Is it OK to blame Doctors always?

In an era of clinical accountability greater accountability of the system is required; maligning doctors won''t do
Is it OK to blame Doctors always?
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"Doctors are greedy, arrogant, and insensitive to sufferings of patients", ask anyone who's been a patient recently. And look how social media is set aflame – accusations involving a lady delivering on road, or a neonate dying of sepsis.

Should entire profession be painted black ?

Trust is the cornerstone of the doctor-patient relationship. Distrust could be dangerous to public health and safety of patients, as patients rely on doctors to help them make life-saving decisions. Pending Government's intervention in using trusted spokesmen and spokeswomen during such crises it is all too easy especially on social web to ruin someone's reputation with an accusation that will embroil them in a humiliating, drawn-out media trial. I would like to start off by saying I am extremely sorry that by irresponsible reporting by some non professionals especially on social web you have been pushed in a situation that has caused you to feel this way about not only a single doctor, but a profession as a whole. I understand that negative experiences can surely influence thoughts on a certain realities , but many of the overarching claims made in your comments especially in social media are simply not backed by any merit. Your statement that doctors "don't know how to heal or cure anything" is a very demoralizing thing to demotivate majority who sacrifice much of their life and dedicate it to the study of medicine and to helping others. The truth is that although there are some true adverse stories about the "pill mill" doctors and those investigated for malpractice or negligence but so many more amazing stories of dedicated doctors around the bad apples do not catch much attention .Ours is a community of people who rarely appreciates rather see the bad than the good. This too tends to paint whole Medicine in a negative light

I started my career as a young physician treating medicine as a calling and a passion, and like many other physicians of this time, I struggled hard with the right to "better health" as every citizen's fundamental right who wishes to uphold patient and their families rights , and fight a good fight for improving provision of care, and help humanity. How come our society ignores when majority of our care providers defy strict curfews and stone pelting of irate mobs or sparing their blood to save lives, why in the ultimate goal of health care, "patient satisfaction", the finger of accusation is always raised against most of them?

Lessons not learnt. Employee engagement and motivation is essential in managing a productive team work especially in healthcare services. Certain care providers in state run health units or hospitals may start feeling burn out and practice defensive medicine to avoid public blame of doctors for issues outside their control. Social movements frequently call for greater considerations when bringing attention to neglected issues. We are all human, whenever there is a problem, we are angry (which is often)on sad incidents catching viral attention , we need to release our tension. Typically, we do so by blaming someone. This may be cathartic (usually it isn't) but blaming never solves a real problem-, so we identify (or name) the culprit, generally picking on the most obvious person, and shame him or her by assigning the blame. Structural "quick fixes" like the present model of quick enquiry with report awaited do not, by themselves, nor have improved quality and effectiveness but having inquiries without root cause analysis and real action plans on adverse events to address the gaps in the system does not change much on the front lines of health care delivery instead where the real outcomes must be achieved, accusations and counter accusations surface. Our focus has been mostly on managing the crisis "du jour." And we keep repeating the same old patterns .Blaming fails to "cure" or even change anything. as it is an emotional process that seeks to discredit the blamed.

But when people work in an atmosphere of blame, they naturally engage in defensive routines, mattresses like things will be put on hospital corridor's to accommodate rush of patients. On the other hand a legal obligation on state is to ensure access to timely, acceptable, accessible and affordable health care of appropriate quality as well as to providing for the underlying determinants of health but ,it is me who end up being a scapegoat for other people's failures, on any gaps in provision of care for adverse event resulting out of inadequacies of human or material be it inadequacy of equipment's like ventilators, incubators etc, beds/ICVU), protocols, burnout ,exhaustion and compromised ratio of Doctor's/nurses to spend with patients. I don't know whether all major stake holders DHSK:GMC and SKIMS are signatories to any MOU's or written agreements or clinical best practice protocols on transportation, coordinated referral system(interhospital or peripheries to higher levels) so that once patients land in causality unannounced hospital bed management is not an issue .A best practice accountability agreement must be a fair business bargain. That makes sense, doesn't it?If any administrator is being held accountable for improving staff/physician –patient moral, and the provincial government doesn't support their administrators how can these officers be held accountable for the results that such an atmosphere will produce?

Without having the necessary resources, conditions and skills to achieve the outcomes for which they are being held accountable. The existing concept and the process of accountability in our health care needs to be fundamentally redefined,reviewed or restructured between stake holders, words lead to actions and patients care improves in reality.
Are we really ready to change? The most important question that is pivotal today.

Following recent inquiries,commissions,expansions, mergers, restructuring on recent incidents , Are provincial politicians and their public servant rectors prepared to review, rethink how accountability is actually designed or integrated into our health care systems and improve structure and processes for achieving high-level outcomes in patient care. A paradigm shift in building tomorrow's healthcare policy plans and visionary mindset is required here without wasting our energies on finger-pointing, making scapegoats and we want media to play their role in addressing genuine demands on compromised resources the effectiveness of our entire healthcare system is neutralized and ultimate sufferer is patient.

(Dr. Fiaz Fazili is Consultant Surgeon and Healthcare Quality Policy Planning )

Dr. Fiaz Fazili

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