A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’?
Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To a...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2022-12-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/631 |
| _version_ | 1797368304881369088 |
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| author | TP Kerry P G T Cudahy H L Holst A Ramsunder N G McGrath |
| author_facet | TP Kerry P G T Cudahy H L Holst A Ramsunder N G McGrath |
| author_sort | TP Kerry |
| collection | DOAJ |
| description |
Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic.
Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed?
Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page
standardised data tool was used to collect data at every consultation.
Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health
Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) – the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%).
Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a ‘musthave’ member of the PHC clinic team, offering a regular, reliable and predictable medical service.
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| first_indexed | 2024-03-08T17:30:35Z |
| format | Article |
| id | doaj.art-50dcca4d261b437d8ef453e4cd02cdc2 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T17:30:35Z |
| publishDate | 2022-12-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-50dcca4d261b437d8ef453e4cd02cdc22024-01-02T15:33:29ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352022-12-01113110.7196/SAMJ.2023.v113i1.16700A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’?TP Kerry0P G T Cudahy1H L Holst2A Ramsunder3N G McGrath4District Clinical Specialist Team, uMgungundlovu District, KwaZulu-Natal, South AfricaSection of Infectious Disease, Department of Medicine, Yale School of Medicine, New Haven, USA; Department of Internal Medicine, Harry Gwala Regional Hospital, Pietermaritzburg, South AfricauMgungundlovu District, South AfricaNorthdale Hospital, Pietermaritzburg, South AfricaDepartment of Anatomical Pathology, University of Witwatersrand, Johannesburg, South Africa Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed? Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page standardised data tool was used to collect data at every consultation. Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) – the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%). Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a ‘musthave’ member of the PHC clinic team, offering a regular, reliable and predictable medical service. https://samajournals.co.za/index.php/samj/article/view/631NHINCDHIV |
| spellingShingle | TP Kerry P G T Cudahy H L Holst A Ramsunder N G McGrath A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? South African Medical Journal NHI NCD HIV |
| title | A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? |
| title_full | A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? |
| title_fullStr | A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? |
| title_full_unstemmed | A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? |
| title_short | A doctor at a PHC clinic: A ‘must-have’ or ‘nice-to-have’? |
| title_sort | doctor at a phc clinic a must have or nice to have |
| topic | NHI NCD HIV |
| url | https://samajournals.co.za/index.php/samj/article/view/631 |
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