Smaller facilities tend to focus on selected aspects of healthcare and hardly have any bureaucratic processes (Photo: iStock)

Healthcare facilities are so varied in many aspects. One of the main variations is their sizes, they can be big or small, with many in between. There is a tendency to desire healthcare in the biggest of facilities for various reasons. Is this always better, or could you have equivalent or better care in smaller or medium-sized facilities?

Big healthcare facilities tend to pool resources together, aiming for efficiency. You are more likely to find super specialists and more modern equipment in big facilities.

Smaller facilities may be completely different in terms of personnel and equipment. But they may have strengths that you may struggle to find in bigger facilities. Smaller facilities tend to focus on selected aspects of healthcare and have hardly any bureaucratic processes that are sometimes a hindrance to the quality of care.

Getting an appointment in a big healthcare facility can be an arduous process. You must book way in advance. Come the day, your chosen specialist may not always be the one who ends up attending to you. As if that’s not enough, additional diagnostic aides often require further waiting in unending queues. Every additional service point has processes that may not always work in your favour.

What about smaller facilities? They are more likely to be located closer to you. Being locally placed means they are more likely to identify with your community interests. Interpersonal relationships are likely to be better, and you may feel more appreciated. Bureaucratic hurdles are rare, all processes tend to be simpler and clearer. And the cost of care may be more favourable.

So rather than select your healthcare facilities based on their bigness, think about the overall quality. Can you get an appointment without undue hurdles? Do you get to see your chosen specialist or are constantly being delegated to somebody else? Are other aspects of your care as seamless as they could be?


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For example, how easy is it to reach your specialist, get your pending results, or secure a follow-up appointment without undue delay? Bigger facilities may be more alluring and prestigious but are not necessarily better in overall quality of care.

Always think about the kind of care you really want. Some care will only be available in bigger facilities. Equally, smaller facilities may have some aspects of specialised care that you desire.

Undue pressures to attend bigger and more prestigious facilities may not always be in your best interests. Your choice must always be dictated by your specific healthcare needs, including accessibility, cost and most importantly the quality of service provision.

Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist.