Appointment system for medical and gyno services after 1 pm

The hustle and bustle that one normally sees near the doors of the medical specialists at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) seem to have abated since the inception of the appointment system.

Since the success of the appointment system for ENT (Eyes, Nose, and Throat) Department which started on March 1 this year, Departments of Medical and Gynecology have also started the appointment system on March 19.

Talking to Business Bhutan, the Deputy Chief of Quality Assurance and Standardization Division (QASD), Jigme Choden, said following the Royal Audit Authority’s performance audit of the Hospital, it was revealed that the waiting time for a patient was almost two hours against the target of 30 minutes.

“Following the report, the hospital decided to pilot appointment system in the ENT Department first which is the easiest to manage,” she said. She added that with the positive outcome of the pilot program, the hospital then decided to try it out in two more departments.

The Head and Neck Surgeon at JDWNRH, Dr. Phub Tshering, said it was a great leap and a good initiative.

“For the ENT Department, we have made a system in such a way that emergency patients are given priority. The on-call doctors who do not see the routine patients are forwarded the emergency patients and cases those are referred from other departments for ENT consultation,” he said.

However, having the appointment system for the departments of medical and gynecology turned out to be difficult when compared to the ENT Department.

The cases needing serious medical attention were sent to medical department, but with the appointment system, some patients had to wait for the next day to get appointments. Additionally, due to the appointment system, the emergency cases were kept holding.

Following the problem, the management last week decided to have token system for both the departments till 12:30 pm and start the appointment system by 1pm.

“Each department should innovate to endure that emergency services are given priority while the routine OPD (Out-Patient Department) also runs smoothly,” said Dr. Phub Tshering.

Chief Jigme Choden said looking at the complicated cases that come to the medical and gynecology departments, it was decided that all the patients need to be accommodated on the same day. “So the token system that was there then will continue as it is. The only difference is that after 1 pm, the doctors will see the appointment patients,” she said.

One of the medical specialists at JDWNRH, who requested anonymity, said there are people coming from other Dzongkhags who do not know about the inception of the appointment system. So the current system of having token system is best to accommodate such patients.

However, the Doctor said there is a plan to phase off the token system in the future. “But it will be a gradual process,” she said.

“There is also a need to standardize the patients coming to meet the doctors. There are patients without token who barge into the doctor’s chambers. It is so stressful,” she said.

Karma Wangmo, a civil servant, is patiently waiting outside Chamber 3 for her appointment at 11:45 am. “I just reached here and we are already going in to see the doctor,” she said.

She said for people like her who have a nine to five job, the appointment suits them better without having to wait in queue or fight over the token numbers.

However, another patient, Tashi, who is a farmer, believes that the token system was much better. He said while trying to avail appointment system, the patients tend to get the later dates as it’s all filled for the particular day that you are there.

“Because I want to see the doctor today, I would rather wait for the token than make the appointment,” he said.

Chief Jigme Choden said doctors earlier saw about 130 patients in a day having to compromise in quality sometimes. The doctors are able to spend only a minimum of two minutes per patient, but with the new appointment system, each patient gets about 5-6 minutes during the morning hours (during the token system), and 10  minutes per patient are given after 1pm during the appointment system.

With the appointment system going well in the three departments, the Hospital is also planning to start appointment system for Surgery Department, Pharmacy Department and Dermatology Department by May this year.

Lucky Wangmo from Thimphu