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Cancer care Abroad National look. Ahmed I Al-Sagheir Hematologist and medical oncologist KFSH-Dammam King Saud University Saudi Arabia. Fatimah A. 55 yrs old, new seisures, and breast mass Mammogram: suspecious, FNA: cancer CT: confirms metastases, to CNS, bone and liver. Family meeting
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Cancer care AbroadNational look Ahmed I Al-Sagheir Hematologist and medical oncologist KFSH-Dammam King Saud University Saudi Arabia
Fatimah A • 55 yrs old, new seisures, and breast mass • Mammogram: suspecious, FNA: cancer • CT: confirms metastases, to CNS, bone and liver. • Family meeting • Need to start palliative radiotherapy and chemotherapy, both are available • Poor prognosis • A week later the family wants a medical report, pathology slides and want advise about going to US, Germany or UK and may be Thiland.
Cancer care…definition What do patients want? What does the society want? What does the health of the society need? Introduction
What is the magnitude of the problem? No good Data
Cancer care…definition What do patients want? What does the society want? What does the health of the society need? Cancer care Not only therapeutic intervention Screening programs Early detection Palliative care Introduction
Best possible care Access to health care Support Education Communication Family support Financial support Why do patients choose to go abroad ? Patients need
Best possible care Access to health care Support Education Communication Family support Financial support Pros Confidence in health care Lack of confidence in local services Assumption that medical errors are less frequent Availability of the option Culture and expectation Patients need
Second opinion Tourism Summer vs winter Political gains Pros Confidence in health care Lack of confidence in local services Assumption that medical errors are less frequent Availability of the option Culture and expectation Patients need
Cons Illness and homesickness Unnecessary delays Un-necessary diagnostic procedures Lack of familiarity with local diseases G6PD Lack of support Societal religious Financial costs Pros Confidence in health care Lack of confidence in local services Assumption that medical errors are less frequent Availability of the option Culture and expectation Patients need
History Generations of patients going to Iraq, lebanon and Egypt Culture Inferiority complex Value system Guilt feelings Health sector is a major financial drive Jobs Opportunity to support loved ones during illness Companions Vacation Family disturbance Charity Society prospective
Public health prespective • Establishing national registry • Building on experience • Training • Long-term care • Cancer survivors • Costs
Cost of lost opportunities • Building on experience • Developing training for doctors, nurses, pharmacists, etc • National registry • Which ultimately will help identifying pattern of disease • Help in prevention and planning • Jobs • Social impacts
What is the magnitude of the problem? No good Data
Health system in SA • Ministry of Health (MOH) • KFMC • KFSH-D • King Faisal Hospital and Research system (KFSH&RC) • Security forces health system • National Guard Hospitals (NGH) • Military hospitals (MH) • University hospitals • Private sector
New cancer casesSaudi Arabia experiencePopulation 26 M 1 SAR = 0.266 US $
Contributing Factors • Way the media deals with the medical errors • Exaggeration of medical errors • How do health care providers act? • Public awareness • Sharing experience
SolutionsTargetting Patient satisfaction • Satisfied patients are more likely to accept therapy compliance outcomes • High impact easy gains • Nursing quality and courtesy • Cleanliness of the hospital
Some suggestions • How would we act as role models? • What massage does our own actions give.. • Story of AbdulRahman Al-Sagheir…my son..
Some suggestions • Starting research on identifying predictors of good health care at national level • Monitoring referrals abroad • Indications • Monitor outcomes • Quality intiatives • Private • Government sectors • Involving media in talking about achievements • Providing second opinion thought telemedicine
Cancer care…definition What do patients want? What does the society want? What does the health of the society need? Cancer care Not only therapeutic intervention Screening programs Early detection Palliative care Conclusion
Case AbdulRahman Al-Sagheir Thank You