2023-09-10 13:39:56
Groups of doctors from different specialties work in the hospitals of Medellín: pediatrics, gynecology, orthopedics, surgery, emergencies, etc., and it is true that the work in these hospitals is enormous. The number of patients in each room exceeds the work capacity of the staff caring for them.
Hospitals and clinics need better direction from their directors, better control over employed physicians, and feedback. The staff must be ethical and the doctors, excellent directors of young medical apprentices. Unfortunately, this is not the case. In Medellín, and surely in some other parts of the country, doctors mistreat residents and students, who, in turn, when they rise in the hierarchy, give the same medicine to their respective pupils, and thus perpetuate the mistreatment.
After speaking at length with more than twenty medical students who do their internship in the different clinics and hospitals of Medellín, one comes to the conclusion that the doctors who work in these seem to have the intention of leaving their responsibilities in the hands of the students. and residents. Of course, with exceptions to the rule. In each of these hospitals there are also very good, responsible and educated doctors, but they are not the norm.
Let’s look at the most common and widespread forms of abuse with students in the Health sector.
Disrespect in verbal treatment with students and nurses. Confident treatment, often insulting. Some doctors make fun of the physical defects of their students and make jokes with other doctors, in the presence of the young people. One young woman was called the mustachioed one, and another, the chubby one. Some doctors flirt with nurses and students, and even go further. I know of one who slapped a nurse on the hip. The students were witnesses. There is neglect of the rooms, and work irresponsibility is rampant. Many doctors do not do rounds during the day, much less at night. “And call me if things get complicated,” they tell the students! When they have become complicated, it is almost always too late and there is no way to help the patient. They leave their responsibility in the hands of the students. Some doctors spend hours in their offices drinking red wine and watching the Internet. Some have students do the work they are supposed to do. I know of many students who, just at the end of the 12-hour day, before leaving, the doctor asks them for the favor of transferring their medical records to the computer. I know of doctors who paint their nails or go to the hairdresser during work hours.
Doctors do not take the trouble to explain to the patient, in simple terms, what he is suffering from. They ask questions that the patient cannot answer, because he does not understand them: Tell me what you feel? They treat the elderly as if they were a mentally retarded child. When the patient is of very low or no education, the doctor has the responsibility to ask the questions that will allow the patient to know what illness she has. Doctors respond rudely and eagerly to the patient’s needs. They yell at them and treat them despotically. They are especially harsh on the elderly and the poorest in society. Their treatment is cruel, with no compassion for the patient’s pain, hunger, poverty and condition. They show contempt for the patient’s ignorance or lack of schooling and even perform many procedures with physical roughness, increasing the patient’s pain.
Many times doctors do not read medical records. The most common complaints were made to me by students who had rotated in Gynecology, at the General Hospital of Medellín. There the law would seem to be “every man for himself”, whoever is in good spirits. I know of a doctor who had an inexperienced student suture a patient on whom he had performed an episiotomy. There is no right! How can it be that the care of a complicated birth is left in the hands of a completely inexperienced person? Even doing the sutures for an episiotomy requires expertise. Getting it wrong can forever damage a woman’s sex life and her ability to have other births. At least the doctor should have been monitoring the behavior of his student. I know of expressly rough treatment to deliver a baby in a difficult birth.
When residents and students get sick they have to go to work, because there is no planning in which alternate students are available to cover them in those cases and because an absence might be so catastrophic for those left to care for the patients that The sick student feels a duty to go, even assuming the risk of infecting patients who are sicker than him.
When will medicine modernize its practices, starting with rationalizing and moderating work hours and shifts. It has already been scientifically proven how a person’s errors increase when they lack sleep. But, apparently, there is no one who cares regarding changing things.
Nowadays, a person makes a purchase, and instantly receives a questionnaire in their email to find out how it went, how they were attended to, what complaints and claims they have. Hospitals and healthcare lack these healthy practices. Why? one wonders. Why are there no controls on doctors, on hospitals, on clinics, on care, on respect and treatment of the patient? This should be a norm. There is no possibility of progress without feedback. Nothing can improve without criticism of the system.
I removed the Pablo Tobón Uribe Hospital from the list, because the students I spoke with rated it very highly. Although the schedule is extremely hard for students and residents, the doctors carry out their work responsibly, and there is no mistreatment, since there are controls over each member of the staff. It is an exemplary hospital that controls its doctors and its inmates so that the establishment works as it should; at least when Dr. Aguirre was in his direction.
Anyone who has received abuse without questioning it considers it normal to perpetuate it. Things have to change. The golden rule is not only not to do what you don’t want others to do to you, but to act as if the rest of the world will act as you act.
Mental modeling or formalism: extraordinary creation of human culture
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