CAVEAT EMPTOR IN MEDICINE

CAVEAT EMPTOR IN MEDICINE

BY EWALT AINSWORTH              06 25 2012

Patients are not clients and or customers.   Caveat emptor should not be the governing principle in medicine according to a practicing attorney in GT in an invited comment this week.

When dealing with clients and citizens in business the underlying watchword is caveat emptor… …buyers beware.  As it relates to patients it should be do no harm rather than do less harm as seems to be the case.

Patients are growing “naked- scared” of the hospital and are more scared about the lack of health care than they are of finances and employment.    Access to health care is headline news and is on the lips of all especially in GT where productive age citizens are migrating so as to get money and meds to take care of their parents and their children who are left behind.  Official figures are not available, and may not be kept but the problem exists and persists.  Not talking about it is just as bad as not doing anything about it.

Families have to try poultices, bush, obeah or even just do nothing rather than seek medical attention.  Trying the old-time thing takers precedence over visiting the emergency rooms or regional hospitals where the outcome is oft times costly and discriminatory.

The medical system is rife with inequities.  There may be the needed equipment and facilities but not the required and desired staffing.  There may be the staff but not the aptitude to perform certain specialized procedures.  Wellness is never guaranteed or an anticipated outcome.  Life has becomes cheap and death is just another treatment option.

The horror stories are many.  Patients have to provide their own bed pans, sheets, gauzes, pharmaceuticals, medications, meals and even bed.  Relatives have been complaining of their loved ones dying overnight and the staff transferring them to the mortuary without informing them.  They only hear by accident a few days later after family go missing. More disturbing is that the linens the patient dies on are not changed but straightened out for the person next in line.

Medical refugees are now a reality.  Perennially sick patients are following their doctors to North America and checking in to the hospitals without the necessary coverage and appointments and hoping for the best.   Inner city hospitals are turning away these patients in the light of severe austerity moves.  Churches too have been helping their congregations by hosting dinners, cake sales, rummage sales, concerts and other fund raising events.

Some years ago the PPP slapped a ban on philanthropic Guyanese donating equipment, drugs and money to the hospital.  The premise for this refusal was more about underlining the charitable nature of one ethnic sector as against another.  Talk half, leff half.

It is very unfortunate that in Guyana no one takes time to measure the level of harm, the inequities in the way health care is dispensed.

The system has the potential to be great but unfortunately the issues of ideology affects who lives and who dies.  One way of cheapening access is to mount vigorous education programs about speed limits, setting up zebra crossings, cooking with a minimum of oil, eating fresh foods, drinking less and curbing domestic abuse among other things.  Biking, swimming and walking in the city and urban communities should be given greater priority rather than using the banks as money-laundering counters putting in jeopardy the fragile health care system.

Too many guns are in the pipeline and there seems to be an institutionalization of the bad-boy mentality and so grown men and women are now launching out on encore activities thus putting themselves at tremendous risk all as a result of poor leadership and a direct spin-off of endemic corruption.

Last week a prominent lawyer had an accident.  In times past a helicopter would be dispatched and a team of trained medical technicians would be present to offer comfort and emergency treatment.  Guyana wants to attract tourists and security for all it s citizens but there is a commensurate felt need to provide certain basic medical creature comforts.  Timehri airport used to be the principal out-station of the GDF and used to have a medical corps.  These days the Army moves around in hired mini-buses and the nearby Fire Department only gets fuel when there is surplus left over from airlines.

Attorney and Former Lt Colonel Gregory Gaskin was picked up by a medical taxi and chauffeured to a city hospital.  Investigations conducted privately seem to suggest that there is a felt need for certain basic infrastructure and systems to be put in place to attend to all emergencies.   Mr. Gaskin had a low-speed motor cycle accident at the South Dakota circuit and died some time later even though he had declared himself “okay.”

Investigators are also suggesting that sirens and proper bold markings/colors should be painted on emergency vehicles.  Guyana has been adding 10,000 new vehicles annually but there has not been the creation of any new highways in 40 years.  Some roads have been expanded but neutralized because of the addition of unbridled vehicular traffic.  Every hour is now a rush hour and trucks for example are quarantined between 7.00 am and 9.00 am in the mornings and 4.00 pm to 6.00 pm in the afternoons.  Politicians and a privileged few if caught in traffic can dial a certain number and the Police outriders are obliged to cherry pick and create an express lane.  This facility was not extended to the former Lt Colonel.

In certain medical facilities in the diaspora, nurses and doctors are confronted with disciplinary for not smiling with patients.  There are mirrors and technology devices set up to ensure that there is equity and not discrimination or dereliction of duty.  Doctors have to click a mouse each time he asks a question.  There is an a-la-carte list of things all attendant medical staff have to complete and at the end of the day, the patient is handed a list verify and qualify the level of service ranging from excellent to poor.

In the medical system in GT there is so much to be desired.  The Hippocratic law has been thrown thru the window and it is the political affiliation that counts.  Too often, too many people die or are made worse even though they may be in the care of the medical system.  That is bad.

There have also been some little good things.  Last week a Guyanese man from Brooklyn who had a confirmed ticket to travel to Timehri, mistakenly put crazy glue in his eyes in error for his drops.  He was taken to two different medical facilities and they were both unable to  un-glue his eyes.  The patient persevered and travelled home and was able to get immediate attention and now he can see.

This should be the experience with every patient and not the woes and wusses you hear about day in and day out.

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