Hossam Badrawi Official Website
Wednesday weekly dialogue
“The greatest and most worthy of appreciation”
Written by Hossam Badrawi
The medical profession and serving patients is one of the greatest and most worthy of appreciation. But as it happens in everything around us, knowledge and the means of obtaining it have evolved, the teaching of medicine has evolved and digital has overlapped in it, and the means and speed of providing services have changed. The doctor, nurse, and support services all work in harmony and integration, and building the health system of any country depends on a digital administration that has 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 research and development teams, and health insurance systems that ensure financing is sustainable.
The young man, a 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 fleeing from being appointed to the Ministry of Health, while the majority is looking for travel to Europe and America.
I said: I know that, although working in the university or in the Ministry of Health gains experience and opens ways to excellence and obtaining higher degrees and then being appointed as faculty members or consultants, which raises stature and increases honor.
His colleague laughed and said: Times have changed, Doctor. The unfair treatment we face from patients’ families and the media, without appreciation for our inhumane working hours or our meager salaries, which do not open homes or allow life to begin.
.. He turned what was a demand and goal into a rejection and escape from junior doctors
One colleague said: I read about a member of parliament attacking doctors in their workplace, accusing them of negligence, and before them were living presidents and governors. Are all of these people unjust?
I said, my friend, what you do not know is that doctors are faced with two things: a shortage of supplies, which they often buy with their own money, continuous working hours, and large numbers of patients, and they have to face an angry public, for which the doctor is sometimes held responsible for something that is not his fault, for the death of a relative, or a lack of capabilities, or The occurrence of complications that are accepted by science and the profession
He said: Doesn’t the Doctors Syndicate defend them and take care of them?!
I said: As I see, the union has its hands tied, and there is coldness between it and the Ministry of Health. Their letters are not responded to, their suggestions are not discussed, and the state does not give importance to their intervention. It is the union that represents the profession…
He said: Is it a Muslim Brotherhood union or what?
I said: No, but rather a moderate civil movement…
One of the doctors who dream of tomorrow said: For hours, I feel that there are parties in the state that do not prefer to deal with the moderate civil current, which agrees and disagrees sometimes, and requires effort and culture in dialogue and persuasion, and they find it easy to deal with those who can be accused. Doctor, I see that this is part of the weakness of the state administration. It is the intolerance of differences of opinion, and the division of people into loyalists, semi-servants, hostiles, and semi-traitors.
I said: The captain is a distinguished, respected professor and was deservedly elected twice, and before that, he was dean of the Faculty of Medicine at Kasr Al-Ainy, and the union’s board of directors represents me and every doctor in Egypt. Respect for the union is our respect as a group of Egyptian doctors, and it is unthinkable not to cooperate with them
I added, I understand what you are saying, my son, and the extremist’s argument is always based on the inability to disagree and the lack of knowledge that allows dialogue, but we have a role as doctors and therapists to expand our hearts, as the profession still has respect and nobility.
She went on to say: Let us be positive. The country needs qualified and experienced medical staff, so what do you suggest?
The newly graduated doctor, who is passionate about 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 government, private, and armed forces, from 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, including about 130,000 doctors in Egypt and the rest outside Egypt as a result of secondments or emigration, which has been increasing steadily in recent years, especially after the doors of many countries were opened to receive Egyptian doctors. Welcoming them, and my information is that thousands of travel visas are given to doctors to Europe and America to cover the needs of these countries.
If we consider the international standard as 1.8 doctors per thousand people, then the ratio of doctors to the population in Egypt is 1.3 doctors per 1,000 people, and therefore, our percentage is not far from the international standard.
I said: This is a generalization that may distort the results of the statistics because according to my knowledge, the number of doctors in the government (in the Ministry of Health) is according to the last census I read, and the capacity deficit of about fifty thousand doctors may have changed.
This deficit is increasing as a result of the migration 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 added:
– Another important point in the deficit, as it results from the imbalance in the distribution of doctors among the governorates. Not to mention the absence of some specialties such as family medicine, anesthesia, intensive care, etc
My friend 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. It is unreasonable that after 15 years of study, training, and diligence, the salary of an intern doctor would be 2,200 pounds per month and about 3,000 pounds for a resident doctor, and that the work and housing environment available to them would be unsuitable in the governorates. However, I must attest that there is interest that began to appear before and increased after the Corona crisis
– 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. Before the Corona crisis, we noticed the number of repeated attacks, beatings, and insults against doctors and daily attacks on health facilities without deterrence, which hurts and saddens me.
My friend said: I heard you more than once talking about the role of the Ministry of Health changing from what it was, so what did you mean?
I said: The ministry has to lead the provision of primary health care services, through it or in partnership with the private sector, provided that the cost is borne by the health insurance system. The state is the regulator of service delivery and not the provider. It takes care of quality and sets its standards, collects and analyzes data, and implements the declared state policy. It is also responsible for public health, healthy food and the environment, and resistance to endemic diseases, epidemics, and chronic diseases, and the catalyst for the healthy life of citizens. The ministry is the brain of the state in the health care of citizens, and it has finally succeeded in getting rid of the hepatitis C virus, as it has succeeded throughout history in getting rid of the country from schistosomiasis, polio, pulmonary tuberculosis and other endemic diseases, and its program in vaccinating children was successful and influential In reducing infant mortality rates and increasing the average age of Egyptians to 72 years, an increase of up to 20 years from what it was in the fifties. This is a cumulative achievement for the state that deserves praise, in the hands of its doctors and health staff…
The young doctor said: What is your opinion about increasing the number of doctors by graduating exceptional batches or converting pharmacists into human doctors to cover the shortage resulting from the escape of doctors and not the absolute shortage in their number..
I said: The graduation of an exceptional batch from medical schools represents a reality of thinking and a philosophy that I do not understand, and it has no equal. A physician, in order to be qualified to provide health services, needs at least ten to twelve years of education, training, and supervised practice. Graduating an exceptional batch does not mean that they will be graduated before their education or training is completed, which would be a disaster. As for converting pharmacists into doctors, it is possible, but it requires a new academic system, and I do not understand that a successful pharmacist will leave his respected profession, which young people are flocking to, to spend four new years learning the profession of human medicine. This is a naive perception unless it is intended to increase the number of clinical pharmacists, which is a pharmacist’s specialty and not a referral to a human doctor.
But what is possible now is a balanced distribution of doctors across the country, using incentives and not coercion 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 one that deserves respect and appreciation. The profession of integrated human care has its pillars in the wings of nursing, physiotherapy, clinical pharmacy, medical scientific research, and auxiliary and support services for the medical profession and the wise..
This is a time for solidarity between state agencies and representatives of health care services, not a time for disagreement. This is an invitation from me to everyone to listen to each other because we are partners in the nation
