1. Quality of Care: Patients' Perspectives
1.1. highly appealing to Egyptian patients (educated elites)= "patient-centered medicine," involving high degrees of "interpersonal competence," marked by caring, concern, and compassion
1.2. 5 Key difference between "patient-centeredness" vs. "traditional biomedical models:"
1.2.1. "patient-centeredness"
1.2.1.1. biopsychosocial perspective: a willingness
1.2.1.2. "patient as a person" understanding individual experience of illness
1.2.1.3. paternalistic power: patients are active consumer
1.2.1.4. therapeutic alliance: personal relationship greater priority
1.2.1.5. "doctors-as-person" influencing each other
1.2.2. patients appreciate interpersonal skills and " the human dimension" = it is very important to have a good relationship
1.2.3. PUBLIC HEALTHCARE DOCTORS ARE VERY BUSY BUSY "LONG TIME WAITING," "MERCHANDISING QUALITY," "MEDICAL MALPRACTICE," "CROWDED WAITING ROOMS," "CLINIC STAFF CHATTING AROUND"= LACK OF TIME AND ORGANIZATION
1.3. DOCTORS COMMUNICATING CLEARLY AND COMPLETELY
2. Private Providers and the NRT "Epidemic"
2.1. Medical modernity = able to provide " cutting-edge" Western technologies to highly sophisticated consumers in a competitive medical market place characterized by ample "consumer choice"
2.1.1. "Epidemic of new centers", most of them offering "low-quality service"
2.2. Risks of Adverse effects due to competition, 4 major problems of unfettered reliance:
2.2.1. Adverse forms of competition in terms of quality or service intensity
2.2.2. Lack of formal regulation =government and professional associations "lack information" of private sector = adequate "policing"
2.2.3. Equity issues + private sectors in favor of elites = privatization ultimately "hurting the poor"
2.2.4. Overprivileging of private sector activity at the expense of the public health care sector
2.3. Absence of more health clinics = Poor citizen (rural areas) = heavily rely on government health clinics
2.3.1. (Urban AREAS) increasingly rely on private practitioners who run (home-based clinics, massive hospital complexes
2.4. Third World private health care provision: " poor quality services, over reliance, over promotion
3. Private IVF Providers of Egypt
3.1. Dr. Yehia represents the new face of Egyptian reproductive medicine, technologically savy, Western-trained sub specialist = build highly successful IVF practices in urban Egyptian settings.
3.1.1. he is a "handsome movie star"
3.1.2. He quoted " the worst thing is competition. Even though it means that IVF services should improve, there will always be more failure than success"
3.2. patients prefer excellent doctors
3.2.1. the ability to give hope to otherwise hipless patients
3.2.2. Muslim, Compassionate and concerned, Patient-centered, involved, and Well-educated, handsome
3.2.3. "comforting" "reassuring""friendly" "with a smile" "personal bias" "confident" "well-mannered"
3.2.4. "highly religious doctor who therefore can be trusted"
3.2.5. seek mutual beneficially "dependency" relationship = foreign consultant brings special expertise "direct;y from the West"
4. Quality of Care: Physicians' Perspectives
4.1. 6 major industry wide problems in private IVF in Egypt:
4.1.1. clinic maldistribution
4.1.2. dependency among Western experts and materials
4.1.3. costs and shortages of equipment and supplies
4.1.4. problems of local infrastructure
4.1.5. local shortages of qualified staff, especially laboratory personnel
4.1.6. lack of a nationwide regulatory system to monitor clinic operations and coordinate data collection