Last Updated: Tue Nov 02, 2010 20:05 pm (KSA) 17:05 pm (GMT)

The business of medicine

Nermeen Murad

The head of the Jordan Medical Association said this week that an accountability law for physicians must not be a “punishment” but a “preventive” law. He also said that doctors should not be made liable for all the medical mistakes that occur, because he believes the system as a whole bears responsibility for many failings.

I agree with the doctor on the need to work on prevention, and I certainly believe that there is need for a scrutiny of the entire medical system in the country. But I also strongly believe that this shouldn’t exonerate physicians from their responsibility within the system.

 Now that Jordan has become a destination for medical tourism, business interests have come into play and they have, so far, influenced this sector negatively by considering only quick financial gains rather than good long-term business strategies 

Personal responsibility cannot be removed and made into a collective responsibility. Any law that is seeking to address the issue of medical liability should certainly be taking into account both, on equal level.

The fact that Jordan has gained a reputation for providing excellent medical care in a professional and hygienic environment was not easy to accomplish, and came about only after long years of commitment by the army, the government, and pioneering doctors and surgeons who together built a solid and highly regarded system of medical care that has served us well.

Now that Jordan has become a destination for medical tourism, business interests have come into play and they have, so far, influenced this sector negatively by considering only quick financial gains rather than good long-term business strategies.

This downwards spiral must be controlled by the profession itself, not by placing more restrictions and devising dramatic steps for certification of doctors who studied abroad, but by setting service standards for the whole system. Good medicine and good business sense must come hand in hand to make a success of this venture, and people may pay today for a mediocre service, but they will quickly go somewhere else if doctors here don’t deliver.

 Smoking in hospitals should be completely banned. When I see doctors and nurses chatting and smoking in hospital cafeterias, I definitely wonder about the level of their responsibility for the health of the patient 

I am not a physician, so I cannot go into the details of medical care with any authority. But I want to point to what makes me, an individual, decide on where I am going to go for my care. The three rules, as far as I am concerned, are cleanliness, respect for the humanity and time of the patient, and reputable and responsible physicians or surgeons.

When I walk into a hospital, clinic or doctor’s surgery and find that the premises are clean, the staff is courteous and the doctor meets me on time and addresses my concern, that is when I feel that I could be a return patient.

Several measures should be addressed by those looking at reforming the medical system in Jordan.

Smoking in hospitals should be completely banned. When I see doctors and nurses chatting and smoking in hospital cafeterias, I definitely wonder about the level of their responsibility for the health of the patient. Visitation hours should be exactly that, times for visits and not long-term accommodation. Only children of the patient should be allowed in hospitals, so they don’t turn into noisy playgrounds for children. And doctors should separate their drop-in surgery hours, where one expects to wait, from appointments with patients, which are pre-scheduled and therefore should be respected.

 There is also this attitude - I think we all recognize it - where someone in front of you who is in the seat of power looks right through you as if you don’t exist; a temporary one, I might add 

There is also this attitude - I think we all recognize it - where someone in front of you who is in the seat of power looks right through you as if you don’t exist; a temporary one, I might add. So receptionists at doctor’s clinics, attendants in emergency rooms, nursing assistants in hospital wards, cleaners, etc., recognize that they have you under their authority for that moment, and they abuse that power.

The JMA head claims that there have not been any malpractice complaints against doctors and cites the ridiculously low number of 82 complaints, most over the rising cost of medical care or certain behavioural problems. I believe that if a group of people sat together and exchanged stories, they would come out with a higher number. The reason people don’t complain, unless there was a death or permanent injury, is that there is no legal recourse for making the doctors liable for their actions, and whatever recourse there is, it is a lengthy, protracted process that allows for the interests of several parties to come into play.

The JMA doctor has made valid points in addressing the very important issues of prevention and the need to upgrade the whole medical system. I also believe that the medical system could probably enforce some societal change by providing a superior standard of medical care within a more highly regulated system. That includes making the doctors themselves legally liable for their actions. Accountability is the only route to credibility and that is the one ingredient that will keep our medical services/tourism viable.



* Published in Jordan's THE JORDAN TIMES on July 13, 2009.

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