Wednesday, April 27, 2011


Wednesday, April 27, 2011 0

It’s been a long time, eyh? I just couldn’t find the time to write something, or couldn’t find something to write on actually. I registered 5 subjects for this second semester. 3 modules of system; Neuroscience I, Neuroscience II and UroGenital. Another 2 subjects with 1 credit hour each (I know what you’re thinking, believe me they’re essential) are Medical Ethics and Health Administration. So for the first time since I pronounced myself a medical student of JUST, we have to do an assignment on Health Care System Problems from administration or management point of view. Oh it’s been forever since I was asked to do a comprehension-like thingy. Since I’ve been thinking of updating this wasted blog of mine, why don’t I post my article here?
Please note that this is merely an assignment with no relevant proofs or facts. It’s just a bunch of words I put on together in an hour in an attempt to complete a 3 pages requirement (bonus marks alert!). So don’t take anything seriously because I don’t think serious when writing this. I assigned myself a topic of Incompetent Doctors. Okay, cut the crap, read on!

Nowadays, health care institutions especially hospitals have become one of the most important social services for every living person on the earth. A hospital is an essential element in any community in building a great country or so. Unfortunately, so many problems in one particular hospital will affect the way it should be functioning. Besides promoting the well-being of people, health care workers also held the responsibility to educate them. A great community can be built if all the members of the community are concern and realize the importance of leading a healthy lifestyle, thus creating a healthy environment.
From this point onwards, we already agreed the role of health care workers in educating people. Generally, an ideal hospital should consist of upper level workers and lower level workers. We are concerned about the managers, head of departments, chiefs and so on when describing the upper level workers. Lower level workers are usually the ones we are always talking about; the doctors on duty, nurses, technicians, receptionists and so on. So distinctively, the lower level workers are the ones who are closer to the people or patients requiring any hospital service. Of any workers they refer to, doctors are undoubtedly the closest any patients could have (in the hospital) as their trustees.
Therefore, doctors should be the one to educate people in encouraging the healthy lifestyle for them to carry on and spread on. Doctors’ words are usually what patients listened to afterwards. Educating people is not merely by treating, preventing them away from any harm or explaining the problem. This is more than about promoting the well-being. This is about making people understand the importance of this and that, here and there. Doctors become teachers in this situation.
So up until now, we already agreed that the most suitable persons in charge of educating people are the doctors. In order to carry out this plan, we will need a great deal of doctors. Competent doctors are the ones we are talking about. They need to be competent in completing their tasks. They should have the ability to fulfill anything required as long as they hold on to the title; Doctor. A competent doctor must not only know how to diagnose a disease, or how to treat a patient. They have to be able to carry out the duty as role models in one particular community. People often look up on doctors, on how they lead their lives, how they do their tasks, how they communicate, how skilled they are, how stable they are and so on. This is because a patient’s life at one time is technically depends on the doctor assigned to him/her. So a patient will demand to know how competent his/her doctor is to be trusted on his/her life. It’s not about taking care of things or whatsoever; it’s about the life of people. Handling a patient’s life is not an easy job because people are emotionally attached.
How competent a doctor should be? What kind of competency do we need? How do we assess the competency of any doctors? One of the problems rising up now in most countries nowadays is incompetent medical graduates or incompetent doctors. Too many doctors are useless if they can’t keep on their competency up to the level where people can trust them.
First aspect of competency is clinical and medical skills. Any unskilled doctors should not be trusted to handle a case alone. Medical graduates should’ve mastered the techniques and skills in carrying out their medical profession. Again, we are dealing with life of people or patients. Any mistake could be one step closer towards unwell-being. Patients will always be assessing the way any doctors handling them. How skillful they are? Are they capable enough to do a tracheal intubation? Can they be trusted to do a lumbar puncture? As far as we are concerned about the issue of unskilled doctors, there has been many reports on how doctors can’t find a vein, thus keep on poking the arm of the patients by the needle until they find one. If this one minor procedure can’t be mastered, how do we trust them to do a solo surgery, cutting the patient’s body open? Skillful and competent doctors will not only ease their job, it will also help in public display of the hospital.
We’re done talking about how incompetent a doctor can be in carrying out a medical procedure, even a minor one. The next aspect is the communication skills. Surveys proved that most patients couldn’t bother enough to ask doctors the real situation or status of their health because they’re afraid of disturbing the always-busy-doctors with some silly questions. This shouldn’t be happening. A good doctor should be able to have some time provided for his/her patient. There shouldn’t be a cold atmosphere between a doctor and a patient. They should be able to discuss freely. Again, we are dealing with people thus dealing with emotions and feelings. We are not to give judgments or giving harsh words. We are to ease patients. This is where communication skill is essential.
Those were some examples of how incompetent a doctor can be nowadays. How do we solve this problem? Let’s take a look on how it should be done from a manager’s seat point of view. Before accepting any application, a manager should have the applicants interviewed. A good manager will review the performance of each applicant then synchronizing it with the current needs of the hospital. This will also helps in financial aspect of the hospital because we are prioritizing the needs over any other things. A manager should hire a doctor upon his/her reviewed performance and the current needs of the hospital. From there, we might be able to find a skillful and competent doctor. The decision of a manager whether to hire or not could be the determination of the future of his/her hospital.
That is before hiring. After hiring, a good manager should go on with assessing the performance of each worker monthly or so. Sometimes they are good, sometimes they aren’t. So we need to know the status of their performance in carrying out their tasks. This includes the nurses, technicians and others involved. There can be an assessment form or so to keep track on how the workers are doing. When we detect something troubling, we will take some prevention action. That’s the purpose of an assessment. There should be a follow up, not just merely a record. Actions must be taken to prevent the workers from a deteriorating performance.
Next step is to delegate tasks evenly or doing shifts. Sometimes incompetent doctor results from less exposure thus lack of experience. This applies more on interns, residences and general doctors. They should not be picky with their tasks. A system of rotation from one department to another is helpful to help the doctors gaining or even balancing their skills and experiences. There shouldn’t be any compromises. All doctors have to abide the rules and shifts scheduled for them so everyone will gain something different each day.
My last suggestion of solution on these incompetent doctors is to hold a course or something like that in order to build the character of a competent doctor. This should come from the manager. This is a very universal solution because we can train almost everything in one particular course. For example, a course for bedside manners and doctor-patient relationship. The experienced managers may share the skills and techniques they developed from their experiences. Furthermore, we might be able to create the personality of our doctors as role models in one particular community through this course. It’s sort of a self-development program.
As for a conclusion, an incompetent doctor may results from the ignorant character of the doctor him/herself, or also comes from a bad management. One thing for sure, it’s the responsibility of the managers themselves to realize the situation, keep tracks on the performances and then taking such actions to ensure the development of a trusted hospital. A good hospital is reflected by its workers and doctors especially while a good doctor is a reflection of a good manager who successfully managed his workers.

Until then, TQ!
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