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Doctor attending to a patient.

You are unlikely to get treatment until you deposit some hefty amount of money with the hospital.

Accidents need a prompt medical response from healthcare providers to save lives. This also applies to patients with long-term medical conditions such as sickle cell anaemia and high blood pressure.

However, in Kenya, when you get an accident and a good Samaritan takes you to any of the hospitals, you are unlikely to get treatment until you deposit some hefty amount of money with the hospital.

If you are unable to raise the funds, you can be left to die or your relatives or friends will have to transfer you to a lower-level hospital - in most cases, a government hospital.
I know a case whereby an accident patient was asked for a Sh100,000 deposit before treatment.

Accidents are not planned! So how do hospitals expect an accident victim to have that amount of money at hand?

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Or is it possible for a sickle cell patient to predict an attack?

The question then is: “What is the difference between a patient and a customer in a hospital?”

The subtle difference in calling patients customers or consumers is a result of American hospitals becoming more business-like. Hospitals’ management should be wary of this shift in attitude.

This is as hospitals fight to survive in a competitive marketplace while ensuring appropriate quality health services for the community.

Financial obligations

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It is a fact that hospitals have financial obligations in the form of daily expenses.  For example, they must purchase the resources required for treatment and must pay their staff.

However, the characteristic of a patient as a customer is unique and so should be approached differently.

This explains why around Kenya’s independence, hospitals were run by missionaries as charities. The hospitals are too expensive for many of us.

In 2015, Shine Long gave reasons why patients are not customers.

First, nobody likes to be in the hospital for treatment because disease or accidents cause pain. 

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Compare being sick and visiting a doctor as opposed to visiting a five-star hotel for lunch.

At the hotel, you would be in a happy mood. Secondly, patients are required by circumstances to seek hospital service but have no idea how much a visit to a hospital, in the case of an accident, will cost them.

Thirdly, the patient rather than the doctor becomes the servant.

Fourth, there are many procedures in the hospital that increase rather than reduce pain.

Fifth, the patient can die as a result of treatment procedures, which is not what a patient seeks from the hospital.

Lastly, there is no neat association between patient satisfaction and the quality of the service provided by the hospitals.

The fear is that hospitals that look at patients as customers are likely to focus on money at the expense of saving lives.

Customer service is the provision of a product or service to a customer before, during and after the purchase.

Some doctors in hospitals tend to focus more on their fee than saving lives by charging remarkably high fees.

Some even forget that during their training days, they benefitted from the taxpayers.

Little money

The consultation fee is high for many patients, and the doctor is likely not to examine the patient who fails to pay the fee.

For example, a doctor who charges Sh2,000 if they attend to 20 “customers” a day will pocket Sh40,000, a staggering amount by all standards.

Let us accept that there is no way a patient can be a customer because the patient never wanted to be in the hospital in the first case.

Going to a hospital to consult a doctor cannot be equated to shopping in a supermarket.

It is the preceding observation that makes the nursing job a challenge.

Nurses must deal with a “customer,” who does not even know what they want or doesn’t like the service being offered.

Many patients wish not to buy the service offered by the customer.

On the production floor in manufacturing, few workers meet the customers.

However, a health service provider is the worker who nurses the customer back to health.

The challenge most hospitals face is how to meet the expectations of the patients without sending them to bankruptcy.

There is a need to look into the way we deliver healthcare without overemphasising the money factor.

There are many people being denied healthcare because of potential high hospital bills.

 -The writer teaches at the University of Nairobi  

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