ABSTRACT
Respiratory illnesses are common causes of morbidity and mortality in children. Postgraduates in Pediatrics spent significant time in learning to manage respiratory disorders. Improved survival of preterm neonates, improved diagnosis and survival of chronic respiratory problems, and advances in diagnosis and therapeutics have increased the need for specialists trained in managing these patients. Training programs in Pediatric Pulmonology are evolving over the past few decades. In India, super-specialty training in Pediatric Pulmonology has grown over the past few years. There is a need to modify the training structure used in industrialized countries due to differences in patient population, priorities, and limited available resources and expertise. Formal training courses have been started in a limited number of institutions. There is a large gap between the need for a trained workforce and the available specialists in the limited number of institutions. The Indian Academy of Pediatrics National Respiratory Chapter (IAPNRC) has initiated a fellowship program to bridge the gap. Comprehensive training involving academic and hands-on training may go a long way to improve the care of children with acute and chronic respiratory problems. For sustainable development of the super specialty, there is a need to work towards creating Pediatric Pulmonology service departments in various institutions that may be responsible for comprehensive training and research activities to answer common research questions.
ABSTRACT
Background: There is lack of information regarding patient-doctor ratio in government hospitals in India. The aim of the present study was to measure patient-doctor ratio across nine super specialty clinics. The objectives were to measure Outpatient department (OPD) patient-faculty and patient-senior resident doctor ratio, to measure number of patients seen per unit time and time spent per patient in OPDs across nine super specialty clinics.Methods: Total number of OPD patient visits in year 2018 was retrieved for cardiology, gastroenterology, gastrointestinal surgery, neurology, neurosurgery, nephrology, urology, paediatric surgery and oncology. Number of faculties and senior residents working in above specialties were obtained. Ratio of OPD patients to faculties and senior residents across nine above clinics were derived and compared. The average time spend per patient in OPDs across nine above clinics was calculated by number of working days in year 2018 and number of working hours or day in OPD clinics, excluding public holidays.Results: Total 3,59,099 OPD patient visits were registered in year 2018 across nine super specialty clinics. Patient to faculty ratio was highest for gastroenterology followed by neurology and cardiology, while least for neurosurgery and paediatric surgery in descending order. Gastroenterology, neurology and oncology OPDs saw more than 200 patients per working day; with average time spend per patient consultation was two minutes. Compared to super specialty physicians who spend average of 2.2 minutes per patient consult, surgical disciplines used an average of ten minutes per patient for consultation.Conclusions:Super specialty clinics in government hospitals are over worked and under staffed with heavy patient load. Multiple parallel clinics in concerned specialty will provide more time and quality of services per patient.