Amid growing concerns over the limited number of tokens in hospitals and clinics, the Ministry of Health (MoH) has identified several key reasons for the token limitation, alongside the measures being taken to address the issue.
According to MoH, one of the primary reasons for token limitation is the number of patients, especially in departments such as radiology and diagnostics. With a high patient load, doctors use an electronic patient information system (ePIS) that limits the number of patients they can manage daily.
Unlike the paper-based system, where doctors could flexibly accommodate more patients, the ePIS implements stricter patient management.
However, occasional technological glitches with ePIS also contribute to reduced patient intake.
Moreover, some departments, such as MRI, face particularly acute shortages. MoH highlighted that Bhutan currently only has one MRI machine, which is running at full capacity. However, with each MRI session taking at least 40 minutes, long wait times for appointments are inevitable.
According to MoH, the other reasons are mainly due to increased patient demand, increased prescribers and a lone machine in the whole country. The issues become more critical when the machine breaks down.
In response to these challenges, MoH has said that they have already proposed the purchase of additional MRI machines.
Efforts are being made to secure funding from international organizations such as the World Health Organization (WHO) and Japan International Cooperation Agency (JICA). These additions will alleviate the pressure on the existing equipment, and help reduce wait times for essential diagnostics.
To improve overall access to healthcare services and reduce congestion in hospitals, MoH said they have taken several steps.
MoH stated, “The issues related to token limitations have already been taken care of by increasing the number of OPDs for the doctors, but at times, there will be some issues related to the reasons stated above. The remodification of the token counter at the hospital is currently underway, and is expected to be completed soon. Once finished, there will be a total of 10 counters for the laboratory.”
“We are also planning to establish a centralized token system, allowing patients to obtain their token from any counter rather than a specific one. The number of medical doctors stationed in the medical OPD has been increased,” MoH said.
MoH also revealed plans to roll out a patient App developed by the ePIS team. The App will allow patients to book appointments with doctors and access their medical records, reducing the need for long waits in hospital corridors. MoH said, “Through this App, the patients can book an appointment with their respective doctors without having to wait and can also get access to their medical information through this App.”
When asked about the impact of token limitations on vulnerable groups such as the elderly, disabled, and patients with chronic conditions, MoH reassured that these individuals are given priority access to services. “For elderly and those with disabilities are given priority access and are not subject to any token limitations. They are taken as walk-in patients. For patients with chronic conditions, if their visit is solely for refilling medications, they can access services through thromde health centers, ensuring they receive the necessary treatment without being impacted by the token system,” MoH said.
Looking ahead, MoH is implementing long-term strategies to prevent token shortages from becoming a recurring issue. In addition to improving healthcare infrastructure and expanding digital platforms, the ministry is also focused on optimizing patient flow.
This involves streamlining the in-country referral system and addressing staff shortages by increasing the intake of medical students at both undergraduate and postgraduate levels.
Public education also plays a vital role in mitigating the issue. MoH emphasized the importance of educating patients on the effective use of healthcare resources, such as the upcoming online booking system and the thromde health centers for routine visits like medication refills.
By empowering patients to make better use of these services, the healthcare system can reduce congestion and ensure smoother access for all.