PHYSICIANS IN ALEPPO

PHYSICIANS IN ALEPPO

First I want to apologize for not posting for the last several weeks, we had a sickness in the family but things are back to normal Alhamdulelah


Now back to posting,

We have reached to talk about the private sector in Medicine in Aleppo

We have always heard the rhetoric that Aleppo is saturated with physicians and today I will try to clarify that point

As we have said before that the population of Aleppo City itself is around 2.4 million although the majority of People living in greater Aleppo do depend on the city itself for at least there advanced medical care

  

Below is the numbers of physicians currently registered as practicing in Aleppo in different specialties (up to 2010).

to give some meaning to those numbers I am comparing them to the numbers in Cleveland Clinic Health system. As you know CCHS covers the are of north east Ohio where 2.2 million people live, and at best the CCHS covers 75% of the need in that area, so this resembles the population of Aleppo City (although as I said on all practical levels almost the whole 4 million people in greater Aleppo do seek medical care in Aleppo at some point)

(the number in CCHS is obtained though there website keeping in mind that those numbers do include nurse practitioners and some shared physicians between different departments)

Number of physicians:

                                                Aleppo                       versus                        Cleveland Clinic

Internal Medicine                        278                              -                                  159

Cardiology                                  61                               -                                   158

Lab.                                          196

Pulmonary                                  26                               -                                    56

Thoracic surgery                        27                               -                                     44

General                                     183                              -                                   73 (family physician)

Neurology                                 32                               -                                   106

Neurosurgery                           22-                                                                    30

ENT                                         91                              -                                      49

Rheumatology                          14                               -                                      37

Gastroenterology                     37                              -                                        60

Gastro-surgery                        21-

Endocrinology                        15                              -                                         46

Nephrology                           12                               -                                        31

Urology                                82                               -                                         80

Anesthesiology                      29                               -                                       221

Pathology                             11                               -                                        35

Plastic surgery                      20                               -                                         15

General surgery                    224                                                                       45

Ob-Gyn                              238                            -                                         101

Psychiatry                           14                              -                                           58

Pediatrics                           253                             -                                         221 (mostly-subspecialty)

Pediatric surgery                 13                              -                                         12

Orthopedics                      150                            -                                          101

Dermatology                      74                             -                                          49

Ophthalmology                 91                              -                                            48

Hematology-Oncology     18                             -                                             37

Radiology                        100                           -                                            177

So what does that tell us?

First that with the exception of Pediatrics, Ob-Gyn, Gen Internal Medicine and Gen Surgery, all other sub-specialties are much underserved. And even for the ones that are served, remember that we are only comparing with CCHS and we are not talking about the quality yet. So the bottom line I do believe that regardless of the specialty we are talking about it is needed

Second is the issue of distribution

there is what I call the east-west phenomenon. Most general specialties (pediatrics, IM etc....) are distributed in the eastern part of Aleppo (which is more condensed) and the more specialized the physician is the higher the chances that he moves to the western part of Aleppo (see the attached picture where I plotted all the Hematology-Oncology doctors in Aleppo with red dots)





As it stands right now, almost all of those physicians are practicing in a single specialty clinics style, and although the medical center law has been around for several years but only dentists have actually taken advantage of it (compared to Damascus where multi-specialty clinics are picking up pace)

Obviously many factors do play roles in the mechanisms of choosing a place for a private clinic but in general the are certain rules:

1. following the dense population: the most famous examples of this include

• قهوة الشعار: This providor for health care in the eastern part of the city
• شارع سيف الدولة where this serves the whole area of south western and southern parts of the city and this a very very condensed area

1. Being accessable and near public trasportation: this is a very important factor, we have to remember that not all people have cars and that Taxis are not cheep (example, if a person lives in الميسر and wants to go and see a doctor in حلب الجديدة then this is an extra 100 SP on the top of the consultation cost). The most famous examples would be the old and traditional center of the city concept 9العبارة - الجميلية- العزيزية ) where for a long time those were considered the hottest areas for clinics. Then with the movement of the كراج الشرقي  which is the landing station for anyone coming from the eastern part of greater Aleppo and further (نبل - منبج ) hd been moved to قهوة الشعار that boosted the market there
2. Serving people with similar ethnic back ground (armenians in الميدان )
3. Being near a Hospital (mainly private hospital) and this is usually when the physicians owns shares in those hospitals and they want to be near it (the exmaple would be the physicians sharing the Al-Shahba hospital who moved near that area even though it was considered a Helath Market)
4. And Fianlly Emerging areas where they share several of the above mentioned factors, the most famous would be the AL-Razi Street and سوق الانتاج area. This is curretnly the hottest are for physicians, and considered the new الجميلية if you want although it a much higher scale. And still very accesable by public trasportation

One thing to mention is the fact that it is hard to defy the rules of the Market. for instance, although the شهباء area has the highest level of living standards if you want but it is not a health care providing area and altough many doctors can buy there and open if they wanted to but usually they dont and we have some examples for people who tried and failed,

this is only my personal opinion