HT Spotlight: PGI’s OPD is Overcrowded and Pressured Department
The sun has not risen yet, but the ordeal has begun for Hemraj Kumar (60), who is packing a bag to visit the New Out-Patient Department (OPD) at the Postgraduate Institute of Medical Education and Research (PGIMER). In an hour, he is at the hospital.punjab Updated: Sep 02, 2016 12:39 IST
The sun has not risen yet, but the ordeal has begun for Hemraj Kumar (60), who is packing a bag to visit the New Out-Patient Department (OPD) at the Postgraduate Institute of Medical Education and Research (PGIMER). In an hour, he is at the hospital. It’s 5am, and he is waiting outside the New OPD along with other patients as the gates are still closed.
Every day, more than 8,000 people from near and far visit the PGIMER’s OPD. Queues start getting formed as early as 3am. A guard opens the department gate at 6am, and the people rush inside to grab the first position at the registration counter. Hemraj is tenth in line but is satisfied. Another two hours later, the counters open and he gets a card made by 8.30am. But there’s a hitch.
“Despite telling the staff that the ESIC Hospital in Baddi (Himachal Pradesh) has shifted my wife to the plastic surgery department, the on-duty person made the card for the neurology OPD,” he says. The patient was undergoing treatment in the neurology department at Baddi, hence the staff apparently got confused and made the card for that OPD.
Till 10am, Hemraj waits for his son who is getting along his ailing mother Shanti Devi (58). “He again stood in line and got a new card made for the plastic surgery department. It did not take him much time, as he skipped the queue,” Hemraj says.
Around 2pm, they finally get to see the doctor, who informs them that they need to visit the general surgery wing instead. Hemraj and family leave without any treatment, only to come back the next morning.
There is another such case from Himachal’s Rampur, 240km from Chandigarh. Lokesh Kaushal’s wife is suffering from severe diarrhoea and anaemia, and has lost 20kg weight in two months. She was undergoing treatment at the local hospital, but, as doctors failed to figure out the exact problem, they referred the case to the PGIMER.
“I stood in the registration queue at 8am and got the card after two and a half hours,” says Lokesh. He then takes his wife, who can hardly move, to the Medical OPD on the third floor. While his wife sits on floor, he stands in a second queue outside the doctor’s room. Not knowing when his turn will come, he peeps into the treating room several times. “Why can’t they start the token system,” he says. “At the registration counter itself, they should give a token and the number should be written on the card. Patients should be called as per the number, so that we can have a fair idea when our turn will come.”
“At present, we have to stand in long queue at registration counters. Then the attendant takes the card to the doctor, where cards get mixed up, and thus a person who comes late is often called first,” he explains.
Lokesh’s wife is examined at 4pm and referred to the Emergency.
In the last five years, the number of outdoor patients examined at the New OPD and other, departmental OPDs registered at the PGIMER has increased by 33%, from 18 lakh in 2011-12 to 24 lakh in 2015-16. Of these, new patients were nearly 7 lakh in 2011-12, which crossed 9 lakh in 2015-16. The OPD wings include the New OPD, the ones at Advanced Eye Centre, Advanced Paediatrics Centre and Advanced Cardiac Centre, the oral health centre and the drug de-addiction centre.
For instance, at the endocrinology OPD, 900 patients are examined a day, by an average of 15 doctors. That is, 60 patients per doctor. As a result, OPD timings stretch from 8am to 7pm. It’s held only on Wednesdays and Thursdays.
“In 2004, the number of consultants at the OPD was two, which has increased to six, but the patient load is increasing at a faster pace. The PGIMER is a tertiary care institute and should be treated like one. The process of referring back patients should begin. Also, to facilitate patients, online appointments and time slots should be issued to them,” Dr Sanjay Kumar Bhadada, a consultant.
More than 600 patients are examined per OPD for neurology, with 15 doctors on duty. That is 46 cases per doctor, every Monday, Wednesday and Friday. “At the neuro OPD, many patients are those who can be easily managed at other hospitals. These patients waste the time required for critical cases as well,” said a neurologist at the institute.
But the real picture is even worse. According to a senior faculty member, “Consultants (the senior most faculty member in the OPD) have to also examine patients who are primarily examined by junior and senior resident doctors. So, these consultants end up examining 200300 patients per day.”