Friday, May 22, 2009

This is not an entertaining post.

This is a post full of complaints. It's not funny or entertaining in any way. It's just the truth.

Doctor's are currently picketing and toyi-toying in their lunch hours in South Africa.

We are sick of the pathetic working conditions we suffer.

We are tired of the ridiculous hours we are forced to work.

We are insulted that compared to other government workers in similarly highly educated fields in this country ( the judiciary for example) - we are getting paid 50 percent less .

We are emotionally drained by the sheer volume of patients we are under pressure to "see" every day.

This disheartens us as we are unable to provide the quality of service we know we are capable of, simply as a cause of poor management.

We are tired of being told that we chose to be doctors, and that we should just deal with it as this is the way it has always been.

We are disgusted by the service we "provide" to our patients. It's unfair that this will be their health "care" experience.

Why are other fields not forced to do community service like us Good Samaritan medics?

Teachers could do community service in the township schools.

Engineers, lawyers, IT consultants, business graduates should all be forced to serve their communities in the way medics are.

The members of those disciplines would be up in arms about it.

Not like us - we just blindly accept our fate, and continue pushing ourselves to our limits.

Why are doctors such pushovers when it comes to our own quality of life?

I'm certain it's a mixture of guilt, compassion for others and indoctrination by the heirarchy.

I'm very worried about the future of government health care in this country. There is no incentive for us to continue working for the government sector. Why would anyone continue here? The department of health only have themselves to blame for the "brain drain" of doctors emigrating for a better life overseas.

I get to work, and am scared because people get shot in the area that the hospital is situated in.

When I walk in the door - I'm immediately confronted with 200 or more patients crammed into the small waiting area - who have been sitting there since 4am to ensure that they are the first to get a number. The magic number that means you will be one of the patients lucky enough to be seen by a health professional that day. If you don't get a number - you are turned away and told to come back tomorrow - where it's not certain you will even be seen then.

The patients know I'm the doctor - despite trying to be inconspicuous - and immediately start harassing me with demands.

"When are you going to see me doctor?"
"I've been waiting for ever!"
"Please just rewrite my medication so I can get it from the chemist."
"Can you have a look at my foot please it's turning black"
"My baby, doctor, just listen to my baby's chest please!"

This occurs while just walking down the passage to the consulting room. Although one can't exactly walk down that passage - it's more like an obstacle course, having to step over people lying on the floor and children running around everywhere.

I have no safe place to leave my things - we are not issued with lockers or keys to the rooms. Even the tea room is unsafe - so wherever I go I have to take my bags and coat with me. Even into the toilet. Or across the hall to use the one phone in the whole hospital.

The nurses tell me that everything gets stolen - even your food out the fridge, even the plug socket coverings on the wall, even the metal plaques on the doors. everything!

By the time I start seeing patients they are already so pissed off from the long wait that they are not interested in a damn thing I have to say. They just want their meds and want to get the hell out of there.

If I even leave my consulting room for five minutes just to pee, the patients start grumbling...Where is she going? Is she going on lunch? How long will I have to wait NOW!? These doctor's don't care about us at all!. I don't make eye contact with them.

While on call in the trauma unit - all night, despite having worked a full day as well, we deal with violence on an unimaginable scale. The doctor's from first world countries are shocked by the violence. I met a doctor from the UK who had seen one gunshot wound in his life. His first night in the trauma unit and we had five gunshot wound cases - one guy had 16 holes in his body.

While on call, the security guards supposedly protecting us have been beaten up by gangsters, the trauma unit has been surrounded by gangsters with guns and I've narrowly escaped assault by patients.

And if that's not enough. It is perfectly acceptable, after working a full day and night - NOT to be allowed to go home when the on-call shift ends. Oh no - it's law that you have to stay and see a certain amount of patients post-call before you go home.

Their thinking is that if you just went home, it would mean that you didn't actually work on the day post your call. Which is BULLSHIT as you actually already worked 7 hours of that day - from 00h00 to 07h00. Assholes.

How is this going to change? I don't know the answers - but it has something to do with making us feel valued. Pay us properly. Improve our working conditions. Give us a reason to stay here. Pump more money into education - so that we have a bigger pool of candidates to train to become health professional - thus alleviating the short-staffing.

Perhaps the fault lies with doctors themselves, who have allowed themselves to be mistreated for so long. Our dog's life is simply accepted as par for the course. Our way of coping is to put our heads down, and just get on with it. This is our normality. We don't know any better.

I'm very tired today. Last night's call was exhausting. And then I still had to deal with rude patients in the consulting rooms this morning. I had to restrain myself from shouting at them.

There - I've gotten all my moaning out my system. Will try make the next post entertaining. There were a few things from last night that stood out.

Have I mentioned that this blog is my catharsis? I figured it would be safer than being an alcoholic or drug addict. And certainly cheaper than therapy.


femail doc said...

So once again, I contrast my day. After seeing twenty or so patients and fielding about twelve phone calls and thirty prescription requests, we cut it off early for the holiday weekend. Two patients leave messages on the emergency line whining lightly about the fact that we are not still open. Then some dude calls with the following message:
"You guys are so fricking lame. I call and you say you called in my god-damn fucking prescription and you didn't do it you fucking pieces of shit."
I am sorely affronted, but he doesn't leave a name so I can't invite him to seek healthcare elsewhere.
So that's how tough my day was. Not. Sorry yours was, is, and will be (for five or so more weeks) a nightmare. And what makes our government so sure that they can do a better job taking over our healthcare?

Dr S said...

Oh lucky for you! I love holiday weekends! Hope you're putting yours to good use.

However, that guy - that RUDE guy who called you. That was WAY WAY out of line. How disgusting! I hope you never ever ever repeat his prescription - unless it's for laxatives. a lot of laxatives.

That's enoungh to ruin anyone's day.

I'm interested to know the direction health care is taking in your country?

Everything is privatised right? And everyone has to have medical aid. So what happens to the people who really can't pay etc?

I think in theory our system is a good one:

Multiple primary based health care facilities in each community. These then have referrral centres for any patients requiring more assistance or admission. ( secondary level hospitals.) And then the tertiary hospitals - for the really difficult cases requiring in depth specialist care, that can't be treated at secondary level.

Unfortunately - there are just not ENOUGH of these facilities to serve our enormous population. Unfortunately our govenrment is not giving people incentives to stay in SA and train and work in the government sector - so most doctors end up going private. And the state hospitals are then staffed by doctors who are training in their specialities ( the universities are affiliated to state hospitals) and a few doctors who really want to be in the state system.

Ketan said...

That's really sorry--all that you're having to undergo. Things are EXACTLY IDENTICAL in India in the government sector, especially for those pursuing postgraduation education (e.g., MD internal medicine, MD pediatrics, or MS general surgery). Only violence is of milder form and at fewer places. And rebuttal for sloppy work is nonexistent, or people have gained enough apathy to not get affected by reprimands from seniors/superiors. Here also it's only the medicat professionals only who're harassed for public service, and even the patients' attitude is similar.

I'm also planning to do a post on how medical professionals in India one of these days.

The sense of duty and conscience that you've been able to retain are truly admirable.

Just a curiosity--you don't use cell phones?



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