Research reveals why GPs no longer have a doctor’s bag Quality of patient files is “very poor” report states

POSTED: 04/26/12 12:57 PM

St. Maarten – The quality of patient files and the technical maintenance of medical equipment at general practitioners in St. Maarten is very poor and professional communication about the individual patient and the organization of care is a major problem. These are the main findings of a research into the way general practitioners (GPs) ply their trade in St. Maarten.

The survey was done among the twenty GPs that are active on the island between August of last year and February. One GP refused to cooperate. As a follow up, the inspectorate for Public Health visited the GPs.

The survey was presented yesterday at the A.C. Wathey Legislative hall by dr. Bes to Public health Minister Cornelius de Weever. The survey was designed to examine whether the GPs comply with the conditions for qualitatively responsible care. “There are no guidelines about the medical content in St. Maarten,” Dr. Bes said.

The survey found that most GPs practice their job very enthusiastic and that they care a lot about their patients. While most clinics were found to be neat and tidy, “the accessibility for disabled patients was not always assured.”

The inspectorate also found that technical maintenance of medical equipment in the clinics was ‘very poor.”

While the GPs have two organizations – Wima and SMA – the inspectorate found it “striking” that the professional communication about individual patients and the organization of care is a major problem.This problem does not just exist between GPs and medical specialists, but also between GPs and pharmacists. “Except for the inter-professional contacts within Wima and SMA the peer to peer contacts within the GP group needs improvement,” Dr. Bes said.

The quality of patient files is also very poor, the inspectorate found, except among GPs who use electronic patient records.

The inspectorate was amazed about the existing agreement between the GPs and the St. Maarten Medical Center about GP-care during the nights and the weekends. This care is provided in the emergency room of the SMMC,” Dr. Bes said. “That means that almost none of the general practitioners are available at night or during weekends. The emergency room has most of the time a long waiting line; this affects the quality of care negatively.”

The inspectorate also found that while most GPs can be consulted by telephone during office hours. Home visits to less ambulant patients and emergency visits are not provided by a lot of GPs. “This is an explanation for the fact that many GPs do not possess doctor’s bags anymore.”

Other sore points are that St. Maarten does not have an accreditation for GPs, that vocational training is not mandatory and that it is unclear how GPs maintain their skills.

The inspectorate recommends the establishment of a registration system for general practitioners and to set requirements for training and skills. It also recommends canceling the agreement between the GPs and the SMMC and to set up a GP post at the hospital that is managed by GPs.

Another recommendation concerns improving the professional communication with pharmacists and specialists. “Non-communication between professionals is unacceptable,” Dr. Bes said.
Better access for disabled patients, the introduction of electronic patient records, proper technical maintenance and improving the quality of patient files are other recommendations.

Minister De Weever did not immediately react to the findings of the survey said in a brief reaction “I believe it establishes a baseline; it tells us exactly where we are and where we want to go, tells us what we are doing right and which areas need improvement. By having this as a foundation there is room for us to build on,” he said.

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