Garth Rattray

I have always enjoyed an extremely good professional relationship with the medical staff at the University Hospital of the West Indies, (UHWI) but the administration's lack of 'outsider-friendly' systems in some areas is a matter that needs attention. This has been a source of distress and concern for many doctors in private practice. Because of haughtiness, unreasonable/oppressive protocols and persistent problems with communication, many physicians eschew that institution (to the ultimate detriment of their patients).

The health care of patients is being seriously jeopardised by security guards that triage (sort patients according to their urgent need for care) at the entrance to the Accident and Emergency (A&E) department. They decide who is sick enough to enter.

I would communicate with someone in authority at the UHWI about this dangerous practice that has caused suffering and may cost lives, but, in the past, when I complained about a situation with security guards, my three letters and one phone call (over a period of about eight months) were totally ignored. My piece in this newspaper on the subject and the subsequent public request from Mr. Danville Walker (the Director of Elections) for a response from the UHWI administration were similarly treated with disdain. The administration eventually responded to one of our medical associations on the matter.

The previous situation concerned my having to resort to emotive and persuasive arguments (begging) to see my dying brother-in-law (whom I had managed to get admitted into the hospital). I, a physician with identity and proof of my profession, was being denied entry although I arrived only seven minutes outside the visiting hours stipulated for the general public.

Confused patients

Admitted patients are often confused and frightened about what is going on regarding their diagnosis and management. Sometimes they ask the family doctor to find out about their medical status and they feel comforted when they see a familiar (medical) face. However, according to the dictum of the chief executive officer, outside doctors wishing to exchange information (vital or otherwise) about their patients must first contact the head of department or consultant in charge. Bear in mind that consultants are very busy people who often have private practices off-campus and (as a rule) know few details about individual patients unless the case is very serious, very interesting or known to him/her for some other specific reason. Residents are far more informed about the day-to-day status of their patients.

And, if an outside doctor wishes to visit with his/her patient outside the stipulated hours for the general public (but within reason), he/she must first contact the consultant and then the nursing Sister in charge of the ward and present 'appropriate' identification to a security guard (who we already know will only acknowledge UHWI IDs). This onerous onus placed on outside doctors to find out about their patients, to impart vital information about their patients or to console/calm their ill and frightened patients, is counter-productive to patient care.

Without summary notes

Additionally, patients often return to their family doctors (from hospitals) without discharge summary notes. We must therefore attempt to surmise what was definitively diagnosed and the severity of the problem from pill bottles (if we are lucky). Continuity of care is non-existent under these circumstances.

The UHWI Mission and Vision Statements place health (patient) care third in order of priority behind teaching and research. Perhaps that explains the administration's contempt for constructive criticisms aimed at the well-being of our patients.

Dr. Garth A. Rattray is a medical doctor with a family practice.