How much do you trust your doctor?


Thursday, February 13, 2014    

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A few weeks ago some of us were saddened by the news that Abigail Hyman, late of Marymount High School and just shy of her 16th birthday, had collapsed at her school. She could not be resuscitated and eventually died of a "heart condition".

In the rough and tumble of Jamaica, those of us who heard of it may have been moved to see it as just another death, and then, because we have become so punch-drunk at death reports in this murderous country, we may have said, 'Oh well, we have our own situations to

deal with.'

The Sunday Gleaner of February 9 carried an item titled, 'Medical Council gets tough on Doctors -- Continuing education warning issued for doctors.' The article began with: "Amid growing concerns about falling health care standards at some of the country's public health facilities, the Medical Council of Jamaica is warning doctors that they could be banned from practising locally if they fail to meet the annual continuing medical education (CME)."

The article also said: "Chairman of the Medical Council, Dr John Hall, says the requirement is mandatory and no excuses will

be tolerated."

He goes on: "The required hours may be had from seminars which address areas such as review of data on specific subjects, for example, a new drug, cardiology, neurology, or any other area of speciality in medicine."

"Ethics is also a critical component of the requirements for a doctor to maintain his or her position on the council's register," the story quotes.

I place the tragedy of young Abigail Hyman and Dr John Hall's tough talk beside each other and find it more than useful to ask the following questions.

1. Abigail had only 16 years on this earth and the death of one so young is never easy to deal with. Considering that most 16-year-old children are healthy and are running up and down all over the schoolyard, did Abigail at anytime in her short life display any signs to indicate that she was unwell?

2. If the answer to (1) is 'no', then one could conclude that her death was totally unexpected. If the answer to (1) is 'yes', how old was she when the signs were displayed?

3. If signs of illness were indeed displayed, was she first seen by a private doctor, or was she taken to a public facility such as a clinic or a hospital?

4. If she was seen by a private doctor, what was she diagnosed with and what action was taken?

5. If she was taken to a public facility, what was she diagnosed with and what action was taken?

6. If she was taken to a public facility, as would be the likely case if she had shown signs of illness, what was her age at the time?

7. If she was taken to a public facility, were there any major difference of opinion between specialists as to the course of action that should be taken and what was the outcome of that?

I make no judgements, but I find it opportune at the very time that Dr John Hall has made his statements to ask the questions above, and hope that Dr Hall can definitively state that if the child was previously in the care of either private medical care, or especially the public health facilities, she was afforded all that would have been due to her as a citizen of this country.

Over the last two decades I have been approached by many poor people who have told me horror stories of the treatment they and their loved ones have suffered while in the care of those employed by the public health system. At the same time I know that it cuts both ways, as our people can be quite demanding and abusive of medical personnel at public facilities.

In the mid 2000s, while I was in the Accident and Emergency Ward of the University Hospital of the West Indies, just awakening from the effects of a pain-killing injection, a young doctor approached me about 2:00 am, told me that I would have to be admitted (acute pancreatitis) but that no beds were available.

'We will either have to get an ambulance to take you to KPH (Kingston Public Hospital), or would you like me to call the Tony Thwaites Wing?' she said. I told her to call the Wing, but in my mind I was already seeing a journalistic scoop of sorts in observing the KPH from the vantage point of a patient. After she called the Tony Thwaites Wing and told me the required deposit, I insisted that I wanted to be taken to the KPH.

The doctor's jaw fell as she said, 'Mr. Wignall, do you have any idea what the KPH is like?' Her words conveyed much more than any complaining patient could give as details. An hour later, a bed was found for me. Did someone die, or was someone else transferred to KPH, as it would be highly unlikely that a patient would be discharged at three in the morning.

Dr Derrick Aarons who served on the Medical Council of Jamaica (2007-2010) offered the following on the Caribbean Online Forum. "This article stating that the Medical Council of Jamaica is warning doctors that they could be banned from practising medicine in Jamaica if they do not meet the annual continuing medical education requirements is simply stating a high ideal at best, or trying to 'scare' doctors into complying, at worst."

According to Dr Aarons, from his observations, there were no systems of monitoring what went on in the medical practices among the approximately 2,400 doctors in Jamaica in the 2007 to 2010 period. "I proffered an initial idea of how this could be done in a rudimentary way, but was told there was no budget to implement it. It is against this reality that I make the comment that the Council wishes to 'scare' doctors into doing CMEs. It cannot 'enforce' -- it is hampered by what it says is insufficient funds to carry out its work."

On a global scale, Jamaica is a little pond, and our medical community is made up of pretty special big fish swimming around in that little pond. The community is very close knit and seemingly impregnable from those deemed as 'outsiders.' All too often the 'outsiders' are poor people (patients) whose voices cannot survive beyond the confines of the weeping and wailing of the waiting room.





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