Steady progress


So LEI is still using paper charts (pictured above), which is not at all surprising given the limited number of computers on site and the spotty electrical grid.  Most patients keep/maintain their own medical record and are very reliable about bringing notes from previous hospitalizations, clinic visits, etc.  It’s very impressive!  It’s also very funny to see the reactions I get when I tell people that most hospitals in the U.S. have completely done away with paper charts in favor of electronic records.  “WHY???” they exclaim.  I go through the various reasons as I understand them – patient safety, efficiency in communication between doctors, billing.  But our system is so vastly different compared to how things operate here that none of what I describe really seems to make sense.  Take billing, for example – all patients at LEI pay up front for any services they receive.  Everyone arriving for a clinic visit with the cornea specialist comes with a receipt of payment for fifty Nepalese Rupees (about 60 cents).  A corneal swab for culture at the microbiology lab runs 200 NPR ($2.35).  I bought a Coke today after work for the same price as a doctor’s visit.  Fascinating.

Otherwise, I’m making steady progress on the research front and collecting some awesome anterior segment photos.  I also had the opportunity to spend a few mornings in the operating “theater” last week, first observing and then performing some of the steps of small incision cataract surgery.  The number of cases LEI’s surgeons turn out with this technique is truly amazing.  On Friday, four doctors performed a total of 100 cataract surgeries in under four hours.  In a full day, the same number of staff can do up to 300 cases.  Jaw-dropping.  Tomorrow I plan to observe a few strabismus (“squint”) operations.  All in all, shaping up to be a very well-rounded experience!

4 comments to Steady progress

  • Ann Williams

    What an amazing experience and opportunity for you. Thanks for the posts.

  • Alexis Cullen

    The finances are definitely interesting . . . I wonder if they would let you have access to the overall clinic numbers/cost/charges to see how they are able to make a profit? Amazing that you are there . . . and I’m so glad you are blogging! It’s great to live vicariously!

  • Susan Ratzan

    Maybe we should suggest that Mayor Bloomberg put a tax on sugary drinks to raise the price to that of a doctor’s visit and we would make a major dent in the obesity/related co-morbidities crisis at least in NYC. Go Nepal!! Susan

  • Kim Hayden

    So here I am wondering what the Coke bottle cost would be for cataract surgery in Nepal compared to the United States! Your experience of traveling to Nepal and working with the staff and patients of the LEI is once in a lifetime and priceless. I can’t wait to see some pictures and hear some more stories when you get home.

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