Garth Rattray
ON FEBRUARY 17, 2005, my brother-in-law lay dying in Ward 8 of the University Hospital of the West Indies (UHWI). I was making my usual way to the ward to see him, update myself on his condition and to take part in any vital decision-making that might have arisen. I was unavoidably detained and so I arrived at the security gate to the wards at 8:08 p.m. Affixed to the chain-link fence is the sign, "This gate is closed to the public between 8:00 p.m. and 6:00 a.m. By order management" Consequently, the guard barred me from entering and all I got for showing him my Medical Association of Jamaica (MAJ) ID was, "Dat nuh mean nuttin here". I managed to talk my way in and copiously expressed my gratitude.
I wrote to the chief executive officer (CEO) of the hospital and had the letter hand-delivered on February 18. In it I explained that patients benefited best when medical personnel work as a team. I made it clear that patients wanted and sometimes needed visits from their personal physicians even when they were temporarily under the care of someone else. Whilst among strangers, they crave our reassurance. I informed her that we can provide valuable information and insight into the health of our patients because we know more about them than anyone else. I petitioned her to direct the security personnel to allow "outside" medical doctors with MAJ ID's passage to the wards past normal hospital access hours, within reason (as pertains on the Tony Thwaites Wing a few metres away). We pose no security risk. Besides, the staff nurses and attending physicians are always extremely accommodating to doctors that need to visit with their patients and/or speak or meet with the medical staff overseeing their hospital care, even outside posted visiting and access hours.
LONG WAIT
I waited almost two months for a reply or for the common courtesy of acknowledging receipt of the letter. I wrote a second letter repeating my petition and had it hand-delivered on April 11 but the CEO opted to ignore me and the petition once again.
On the evening of July 2, a long-time patient called me crying hysterically. She was on Ward 4 and experiencing all the horrors of total renal failure from complications of Systemic Lupus. She was in full-blown depression, swollen beyond measure, short of breath, in pain and panicking. She wanted to see me because she felt that she was about to die. It broke my heart to tell her that since it was just about 8:00 p.m., the security guards would turn me away if I attempted to visit with her. This prompted me to put my concerns in writing to the chairman of the UHWI board the next day. I delivered letter number three in person on July 4.
He too has ignored me. I even called the office of the CEO (the only portal of communication with the chairman of the board) and left all my contact numbers but no one has had the good manners to respond.
LITTLE TO DO WITH ME
This matter has very little to do with me (as one individual). It has everything to do with the health and well-being of all patients. Since anyone can masquerade as a doctor over the telephone, if a general practitioner (GP) wishes to follow the progress of a patient or to pass on vital information to the hospital staff, he/she often has to go onto the wards in person. By restricting "outside doctors" to the 8:00 p.m. security curfew, the UHWI administration has decided that GP's are a security risk and have little or nothing to contribute to the care of their own patients.
It disturbs and surprises me that the administration of our premier medical institution, the University Hospital of the West Indies, obviously knows nothing of the essential role of the family physician in the continuity of care. Totally ignoring valid concerns from anyone (let alone a medical practitioner) reeks of arrogance. Alienating GP's may cause unnecessary suffering or worse. Hospitals are supposed to do everything possible to assure good patient care.
Dr. Garth A. Rattray is a medical doctor with a family practice.
