Letters

Doctors are not greedy

Dear Editor,

I am a junior physician employed at Princess Margaret Hospital.

I awake at 5:30 every morning to make breakfast for my family, take the children to school, get ready for work, and arrive there not for 9 a.m., but 7 a.m.

Rounds start no later than 7:30 a.m. with ALL JUNIOR physician staff present on my service, to make sure that appropriate care and management is provided for MY patients, and give detailed reports of all events to my consultant.

There are 30 in-patients to care for, postgraduate studies to do; I still have duties, not just to my patients, but to the “doctors-in-training”, who seek to be where I am in a few years, clinic with another 30 patients waiting, and whenever I get home, I will feed my family.

And now, the people, MY people, call us UNREASONABLE.

A 24-hour call can turn into 36 hours quite easily. Why? Because there are patients in hospital to care for.

Emergency Medical Services (EMS) just brought in a patient who attempted to rob a grocery store and the police shot him in his abdomen and I must now rush him into the operating theatre to save his life.

An expecting mother has been pushing in labor for too long and her unborn baby is in distress and she now requires a caesarian section for delivery.

You, a known diabetic who didn’t take your insulin this weekend (because you “ain’t claiming it”), are brought in to hospital by relatives with vitals and blood tests that are incompatible with life, and I must now make efforts to aggressively hydrate you and administer the insulin you need to save your life.

Little Johnny had a cough and felt hot last night and now is having “the fits”.

Never mind I haven’t seen my spouse and children since the morning before. I leave my family to take care of yours. OURS. OUR PATIENTS.

Yes this profession calls for much sacrifice, but it should still provide a quality of life that is humane and REASONABLE to the caregiver.

UNREASONABLE?

After 36 hours, I collect my belongings and with great fatigue head to my car, only to find a tow-away sign stuck under my windshield wiper, just below my valid PMH decal sticker. And to think, I was parked in staff parking. Is a physician not staff?

So why not create a parking lot for physicians where we can be assured that our vehicles are safe and will not be towed away at our expense while we are laboring and caring for the Bahamian people? OUR FAMILY. OUR PATIENTS.

A safe parking lot that is well lit and properly secured and surveyed, and where we need not fear a second traumatic event of some disgruntled man pointing his gun at my head and trying to force me into the trunk of my car. Yes, it has happened before!

UNREASONABLE?

YES, I asked for holiday pay.

On any given holiday, the typical civil servant is where? Not at work! Government offices are closed! Those “servants” who do work on public holidays are compensated for giving their time to the Bahamian people. So why shouldn’t I receive the same? Am I not a civil servant too?

Do I not have a family at home to provide for, and bills to pay? If my family doesn’t see me should they not at least receive the benefits of my labor?

For every recital, sporting event and graduation that I miss to care for the Bahamian people. OUR FAMILY. OUR PATIENTS.

We junior physicians hear our senior colleagues say, “What time is it? 5 p.m. Oh shoots! I forgot to pick up Susie from school”, or “my ONLY son is graduating from high school today, and where am I? In the operating theatre doing an emergency case. I feel as if I don’t know him”.

Why? Because every weekday, weekend, holiday, sun, rain and hurricane, we are here caring for OUR PATIENTS!

UNREASONABLE?

The authority and some of the public feel that physicians should “swipe in” to prove our presence at work and to be properly compensated for the time we work. REASONABLE. But can the authority afford to pay?

Each “call day” has an allocation of staff including two interns/house officer, two senior house officers, one registrar, and one consultant, for most departments.

Five (83.3 percent ) of those six positions are held by junior physician staff.

How can you account for who comes to work on-call on a holiday or any given day?

There is an on-call roster submitted by each department each month.

If you still have doubts, I refer you to the Princess Margaret Hospital’s telephone and paging system operator’s logs.

There are records of each physician “paged” on a day-to-day basis and the on-call rosters are housed there and on each ward in the hospital, as well as within the Medical Secretaries Department. There is NO issue of finding out who worked when.

With regards to the act of swiping itself, there are no swipe-in machine or cards or system available to physician staff. If that is what the Authority prefers for better record keeping, then the Authority needs to provide this, and be prepared to pay.

The truth actually, this “swipe-in” system has already been tested using few junior physicians. When the hours were submitted to the authority their response was, “we cannot afford to pay you all”.

The authority now agrees to pay at a rate of $24.52 per hour per call, and double time per holiday — $24.52 times 24 hours, times eight calls per month, times five junior physicians, times four services, times 12 months is then the amount due to junior physician staff per department per year.

If junior physicians swipe, the proper compensation should be paid to junior staff per month in each department.

This does not include the two hours I worked before the call started at 9 a.m.

Nor does it include the 12 hours at the end of my 24-hour call when there is a gun shot victim, emergency caesarian section, child with appendicitis or gangrenous limb to operate on.

It does not even include the seven days a week I come in to hospital to make sure that my patients are receiving the appropriate treatment and care that they deserve. Is the authority prepared to pay?

UNREASONABLE?

We junior physicians are expected to work a 40-hour work week and 24-hour calls, but our duty goes far beyond that and the expectations of the Public Hospitals Authority.

A lady on the radio station today said she is a civil servant and viewed physicians no different from her.

Yes, we are civil servants, but we are not the same as the clerical staff, or even our great teachers, nurses, or officers.

Our differences stem from our years of training, and the large investments we made toward it and are still paying off.

We differ by the number of hours we spend away from home in the hospital, as the role of the house officer is to stay in “house”. We work weekends and holidays without compensation.

We cannot leave the bleeding victim, near-drowned child, laboring mother, or hypertensive patient to fend for themselves.

We stay there and care for our patients until they are stable, however long it takes. Not because it is what the authority expects, but it is what the people  demand of us; it is our oath.

The police or immigration officer who escorts the prisoner to hospital for emergency medical care leaves once his shift is done and his colleague takes over.

When the mass shootings or casualties come into hospital, we put on our armor, and enter the battlefield to face the danger, all to save life and help the injured.

There is no “risk-allowance” or “health insurance” offered by the government or the Authority that can protect us, especially when the gang leaders come into hospital to “finish-off” whomever victim is still living.

Our 24-hour calls run straight into the start of a new day.

Ask the security officer or the nurse when they show up to work the following day, “Doc, you still here?”

“Doc, when you go home you ain’t gone be no good to your husband; you mash up.”

While we are considered “civil servants” our duty goes far beyond that of the typical “servant”.

We lose precious family time and social life to care for strangers, who for the most part are grateful for the care we provide.

This is time that we cannot get back, but simply ask to be compensated for. Some may view our requests as greedy and unreasonable, but we simply ask for the appropriate compensation for the work we put in.

Yes, this profession is one that requires heart, but heart doesn’t feed family or pay bills.

We work in an institution and under a government for whom we have been declared “unpensionable”, and mandated to contracts.

All of this time, energy and care given to the public and taken away from ourselves and loved ones to have nothing at the end?

Junior doctor

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