Vietnam’s Challenging Healthcare System

Health - Saigon/HCMC: Oct. 31, 2016

As Vietnam continues to rapidly evolve, the country will need to do its fair share of systematic restructuring to meet higher demands. This includes reshaping its $12 billion healthcare industry to meet international standards. This is not an easy task.

The Current State of Healthcare

Everyone probably agrees that Vietnam could use a bit of advice in regards to its healthcare management. With nearly 30 years of experience working as a doctor in Vietnam, Dr. Rafi from Family Medical Practice is in a good position to offer many informed suggestions on how to produce better results in the field of healthcare.

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First, it is important to know that there are two kinds of healthcare systems running concurrently in Vietnam: one is the government ran hospitals, and the other is the foreign dominated private sector. The private sector is made up of small independent clinics. Understanding the difference between these two healthcare options is key in understanding how we can all work together to create a more efficient system for everyone.

The simplest suggestion that could be made in regards to hospital improvement is to focus on a thorough reorganisation of its current system. One of the most significant problems is the lack of modern equipment. Locally produced technology is implemented in many hospitals. Unfortunately, this is not sufficient to provide quality service to patients as it doesn’t meet international standards. Additionally, local doctors often rely too much on the equipment that they have as a crutch rather than a tool, and this can often result in poor treatment. Issues like overcrowding, poorly trained doctors, a lack of proper pharmaceuticals, and an overall disinterest in systemic modification have left many people wondering just what exactly is going on here.

On this ward, we have three doctors and ten nurses for 1,200 hemophilia patients. And, we have to take care of all other blood disorders that come in for treatment... it is better than three years ago.” - Nurse at Vietnamese hospital

Creating Clinic-style Services

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Overcrowding is another issue to be addressed, as anyone who has ever entered a local hospital can immediately notice. What are some ways that Vietnam can restructure their system in order to facilitate less traffic in hospitals? One idea presented by Dr. Rafi is to create small clinical establishments as an alternative to hospitals. Often, locals from the countryside have to travel to major cities in order to get proper medical treatment. The current structure for medical care is too centralised in cities, leaving those residing outside of major centres in need of better treatment in close proximity to their homes. Perhaps if there was more of an interest and motivation to privatise the rural hospitals, there would be a significant increase in patient care. One important thing to mention here is that this kind of restructuring would not cost much money at all. Instead, it would require time spent planning, rethinking and reorganising, while cooperating with private sectors and medical authorities.

Enhancing the Private Sector

The private sector is clearly on the rise as more privately ran hospitals are opening in HCMC, as well as other major cities. This has occurred as a result of the underdeveloped options available, which have sparked a desire in private interests to help create more efficient treatment facilities. The government allows foreigners to practice in Vietnam, but they are limited to primary care and are usually (given a few exceptions) not allowed to operate or own their own hospitals. There is clearly a hesitance to allow foreign doctors and hospital managers to enter the “healthcare bubble”. As a result, you have two different systems (private sector and government ran) operating parallel to each other, when in reality they should be working together to create a better model. Perhaps building a better network and creating more cooperation between the two sectors would be the more practical way, especially considering that the private sector has seen growth in the past several years.

A report also showed that there are more than 30,000 private polyclinics, 87 small-sized maternity hospitals, 30 foreign-invested clinics, and 29 clinics with involvement of foreign doctors across the country.” (ngocentre.org)

Doctor Quality

Another important issue to discuss is the quality of doctors here in Vietnam. It seems that most people, both foreign and local, don’t often trust your average run-of-the-mill physician, and for good reason. The Vietnamese population spends over $4 billion a year seeking medical treatment in places like Bangkok and Singapore due to the limited amount of qualified and skilled practitioners available here. They don’t trust the services provided at the hospitals, corrupt doctors and therefore decide to have medical attention attended to abroad.

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Another reason for this is that unlike Thailand, whose doctors are trained overseas and then return to practice in their home country, the best Vietnamese doctors leave for international quality training and do not return to Vietnam. This is because the salary is low, the working conditions are not ideal, and there is not really any benefit for them to utilise their skills here. In many other countries doctors often enjoy a handsome salary, high social status and strong government support. However, this is often not the case in Vietnam. This pushes the well-trained doctors away and enables “grey medicine” to occur. We’ve all heard the stories about how some doctors choose to compensate for their low salary, and these are often shocking to hear.

“The Vietnamese population spends over $4 billion a year seeking medical treatment in places like Bangkok and Singapore due to the limited amount of qualified and skilled practitioners available here.”

On a rather more positive note, it is worth mentioning how the prevalence of English is having a direct correlation on the education of doctors. Considering the fact that learning English is inarguably a high priority in Vietnam, the results are clearly carried over to one’s inherent ability to self-educate. Doctors now have the ability to comprehend international medical publications, research data and other valuable information that was inaccessible before. Doctors that are driven and have a thirst for knowledge can readily use the internet as a tool to learn more about medicine and apply it to their daily practice.

What’s Next?

While the country progresses economically, people are becoming more educated and aware that there are serious problems facing healthcare. As locals also become more exposed to higher quality services offered in other countries, we can be sure that the demand for changes to be implemented will be on the rise. The question is, how will such public outcry be handled and will there be attempts to refine the system on a national scale? If not, Vietnam will continue to put its money into the pockets of other doctors abroad, and the less fortunate will bear the burden of such a system.