Table 7 Cost determinants – doctors and doctor substitutes
Doctors | Clinical officers/Medical assistant, etc. |
|---|---|
1. Require longer pre-professional education 2. Professional training is significantly long 3. Training requires expensive and highly qualified tutors 4. The training is in tertiary facilities with sophisticated equipment and diagnostic facilities 5. The training tries to meet "International standards", which may mean non-relevant courses 6. Their salaries are higher; they are difficult to retain in rural areas and are more likely to migrate due to international complementary recognition 7. Often require expensive technical backup and support (laboratories, etc.) 8. Patient outcomes better? (Fewer repeat visits?) | 1. Need shorter basic or pre-professional education 2. Require shorter professional training 3. Requires smaller numbers of highly trained tutors and professionals 4. Can be trained in secondary and primary care facilities 5. Training can focus on specific immediate and relevant needs 6. Salaries after employment are considerably lower whilst being retained in rural areas. Unlikely to emigrate: skills not marketable internationally 7. Use of fewer expensive diagnostic tests and equipment in their practice 8. Cost of outcomes/complications to clients may be a problem |