Reducing ENT treatment referrals in Dong Nai

A delegation from the National Otorhinolaryngology Hospital, also known as National Ear, Nose and Throat (ENT) Hospital, led by Associate Professor Dr. Pham Tuan Canh, Director of the hospital, recently conducted a survey and held working sessions with hospitals in Dong Nai to promote cooperation in developing the ENT specialty in the province, with a focus on specialization.

Associate Professor, Dr. Pham Tuan Canh, Director of the National Otorhinolaryngology Hospital.

Associate Professor Dr Pham Tuan Canh shared that the delegation observed a strong determination in Dong Nai province to develop the ENT specialty, from the provincial level to local healthcare facilities. This attempt is a very positive sign, reflecting the attention of all levels of government, the health sector, and hospitals to enhancing professional capacity to provide an increasingly better service to the public.

Supplementing equipment, improving human resource quality

* How do you evaluate the ENT specialty at hospitals in Dong Nai?

After working with three hospitals in the province, namely Dong Nai General Hospital, Thong Nhat General Hospital, and Long Khanh Regional General Hospital, the delegation observed that the hospitals have basically implemented the fundamental techniques in the ENT specialty, particularly in nasal and sinus surgery, ear procedures, and throat-larynx operations. However, many advanced techniques, such as middle ear reconstruction, treatment of complex nasal and sinus tumors, and navigation-assisted surgery, have not yet been widely adopted and still require technical transfer support from the central level.

Regarding equipment, Dong Nai General Hospital and Thong Nhat General Hospital generally meet the requirements but need to upgrade their endoscopy systems, surgical microscopes, coblator equipment, and navigation machines to implement high-level techniques. Long Khanh Regional General Hospital still lacks many instruments for ear and larynx surgery, affecting its ability to perform advanced techniques.

In terms of human resources, the hospitals have a dynamic team of young doctors but still lack specialists in advanced fields.

* So, what conditions do hospitals need to focus on and supplement to develop a specialized ENT specialty, sir?

To build and develop a specialized specialty, hospitals need to focus simultaneously on two key factors: human resource training and equipment investment. If training is provided without the necessary equipment, the acquired knowledge and skills will gradually fade. Conversely, if equipment is available but there is no well-trained team of doctors, it will also result in waste. Therefore, both tasks must be carried out in parallel to ensure sustainable effectiveness.

We need to recognize the practical challenges. Currently, many ENT doctors are inclined to move to private facilities due to more attractive compensation and working environments. If public hospitals do not adopt appropriate policies to retain personnel, the risk of brain drain will be significant. This situation is not unique to Dong Nai but is also occurring in many other localities. Therefore, matters related to compensation, working conditions, and post-training staffing plans must be carefully considered to ensure long-term development.

In 2024, three hospitals, including Dong Nai General Hospital, Thong Nhat General Hospital, and Long Khanh Regional General Hospital, provided ENT examinations for over 67,000 patients and treated approximately 1,700 inpatients, referring around 400 cases annually. Some advanced techniques, such as middle ear reconstruction, parotid gland tumor removal, and advanced sinus endoscopy, still require technical transfer support from the central level.

Focusing on developing specialized specialties

* Do you have any suggestions for Dong Nai to attract and retain ENT doctors to work locally?

We have worked in many localities and found that in some cases, doctors who received specialized training returned to their local areas but were not assigned appropriate roles or lacked follow-up and support. As a result, the techniques were not applied, and the number of surgeries remained low or even zero. This undertaking underscores that post-training organization and management are also crucial and require close oversight from the hospital's board of directors and the Department of Health.

The National Otorhinolaryngology Hospital will accompany Dong Nai province in training, technology transfer, and professional support. However, due to limited training resources, we recommend that the province select core doctors to send for specialized training. Upon their return, they will be the core force to implement techniques and retrain colleagues within the province. This approach will be more effective and sustainable than sending large numbers for training.

Doctors at Thong Nhat General Hospital examine a patient's ear. Photo: Huy Anh

* So, how can we keep patients in the local area for treatment when Dong Nai is very close to Ho Chi Minh City, which has the most developed healthcare system in Vietnam today?

Because Dong Nai is close to Ho Chi Minh City, a portion of the population tends to seek medical care in the city. Therefore, without a team of skilled doctors, advanced techniques, and quality services, it will be tough to retain patients locally. This reality presents both a challenge and an opportunity for Dong Nai to invest in and develop specialties, building trust among patients.

We sincerely hope that the Dong Nai Department of Health and hospitals in the province will continue to focus on and invest in the development of the ENT specialty. On our part, the National Otorhinolaryngology Hospital will provide maximum support in training and technology transfer, especially in advanced areas such as head and neck cancer, skull base surgery, and combined radiotherapy-chemotherapy treatment. This endeavor will enable patients to receive comprehensive and convenient care locally, while helping to reduce the burden on higher-level hospitals.

* Thank you very much, Assoc. Prof. Dr. Pham Tuan Canh!

By Hanh Dung – Translated by Mai Nga, Minho