Anesthesiologists associated with surgeons during surgery in Chittagong have officially announced an increase in their fees. On May 15, Bangladesh Society of Anesthesiology Critical Care and Pain Physicians (BSA-CCPP) Chittagong branch, an organization of anesthetists, announced an increase in fees. Anesthesiologist fees were announced to increase by 50 percent for every surgery. Since then, anesthetists have been at loggerheads with surgeons and private hospital authorities over the new fees. Many concerned also feel that the increased fee will be burdensome for the patients.
Anesthesiologists claim that they have been getting surgery fees as per the old rules for a long time. Although the cost of surgery has increased, their fees have not increased. Anesthesiologists have to be satisfied with what the surgeons give. Again, even if the patient dies, he has to take responsibility. In this situation, BSA-CCPP feels that implementation of enhanced fee schedule is necessary for patient safety and discipline.
Again, surgeons feel that all the responsibilities before, after and during a patient’s surgery fall on their shoulders. So they have to be directly connected with the patient. The anesthetist stays during the surgery. That’s why the cost of surgeons is naturally high. If the anesthetists have to pay additional fees, they feel that they should take it from the patients. This will increase the cost of treatment.
Chittagong Medical College (CHMEC) principal and head of obstetrics department Sahena Akhtar told Prothom Alo that the demand made by anesthetists is somewhat logical. Again the point is not that a junior will get the same fee as a professor. In the list they gave, they divided it according to surgery. But senior-junior cannot get the same fee. And at the end of the day, the surgeon has to collect this additional fee from the patient. Again, surgeons have a lot of work. That should also be taken into consideration.
The notification and fee list issued by the association said, ‘There is no option to modernize the fees of anesthesiologists in the current socio-economic context. In this situation, it has been decided to implement the newly levied anesthesiologist fee from May 16.
Association’s Chittagong branch president Mohammad Sharif and general secretary Pranay Kumar Dutta signed the circular. When asked, BSA-CCPP Chittagong president Mohammad Sharif told Prothom Alo, ‘Anesthesia is very neglected here. Even if a surgeon performs a surgery worth lakhs of rupees, he gives us only 5 thousand rupees. But we have responsibilities before and after surgery and during surgery.’
As seen in the newly levied fee list, the anesthetist fee has been fixed at five-six thousand rupees during cesarean delivery. Earlier, an anesthetist used to get up to 3 thousand rupees for this. Again, during tonsil surgery, a fee of six to eight thousand rupees has been fixed. Earlier in this case three-four thousand taka was given for this.
The new fee for general endoscopy surgery has been fixed at Rs 3,000. The fee for colonoscopy is fixed at Rs 4,000. In case of appendicitis surgery, the fee is fixed at 5-7 thousand rupees. Earlier only one-two thousand anesthetist fee was paid for this.
BSA-CCPP Chittagong vice-president Alak Nandi said, ‘Nepal, India and Sri Lanka have higher anesthetic fees than our country. We have been meeting with surgeons on this issue for a long time. Talks are still going on. Hopefully, there will be an acceptable solution in coordination with everyone.’
When asked about this, BMA Chittagong President Mujibul Haque Khan said, ‘There is a problem with the determination of new fees for anesthesiologists. We will try to find a solution by talking to various parties about it.’
Costs will increase
One caesarean surgery costs up to Tk 25-50 thousand depending on the doctor. The package includes the cost of the surgeon and his assistant, the anesthetist and the hospital or OT. Several obstetricians said that if the additional fee is demanded by the anesthesiologist, be it 3 thousand or 5 thousand taka, it should be paid from the patient. As a result, the patient’s medical expenses will increase.