Dr. Hossam Badrawi Official Website
The greatest and most appreciated professions
Hossam Badrawi
The profession of medicine and patient service is one of the greatest and most appreciated professions, but as happens with everything around us, knowledge and the means of obtaining it have developed, the teaching of medicine has developed and digital has become intertwined with it, and the means of providing services and their speed have changed. The doctor, the nurse, and the support services all work in harmony and integration, and building the health system of any country depends on digital management with a vision, an expensive human infrastructure, long years of study and training, and sustainable financing. Universities, their health institutions, and their research and development teams are at the heart of this, as well as health insurance systems that ensure sustainable financing.
The young medical school graduate said to me: Do you imagine, Doctor, that the top students in the class do not want a job at the university now, and are running away from being appointed to the Ministry of Health, and the majority are looking to travel to Europe, America and the Gulf.
I said: I know that, although working at the university or the Ministry of Health gains experience and opens the way to excellence and obtaining higher degrees and then being appointed as faculty members or consultants, which raises the stature and increases honor.
His colleague laughed and said: Times have changed, Doctor.. The unfair treatment we encounter from patients’ families and the media without appreciating our inhumane working hours or our meager salaries that do not open homes or allow for the start of life has made what was a demand and goal, a rejection and escape from young doctors.
And now we read about a new law to regulate the profession, whose philosophy is unfortunately to increase penalties on doctors without distinguishing between negligence, medical error and complications that may occur as a result of the procedures known in medical and surgical practices, and to rush to imprison doctors.
I said: What society does not know is that doctors face two hardships: a lack of supplies in public hospitals, which they often buy with their own money, continuous working hours, and a large number of patients, and they have to face an angry public that sometimes holds the doctor responsible for what he is not guilty of, such as the death of a relative, a lack of resources, or complications that science and the profession accept.
The number of human doctors, according to the latest statistics from the Doctors Syndicate, is about 240,000, of whom about one hundred thousand doctors are in Egypt and the rest are outside Egypt as a result of loans or immigration. It has been steadily increasing in recent years, especially after the doors of many countries opened to receive and welcome Egyptian doctors.
And my information is that thousands of travel visas are given to doctors to Europe and America to cover the needs of these countries, and there are about one hundred thousand Egyptian doctors in the Gulf, especially in Saudi Arabia.
There is an important point in the deficit in the number of doctors relative to the population, resulting from the imbalance in the distribution of doctors across the governorates, not to mention the absence of some specializations such as family medicine, anesthesia, intensive care, etc.
The brilliant young man said: So it is a matter of human resources management.
I said: The flight of doctors may be closely linked to the art of management, but it is also linked to the material and moral return and the financial and academic attractions in the world.
– I added: In my opinion, the moral appreciation and protection of the doctor is the most influential element, and its absence may be a direct reason for our understanding of the migration of doctors and their abandonment of their work. We have noticed the number of repeated attacks, beatings, and insults against doctors and attacks on daily health facilities without deterrence, which pains and saddens me.
One of the young doctors said: I have heard you talk more than once about the change in the role of the Ministry of Health from what it was, so what did you mean?
I said: The ministry must lead the provision of primary health care services, through it or in partnership with the private sector, with the health insurance system bearing the cost. The state is the organizer of service provision, not its provider, the guardian of quality and its standard setter, the data collector and analyst, and the implementer of the declared state policy, as well as the person responsible for public health, healthy food and the environment, combating endemic diseases, epidemics and chronic diseases, and the motivator of healthy living for citizens. The ministry is the mind of the state in providing health care for citizens, and it has recently succeeded in eliminating the hepatitis C virus, as it has succeeded throughout history in ridding the country of schistosomiasis, polio, tuberculosis and other endemic diseases. Its child vaccination program was successful and effective in reducing child mortality rates and increasing the average life expectancy of Egyptians to 72 years, an increase of 20 years from what it was in the fifties. This is a cumulative achievement for the state that deserves praise, at the hands of its doctors and health staff. If we intend to reform, then the human factor in health care, including doctors, nurses, professionals and managers, is the greatest concern. My children, this is the greatest profession and the most worthy of respect and appreciation. The profession of integrated human care, its pillars are in the wings of nursing, physical therapy, clinical pharmacy, medical scientific research, and auxiliary and support services for the medical profession and the wise..
Everyone asked me about my opinion on the new law to regulate the profession, so I said:
I read and agree with what my friend Dr. Osama Hamdy, a graduate of Mansoura University and a distinguished professor at Harvard University in the United States, wrote in a comment on the law regulating the noble profession and the noise around it and the position of the Doctors Syndicate entitled “What next, wise men?”
He says and I agree:
It is important that every complaint, regardless of its source or recipient against the doctor, must be “filtered” first by the General Medical Committee or the Supreme Medical Liability Committee before or when it is presented to the Public Prosecution and within a specified maximum period, in order to avoid blackmail, malicious complaints and deliberate distortion of the doctor’s reputation before litigation, as well as to avoid the accumulation of thousands of complaints, despite the judge’s monopoly on the ruling – as required by the law and the constitution – which is of course what we support due to our confidence Complete in the Egyptian judiciary, the opinion of a special medical committee of consultants “in the same specialty” is of utmost importance in determining the seriousness of the medical error or gross medical negligence, even if it is not binding on the judge in his ruling, and in the West the judge usually takes it into account for specialization.
I commend the abolition of the prison sentence for doctors for unintentional medical errors, as no doctor is infallible from mistakes, whether small or large.
We must differentiate between medical errors and gross medical negligence in definition and punishment.
We must also establish a deterrent punishment for those who attack doctors and medical facilities verbally and physically.
We must differentiate between fines and civil compensation, as doctors do not commit a mistake against the state to pay a fine in the event of medical errors, and their cases are not crimes as amended. The court must only rule on civil “compensation” that is paid to the patient and his family from insurance companies for professional errors as is the case in the West, and it is sufficient for the cost of legal proceedings.
There is a big difference, gentlemen, between gross medical negligence and intentional harm, and imprisonment for doctors is only if the judge sees that he committed the crime intentionally, i.e. “intentional harm.”
We must also hold the institution or medical facility responsible and punish it in the event of institutional negligence (such as The lack of medical supplies, the lack of safety of equipment, the lack of availability of medicines, the lack of qualified medical staff, the lack of supervision of good training and performance), so the responsibility in many cases of gross negligence is a joint responsibility between the doctor and the medical facility, and both bear it together in varying proportions.
Once again, the definitions must be carefully set with examples (what exactly do we mean by the word medical error?, gross medical negligence?, and intentional harm? And respecting the percentages of possible complications in each medical procedure).
It is necessary not to put in place an elastic law that accepts interpretations and explanations so that it becomes a problem in the future, such as “without prejudice to a more severe penalty stipulated in another law”, because although there is no other law now with a more severe penalty – to my knowledge – there is no guarantee that other laws will be enacted in the future with a more severe penalty, and applied to doctors.
I believe that if the draft law was amended to include these points, it would have relieved everyone, achieved the desired and required balance, preserved the doctor’s right, guaranteed the patient’s right, resolved the current conflict without agitation or exchange of accusations, and restored friendship and familiarity among everyone. A fair law is a requirement for everyone, especially since it is the first law that protects the doctor and the medical facility from verbal and physical assault and protects society from those claiming medical knowledge, with the necessity of preventing doctors from advertising themselves in windows in the streets as if their specialty is a commodity that is bought and sold, and holding accountable and preventing paid television programs from some doctors, many of whom do not have the necessary qualifications to express an opinion on specialties or advertise treatment methods without a recognized and documented medical and academic reference.
This is the time for solidarity between state agencies and representatives of health care services, not the time for disagreement. This is an invitation from us to everyone to listen to each other because we are partners in the homeland.
We attach a link to this video related to the topic of today’s article:
https://www.facebook.com/share/v/15rieyeKM3/?mibextid=wwXIfr
