GHIC 2019: Global Health & Innovation Conference
April 13-14, 2019
Yale University, New Haven, CT

Unite For Sight's 2011 Global Health & Innovation Conference

Blog Report by Chung-Sang Tse, Unite For Sight Global Health Leadership Intern

"Second Cut: Using Private Certifiers To Assess Quality and Safety of Male Circumcision Providers in Developing Countries," Michael Richards, MD, MPH, Doctoral Student, Yale University

Social Enterprise Pitches are ideas in the brainstorming or early implementation stage. Selected participants presented their new idea in the format of a 5-minute social enterprise pitch. Following the pitch, there was a 5-minute period for questions and answers, as well as feedback from the audience. The presenters were directed to focus their presentations on the problem that they are working to solve, the evidence basis for their idea, the expected impact, as well as plans for measuring outcomes, and not just outputs.

If you were living in a developing country and wanted a non-emergency medical procedure performed, how would you choose a doctor? Even more importantly, how can patients avoid mediocre doctors on the left-hill of the quality-distribution curve?

Word-of-mouth is a source of recommendations (and warnings) between family and friends, but this method of transmission provides only a subset of physician profiles. Online doctor-rating websites provide feedback from larger patient populations, but these tools might not be readily available, accessible, or popular in developing countries. How can patients be assured that they are receiving safe, high-quality medical procedures provided by responsible and reputable doctors?

For men seeking circumcision, Michael Richard, an MD, MPH, and PhD Candidate at Yale University, proposes for private certification to be offered. An external company audits and certifies that a doctor’s circumcision method and equipment is up to standards. When patients see this “Second Cut” certificate, they will know that the doctor has been assessed and does not provide subpar service. 

However, the audience raised a question regarding the application. If a physician obtains the “Second Cut” certification, how is the medical practice and community assured of continual, sustained quality? In other words, since medical practitioners provide “services” rather than “products”, how can they be guarded against post-certification quality deterioration since? In response, Michael replied that it will rest on the doctors’ integrity to maintain on-par standards. Since this is not a licensing procedure (that is, it is not essential for qualification to practice), it will not require renewal nor will it have the authority to ban a sub-par physician from practicing.  However, doctors can use the certificate to their advantage. The Second Cut certificate can be an objective measure to show their quality service. In business terms, this is a marketing strategy to demonstrate that they (profit-driven practitioners) are responsive to consumer preferences. Under certain circumstances, this could be a win-win situation for doctors and patients alike.