In my last blog, I talked about the “natural history” of hospitals in the country, and whether they are profitable or not. As a continuation, I’d like to explore the health care delivery system. Specifically, I would like to expound on how a person seeking medical care ends up in a hospital. Then I’ll give a suggestion on how to drive traffic towards your hospital.
In the Philippines, 49% of health care spending still comes from out-of-the-pocket expenditures. Thus a sick patient tries to defer medical consultation for financial reasons. Let’s say Juan suffers from a severe headache. Juan will most likely try to self-medicate initially by purchasing over-the counter drugs. If that does not work, he might ask his neighbor Pedro, who also suffers from occasional headaches, for tips. Only when the pain becomes unbearable will Juan seek consultation.
Juan then has several options. He can go to a hospital on his own and see Dr. Jose Pital. Or, more likely, he goes to a nearby health center and consults a primary care physician named Dr. Mac Inigo. It is the latter, which is more likely to happen, for a number of reasons. First, a health center or clinic is less intimidating. Second, the consultation fee is often lower than a hospital consultation fee. And lastly, a primary care physician often spends more time on patients compared to specialists. Dr. Mac Inigo usually listens to his patients unlike other specialists, according to Pedro. After reading a blog by Dr. Bernard Lown on the internet saying that we need to retire many specialists and train more primary care physicians, Juan is convinced that Dr. Inigo is the right choice.
This brings me to an important point. Because most patients would rather go to a primary care practitioner than to a specialist, it is not a good idea to invite too many specialty care physicians while neglecting generalists. The true driver of dominance in market share among hospitals is the number of primary care physicians affiliated with the hospital. In the final analysis, it is still the referrals of primary care doctors that will enable hospitals to succeed. Dr. Inigo will see more patients, refer more patients for utilization of hospital diagnostic tests, and will feed referrals to the other hospital specialists like Dr. Pital. Therefore, instead of inviting high-profile sub-specialists, it would definitely be wiser to look for the Dr. Inigos in the community and allow them to practice in the hospital, or to at least create a relationship with Dr. Inigo to make your hospital his hospital of choice for referrals.
Is your hospital today geared towards attracting primary care physicians?