In a Healthcare System, Physicians Not the Only Main Actors

Dr. Mohd Mizanur Rahman.

By Dr Mohd Mizanur Rahman

The healthcare system is a complex and multifaceted network of professionals working together to ensure optimal patient care and outcomes. While physicians have traditionally been seen as the central figures in healthcare, modern systems increasingly rely on a broader team of professionals, each playing a critical role in maintaining and improving patient health. This is particularly true in Bangladesh, where the healthcare system has evolved to incorporate a range of experts who, collectively, enhance the quality of care and ensure the system's sustainability.

In Bangladesh, as in many countries, physicians are often perceived as the face of healthcare. They are the professionals who diagnose illnesses, prescribe treatments, and oversee patient care. However, they are just one part of a much larger ecosystem of healthcare workers, researchers, and support staff, all of whom contribute to the effective functioning of the system. To meet the growing healthcare needs of a population of over 160 million people, Bangladesh’s healthcare system relies on the collective efforts of a wide variety of professionals, including clinicians, allied health professionals, health system researchers, health economists, and nutritionists, among others.

The Role of Clinicians Beyond Physicians In addition to physicians, clinicians such as nurses, midwives, and paramedics are essential components of the healthcare system in Bangladesh. Nurses, for instance, play an indispensable role in patient care. They often spend more time with patients than physicians, monitoring vital signs, administering medications, and providing emotional support. Midwives are particularly crucial in maternal and child health, especially in rural areas where access to healthcare can be limited. Their presence has significantly contributed to reducing maternal mortality rates, which remain a concern in Bangladesh.

Paramedics and other frontline health workers are also critical in emergency medical situations. With the growing need for emergency services due to accidents, natural disasters, and other urgent health crises, paramedics are often the first point of contact for many patients. Their ability to provide immediate care and stabilize patients before they reach a hospital can mean the difference between life and death.

The Unsung Heroes Allied health professionals encompass a wide range of specialists, including physiotherapists, occupational therapists, optometrists, medical laboratory technologists, and radiographers, among others. Their role is often overlooked, but they are fundamental in providing holistic patient care and rehabilitation services. 

For example, physiotherapists work with patients recovering from surgeries, strokes, or accidents, helping them regain mobility and improve their quality of life. Similarly, occupational therapists assist individuals in developing, recovering, or maintaining daily living and work skills, especially those with physical, mental, or cognitive impairments.

Optometrists are primary healthcare professionals who specialize in diagnosing and treating vision problems. While many associate them solely with prescribing glasses or contact lenses, their role extends far beyond this. Optometrists are trained to detect early signs of eye diseases such as glaucoma, cataracts, and diabetic retinopathy—conditions that, if left untreated, can lead to severe complications and even blindness.

Medical laboratory technologists and radiographers provide the diagnostic services that physicians rely on for accurate diagnoses and treatment plans. Without the work of these professionals, many diseases and conditions would go undetected or be misdiagnosed, leading to suboptimal patient outcomes. In Bangladesh, where access to advanced diagnostic tools can be limited in rural areas, the role of these professionals is even more critical.

Innovating for the Future In a rapidly evolving global health landscape, health system researchers play a key role in identifying the challenges facing the healthcare system and proposing evidence-based solutions. In Bangladesh, health system research is increasingly important due to the country's unique public health challenges, including high rates of infectious diseases, maternal and child health issues, and the rising burden of non-communicable diseases like diabetes and cardiovascular diseases.

Health system researchers study how healthcare services are delivered, how resources are allocated, and how policies affect patient outcomes. Their research informs the development of more effective health policies and interventions that can address systemic challenges, such as the shortage of healthcare professionals, insufficient infrastructure, and inequitable access to care, particularly in rural and underserved areas.

One of the critical areas of research in Bangladesh is the integration of technology into healthcare. Digital health solutions, such as telemedicine and mobile health applications, have the potential to bridge the gap between urban and rural healthcare services.

Researchers in this field work on developing and implementing these technologies to improve healthcare accessibility and efficiency.

Ensuring Sustainable Healthcare Financing Another key group contributing to the healthcare system in Bangladesh is health economists. They analyze the cost-effectiveness of healthcare interventions, the sustainability of healthcare financing, and the economic impact of health policies. Their work is crucial in a country like Bangladesh, where healthcare resources are limited, and the government faces the challenge of providing affordable care to a large and diverse population.

Health economists study various models of healthcare financing, such as government-funded healthcare, private insurance, and out-of-pocket payments, to determine which systems are most effective in providing equitable access to care. In Bangladesh, out-of-pocket healthcare expenditures are relatively high, which can create financial barriers to accessing care, particularly for low-income populations. Health economists work on developing strategies to reduce these barriers and promote more equitable healthcare access.

Moreover, they are instrumental in evaluating public health programs, such as vaccination campaigns, maternal health initiatives, and efforts to combat infectious diseases like tuberculosis and malaria. By assessing the economic impact of these programs, health economists help policymakers prioritize resources and design interventions that provide the greatest public health benefit at the lowest cost.

Addressing Malnutrition and Promoting Public Health Nutritionists play a vital role in Bangladesh’s healthcare system, particularly in addressing the country's ongoing struggle with malnutrition. Despite economic growth and improvements in health indicators, malnutrition remains a significant public health issue, particularly among children and pregnant women. Nutritionists work in hospitals, clinics, and communities to promote healthy eating practices, develop nutritional programs, and provide education on the importance of a balanced diet.

In addition to combating malnutrition, nutritionists also play a crucial role in the prevention and management of non-communicable diseases (NCDs), such as diabetes, hypertension, and cardiovascular diseases. As the prevalence of these conditions rises in Bangladesh, nutritionists are increasingly involved in developing dietary guidelines and interventions to promote healthier lifestyles and prevent the onset of NCDs.

A Collaborative Approach for Improved Outcomes The modern healthcare system in Bangladesh, much like in other countries, is no longer solely physician-centric. The collaborative efforts of a diverse range of healthcare professionals are essential for delivering high-quality, patient-centered care. From clinicians and allied health professionals to health system researchers, health economists, and nutritionists, each group brings unique expertise and skills to the table.

For example, the management of chronic diseases like diabetes requires a team-based approach. Physicians may oversee the patient’s overall care plan, but nurses, dietitians, and physiotherapists play essential roles in patient education, lifestyle modification, and ongoing management. In rural areas, where healthcare infrastructure is often limited, community health workers and midwives serve as critical links between the healthcare system and the population, ensuring that essential services reach even the most underserved communities.

Moreover, interdisciplinary collaboration is increasingly recognized as a key factor in improving healthcare outcomes. Research has shown that when healthcare professionals work together, patient satisfaction improves, care becomes more efficient, and medical errors are reduced. In Bangladesh, fostering a culture of teamwork and collaboration among different healthcare professions is crucial for addressing the country’s health challenges and improving the overall quality of care.

Moving Toward a Sustainable Healthcare System As Bangladesh continues to develop and modernize its healthcare system, the importance of a multi-disciplinary approach cannot be overstated. Physicians, while vital, are just one part of a larger team working to improve public health and patient outcomes. Clinicians, allied health professionals, health system researchers, health economists, and nutritionists all play critical roles in ensuring that the healthcare system is sustainable, efficient, and capable of meeting the needs of the population.

To create a truly effective healthcare system, it is essential to recognize and invest in the diverse range of professionals who contribute to it. By doing so, Bangladesh can build a healthcare system that not only provides high-quality care but also addresses the broader social determinants of health, reduces inequalities, and improves the overall well-being of its people.

(Dr Mohd Mizanur Rahman is a Vision Scientist and Researcher Assistant Professor and Research Fellow Management and Science University, Bangladesh.)