‘Executive Health check’ has become a very popular term among the urban elites in Bangladesh. The print and electronic media along with various government and non-government organisations have long been running campaign about preventive health care. Their campaign seems to start producing some dividend, at least among the urban population. There is an increasing awareness about health especially its screening and preventive approach. The more informed and more affluent of this population subject themselves to Executive Health Check from time to time. No doubt it has an enormous positive impact on their individual health and the Public Health in general. Some of the large corporate private hospitals have started offering this service for those who can afford it. However, a large number of people also travel to India, Thailand and Singapore for Executive Health Check. This group of people are popularly known as health tourists as they travel abroad for health reason. More about this health tourism later, but first let us explore the issue of Executive Health Check.
What is an Executive Health Check? This term does not have much familiarity in Western world. Health screening, opportunistic health promotion and preventive health care is blended with the Primary Health Care and General/ Family Practice in such a way that ‘Heath Check’ (whether ‘executive’ or not) does not have a separate existence. However, the picture is different in Bangladesh as General/ Family practice has not been playing its due part. The problem has been compounded by our reactive rather than proactive help seeking behaviour. So, the concerned individuals venture out for the ‘Executive Health Check’ in home and abroad. This is basically a screening check. The check may include taking general and family history, assessing risk profile for chronic diseases, general physical examination, baseline blood tests to check for blood count, sugar level, cholesterol level, liver function, kidney function, thyroid function etc and some x rays or other radiological scan if deemed to be relevant. In a nut shell that is what an Executive Health Check is. Does this check really need one to travel to India, Thailand or Singapore? Is our health system that much primitive or bankrupt that we can’t provide such a basic service?
The problem actually lies in the lack of awareness in one hand and the lack of innovative delivery system in the General Practice fraternity on the other hand. All these tests and examinations are available in Bangladesh even in most upazilla level. Some Family Physicians in deed offer these services without calling it an ‘Executive Health Check’. One does not even have to go to the luxurious corporate private hospitals, let alone to other countries. It needs proper reorganising of General Practice with strong preventive care arm and also proper information dissemination among the consumers.
However, there are concerns those need to be addressed before General Practice can take over the bulk of these (Executive) Health Checks. Firstly, we need appropriately trained General Practitioners/ Family Physicians to carry out the task. We need to introduce post graduate training in General Practice. The sooner we start the process, the better we will be in offering this health check. Secondly, this service need be backed by and co-ordinated with authentic pathological testes requiring reliable and authentic pathology laboratories. The pathology services have mushroomed everywhere in such a manner and many a times they are run by such inappropriately trained personnel that people do not have much confidence in the reports from these laboratories. This sector needs to come under proper regulation, not only on paper but also in action. When our General Practitioners will be willing to take up the service and we will have a number of reliable pathology services, These ‘Health Checks’ should be readily available even in upazilla level. This change will not need a billion dollar industry. All we need is awareness, rethinking and some reorganisation. ‘Executive Health Check’ is all about age and demography appropriate screening and preventive health measures. Appropriately trained General Practitioners with the backing of reliable investigation facilities are the right professionals to offer the service. It does not require an Endocrinologist or a Cardiologist or a Gynaecologist and so on. Of course, such specialists may need to be involved in due course should the screening ‘Health Check’ identify the need for further evaluation and management in some cases.
At the beginning of this discussion, I mentioned about Health Tourism where by a portion of the tourism industry in various countries depend on ‘Executive Health Check’ and other health care services. It is not only happening from Bangladesh. In fact people from western countries often travel to Thailand and Singapore for affordable health care as the comparable services in countries like USA, Australia is far much higher. However people from those countries do not travel to Thailand or Singapore for screening (Executive!) health check. They travel for curative health care that is not covered by the universal health insurance of their own countries. Unlike in case of Bangladesh, the western health tourist visiting Singapore and Thailand are the less affluent in their respective countries.
It is obvious that people will travel from country to country to seek better health care at an affordable cost. However, there is no reason why people from Bangladesh have to travel to other countries for the sole reason of ‘Executive Health Check’. We have the personnel and resources. All we need is properly organising our services and up skilling some of our service providers. Most importantly, we need to have self confidence. (Executive!) Health Check is not a rocket science. We do not need to travel abroad or even travel to Baridhara or Dhanmondi for that.
(The writer is a Family Physician practicing in Melbourne and a Freelance Columnist)
BDST: 2226 HRS, MAY 30, 2014
