility whereas private hospitals refer patients who have little hope of survival. Since PGI is a premier medical institution and has produced excellent results, let its doctors devote themselves to serious research work. The OPD workload should be cut down and only referred cases should be attended to. The Sectors 32 and 16 government hospitals should be upgraded and state governments should set up new hospitals.
Col SK Aggarwal (retd), Panchkula

Patients with minor ailments can be referred to primary health centres
Since 1963 PGI has witnessed an exponential rise in the number of patients which even the expanded infrastructure seems to be inadequate to cope with. It is imperative that any minor ailments should be treated at primary and secondary health centres. But what one can do when every visitor to PGI is apprehensive and considers his ailment serious enough, which may not always be the case. All such patients after careful examination should be screened and treatment should be provided only to those having serious ailments, with the rest being referred back to health centres.
Vijay Kumar Soi, Chandigarh

Doctors must focus on critical cases
Doctors at PGI should only attend only to patients with serious ailments which, besides giving appropriate attention to patients in acute distress, will provide them time conduct medical research. Doctors should attend only to critical cases referred to by other hospitals and refer routine patients to the innumerable hospitals and dispensaries in the city.
MPS Chadha, SAS Nagar

Only tertiary care must be provided
PGI should provide only tertiary care services. Changes must be introduced to ensure equitable and optimized distribution of services and government resources and benefits to patients are maiximised. Patients do not benefit from the existing system as travel time and treatment costs are high and outcomes are not optimized.
Manav Chaudhary, SAS Nagar

PGI must attend to only patients with serious ailments
It is a fact that PGI is has become overburdened with patients. The number of daily patients in the emergency ward alone swelled from 18,000 in 1990 to 72,000 in 2014. To tackle this rush there is need in the neighbouring states to have a mulspecialty medical institution like the AIIMS in New Delhi. There has to be an effective system at the OPDs to screen and segregate incoming patients. Patients not requiring tertiary care should be referred to local hospitals to ease the rush at PGI.
Amar Jeet Kumar, SAS Nagar

Admn should upgrade other hospitals, dispensaries
Everyone knows thousands of outdoor patients from neighbouring states visit PGI every day and doctors there try to give the best service to them. But due to time constraints the doctors cannot attend all the patients properly. Only serious patients and those with chronic diseases should go to PGI so doctors can provide the best treatment. Also, the UT administration should upgrade standards of hospitals and dispensaries so the patients can get reliable treatment there.
Sumesh Kumar Badhwar, SAS Nagar

PGI should increase OPD fees
PGI should attend primarily to emergency, serious and referral cases from other hospitals, including private ones. Those taking treatment at other hospitals but still wanting to consult doctors at PGI may do so by paying a higher OPD fee, say Rs 100, against the normal fee of Rs 10. The option for first time consultation can also be kept but at a much higher fee. In all cases there should be quick initial screening by junior resident doctors before admitting a patient to PGI. Keeping in view the ever increasing number of patients, superspecialty government hospitals should be set up in the satellite towns of Mohali and Panchkula.
Tejinder Singh Kalra, via email

Patient counsellors required
Due to lack of awareness about medical facilities available in other hospitals and the prohibitive cost of treatment at private hospitals, most tricity residents prefer to visit PGI despite all the hassles involved. Some of the workload of PGI doctors can be shifted to other government hospitals but in no case should the doors of the hospital be shut to patients who may not need tertiary treatment. Also, PGI will do well to appoint patient counsellors in most of the departments.
DS Banati, SAS Nagar

Doctors at private clinics, hospitals can be accredited
PGI should involve its alumni as well as other qualified doctors at private clinics and hospitals in providing services. This can be done for relatively uncomplicated problems as well as for follow-up management and maintenance treatment of patients with chronic diseases. To maintain standards, these doctors may be accredited by the institution. If necessary, short training in specified activities may be made available. The doctors should also be held accountable.
Dr Aditya Jindal, Chandigarh

Set up more hospitals in tricity
The growing influx of patients at PGI needs to be reduced provided other tricity hospitals have all the required medical facilities. Only after more hospitals are set up will patients stop going to PGI for routine treatment.
Opinder Kaur Sekhon, Chandigarh

Local hospitals should be upgraded
Local hospitals should be upgraded with modern technology to meet the requirements of patients. It will be a grave injustice if they are not allowed to go to the hospital of their choice. One solution is setting up an independent department at PGI where patients can be screened and diagnosed and treatment provided the same day under one roof. Other patients needing special treatment can be shifted to other PGI departments.
Devinder Garg, Chandigarh

PGI should be declared a referral institute
In order to ensure smooth functioning at PGI there is an urgent need to limit the number of patients visiting the hospital and this may be possible only if it is declared a referral institute as originally conceived. Further efforts need to be made to upgrade local dispensaries and neighboring states should also set up hospitals like PGI.
SK Khosla, Chandigarh

First Published: Apr 27, 2015 11:38 IST