Professor Nguyen Gia Binh, Chair of the Vietnam Association of Emergency, Intensive Care and Clinical Toxicology, says that medical professionals should not be involved in hospitals’ financial matters, and that funds should be set up to support poor patients.

Binh noted that staff face daily pressure from patients, their families, as well as issues like hospital bed shortages, health insurance disputes, and financial issues when patients leave hospitals without paying. For years, to prevent financial losses, some hospitals have assigned this responsibility to departments, particularly emergency units, which often bear the highest compensation costs.

With “salaries are barely enough to live on,” doctors must not only focus on treating patients but also ensure no financial losses occur. “If hospital fees are not collected, departments will be held accountable, creating immense pressure,” he said.

In many cases, when treating poor patients, doctors sometimes have to personally seek support from philanthropists. “Once, when I called for sponsorship, I was told ‘Asking for donations again?’” he recalled.

Binh said that it’s time to clarify the roles of medical staff. They should focus on their expertise without worrying about hospital finances. “Doctors should only handle examinations, medical histories, and appropriate prescriptions. Financial management is the hospital director’s responsibility, not something to push onto doctors”

Dinh Thi Thanh Hue, of the Department of Emergency and Intensive Care, Hanoi Medical University Hospital, said: “Such incidents are not rare. Anyone who has worked in healthcare, especially in the Emergency Department, has faced this at least once. Night shifts are not only physically exhausting but sometimes leave lingering thoughts when patients leave quietly, with unpaid hospital fees.”

“What makes us tired is not the heavy work, but the lack of cooperation, lack of responsibility and sometimes even indifference from some of the people who come to seek support,” she added.

Humane solutions 

At central-level hospitals, some revenue sources help cover treatment costs for patients who evade fees, while at lower-level hospitals, doctors often use their salaries or shift allowances to cover these costs. Thus, a sustainable solution for emergency patient care is essential.

To address this, Professor Binh proposed promoting universal health insurance and developing private insurance options to give people more choices. A state-managed fund to support poor patients should be established, sourced from government budgets or social contributions to cover treatment and meal costs, with strict oversight to ensure proper use. Many countries have such funds to promptly assist struggling patients.

Associate Prof Vu Van Giap, Deputy Director of Bach Mai Hospital in Hanoi, said the fund for poor patients would allow doctors to focus on their expertise, especially in emergencies, without worrying about patients’ ability to pay. Administrative procedures and fees can be completed after the patient’s condition stabilizes.

Some hospitals have already established such funds. At Hanoi Heart Hospital, a fund for poor patients is sourced from hospital revenue, with a review board to support special cases, such as emergency patients without relatives or those from disadvantaged remote areas. The goal is to ensure timely treatment for all patients, regardless of circumstances.

Dr Ha Anh Duc, Director of the Medical Examination and Treatment Management Department under the Ministry of Health, noted that hospital fee evasion sometimes creates tension between doctors and patients. However, hospitals now have Social Work Departments that connect with philanthropists to provide financial support for struggling patients. 

Under Decree 60 on financial autonomy, hospitals can establish funds for special cases, including those unable to pay or people who pass away.

Hospitals have followed procedures prioritizing emergency treatment before administrative completion. Duc stressed that medical staff must be flexible and not rigidly demand completed procedures before treatment.

Initiatives to support poor patients

Several initiatives have been launched to assist disadvantaged patients. Funds like “Heart for Children” or “Bright Tomorrow” have delivered practical results. Some smaller hospitals place donation boxes for direct contributions. Social Work departments serve as bridges, mobilizing community support for special cases.

Currently, over 90 percent of Vietnamese participate in health insurance, reducing the financial burden in emergencies. Hospitals are encouraged to thoroughly study health insurance regulations to maximize patient benefits. Those facing difficulties can contact Social Work departmemts for community support.

Establishing and operating funds for poor patients is not only a financial solution but also reflects the humane spirit of the healthcare sector, ensuring thar no one is left behind due to financial reasons.

Phuong Thuy