The greatest and most valuable profession

The profession of medicine and patient service is one of the greatest and most appreciated professions. But as is happening in everything around us, knowledge and means of obtaining it have developed, the teaching of medicine has evolved and digital has overlapped in it, and the means and speed of service provision have changed. The doctor, nurse and support services all work in coordination and integration, and building the health system for any country depends on a digital administration with a vision, an expensive human structure, long years of study and training, and sustainable financing. At the heart of this are universities, their health institutions, and their research and development staff, and health insurance systems that ensure the sustainability of funding. The young graduate of the Faculty of Medicine said to me: Do you imagine, Doctor, that the first batch do not want a job at the university now, and are escaping from being appointed to the Ministry of Health, and the majority are looking to travel to Europe and America?

I said: I know that, although working at the university or in the Ministry of Health gains experiences and opens ways to excel, obtain higher degrees, and then be appointed as faculty members or consultants, which raises his stature and increases honor. His colleague laughed and said: Time has changed, Doctor.. the unfair treatment we receive from the patients’ families and the media without appreciating our inhuman working hours or our meager salaries that do not open homes and do not allow life to begin..

He made what was a demand and an end, a rejection and an escape from the junior doctors.

A colleague said: I read about a member of parliament attacking doctors in their workplace accusing them of negligence, and neighborhood heads and conservatives accepted them. Are all of these unjust?

I said, my friend, what you don’t know is that doctors are faced with the lack of supplies, which they often buy from their money, and continuous working hours and large numbers of patients, and they have to face an angry audience that sometimes carries the doctor what is not his fault, due to the death of a relative, lack of capabilities, or complications that he accepts. It has knowledge and profession.

He said: Doesn’t the Doctors Syndicate defend and take care of them?!

I said: The Syndicate, as I see it, has its hand tied, and there is a chill between it and the Ministry of Health. Neither their speeches are answered, nor their suggestions discussed, nor is their intervention given importance by the state. It is the union that represents the profession.

He said: Is it a Brotherhood union or what?

I said: No, but a moderate civil current.

One of the dreamers of tomorrow said: Hours, I feel that there are people in the country who do not prefer to deal with the moderate civil current, which agrees and differs sometimes and requires effort and culture in dialogue and persuasion..

I said: The captain is a respected and respected professor who was well-elected twice, and before that was the dean of the Kasr Al-Ainy Faculty of Medicine, and the Syndicate’s board of directors represented me and every doctor in Egypt with him. Respecting the Syndicate is part of our respect as a group of Egyptian doctors, and it is unreasonable not to cooperate with them.

And she added, “Let’s be positive.” The country needs qualified and experienced medical staff, so what do you suggest?

A recent graduate doctor with a passion for research and statistics said: The doctor shortage crisis is not real and its solution is not to increase the number of graduates, but rather to retain them. Statistics say that we have 30 medical colleges between governmental, private and armed forces, in which approximately 12,000 doctors graduate annually. The number of human doctors, according to the latest statistics of the Medical Syndicate, is about 240,000, of whom about 130,000 are doctors in Egypt and the rest are outside Egypt as a result of secondments or immigration, which has been steadily increasing in recent years, especially after opening the doors of many countries to receive and welcome Egyptian doctors, and my information is that thousands of travel visas are given to doctors. Europe and America to cover the needs of these countries.

If we consider the global standard of 1.8 doctors per thousand people, then the ratio of doctors to the population in Egypt is 1.3 doctors per 1000 people, and therefore, our ratio is not far from the global standard.

I said: This is a generalization that may prejudice the results of the statistics, because according to my knowledge, the number of doctors in the government (in the Ministry of Health), according to the last census in 2018, has a shortage of about fifty thousand doctors.

This deficit is increasing as a result of the emigration and resignation of a large number of doctors in recent years, she says. So the number of doctors is not the essence of the challenge, but rather the lack of doctors working in the Ministry of Health is the challenge.

Then she realized:

Another important point is the deficit, which results from the imbalance in the distribution of doctors over the governorates. Not to mention the absence of some specialties such as family doctor, anesthesiology, intensive care, and others..

My friend said: So it is a matter of human resource management.

I said: The flight of doctors may be closely related 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. It is inconceivable that after 15 years of study, training and seriousness, the salary of an internship doctor will be 2,200 pounds per month and about 3000 pounds for the resident doctor, and that the work and housing environment available to them is not suitable in the governorates, but I must testify that there is interest that began to appear before and increased after the crisis Corona.

– And 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 emigration of doctors and their leaving their work. Before the Corona crisis, we noticed the number of repeated attacks, beatings and insults to doctors, and attacks on daily health facilities without deterrence, which hurts and saddens me.

My friend said: I have heard you more than once talking about changing the role of the Ministry of Health from what it was, so what did you mean?

I said: The ministry should lead the provision of primary health care services, through it or in partnership with the private sector, provided that the health insurance system bears the cost. The state is the regulator of service provision, not the provider, the quality sponsor and setter of standards, the data collector and analyst, and the implementer of the state’s declared policy, as well as the person responsible for public health, healthy food and the environment, resistance to endemic diseases, epidemics and chronic diseases, and the catalyst for the healthy life of citizens. The ministry is the mind of the state in the health care of citizens, and it has finally succeeded in getting rid of the hepatitis C virus. It has also succeeded throughout history in ridding the country of schistosomiasis, polio, tuberculosis and other endemic diseases, and its program to vaccinate children was successful and effective in

Reducing child mortality rates and increasing the average lifespan of Egyptians to 72 years, an increase of up to 20 years compared to what was in the fifties. This is a cumulative achievement for the state that deserves to be commended, in the hands of its doctors and health staff.

The young doctor said: What do you think of increasing the number of doctors by graduating exceptional batches or transferring pharmacists to human doctors to cover the shortage resulting from the doctors’ flight, and not the absolute shortage in their number?

I said: The graduation of exceptional batches from medical colleges represents a reality of thinking and philosophy that I do not understand, and it has no parallel. A physician to be qualified to provide a health service needs at least ten to twelve years of education, training, and supervised practice. Graduating exceptional batches does not mean that they graduate before completing their education or training, which would be a disaster. As for the conversion of pharmacists to doctors, it is possible, but it requires a new academic system. I do not understand that a successful pharmacist will leave his respected profession, which young people seek, to spend four new years learning the profession of human medicine. This is a naive perception unless the intention is to increase the number of clinical pharmacists, which is a pharmacist specialty and not a referral to a human doctor.

But what is now possible is a balanced distribution of doctors over the country, using incentives, not reparations and insults.

If we intend to reform, 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 has its pillars in the nursing wards, physiotherapy, clinical pharmacy, medical scientific research, auxiliary and supportive services for the medical profession and the wise men..

This is a time for solidarity between state agencies and representatives of health care services, not a time for disagreement. This is my invitation to everyone to listen to each other because we are the partners of the nation.