Saturday, June 30, 2007


In Sri Lanka there is a fast growing heathcare industry.The healthcare industrialist generally gets into debt in putting up the infrastructure.The patients agenda who seeks refuge in these establishments is to get well with least possile time with least possible expenditure.The industrialist is interested to keep him/her as long as possible to see that
she/he spends as much as possible and if possible to cure him in the process.The doctor who serves in the industry has a conflict of loyality.If he is loyal to the patient the industry will not like him.The patient can hardly find out whether the doctor is loyal to him or to the industry.Being "black listed " in the industry is loss of practice thereby loss of income.Thus majority of doctors activate the indutrialists agenda rather than the patients agenda.This has a tremendous negative effect on the cost efectivness of healthcare. Unnecessary invsetigations/treatments /surgical procedures are commonly carried out.
Most patients seek refuge in these establishments because of inadequacy and ineffciency of the State healthcare service.This is a tragic situation experienced by the Sri Lankan patients as only a very small minority of them only are covred by health insurance.

Sunday, June 24, 2007

A "Sri Lankan National Formulary" !

The 53rd Edition of British National Formulary(BNF) was out in March 2007.It is published twice a year in March and September.The book fits into a doctors overcoat pocket.
Sri Lanka has about fifty brands of amoxicillin - an antibotic and about fifty brands of diclofenac sodium - a pain killer.UK has only two brands of each of these drugs.It is the same with other drugs.Sri Lanka has large number of brands of every drug This is of no benefit to the docor or the patient. The reason for registering large number of brands is known to the beaurocrats.In fact it causes much confusion in both parties. If a formulary is published all these fifty brands have to included.It will have to be prepared in several volumes and will fit in only to a wheel barrow !

Monday, June 18, 2007


Recently one of my GP coleagues had a funny experience.Going through records brought by a new patient he came across a neatly written diagnosis card about an operation performed on the patient. He became intersted and started going through it with much admiration.His euphoria lasted only till patients husband interrupted to say "Doctor,that was not a operation that was really performed.It is a document for an insurance claim."The document was signed by a consultant surgeon and was in the official stationery of a leading nursing home in Colombo !

Sunday, June 17, 2007

Fast Track Consultation

This is one of latest arrangements.If you want a early appointment pay double the fee! Contact telephone number given to richer clients.It is circluated among richer clients.This done with connivance of the establishments arranging consultations.