PERSONAL OPINION ON MMED PRE-ENROLMENT PROFESSIONAL INDEMNTIY COVER

The now entrenched demand that those who apply for masters straining in clinical subjects obtain indemnity cover had generated more heat than light. Many an applicant would like to know why this is paramount before one is even considered for interviews.

From the onset, my personal opinion about this requirement is a big nay. Professional indemnity takes over in cases one, practicing on their own is involved in a legal suit arising from acts of omission or commission while discharging duties of their profession.

For started, persons applying and joining teaching hospitals do so to be taught and are not in any way entitled (whatever they do in these facilities cannot be termed as private practice) do private practice.

It is therefore expected that these apprentices who act and discharge their duties at the behest of their tutors are at all times guided and whatever they do is at all times interrogated. Thus the teachers must indemnify the trainees by bearing overall responsibility. Moreover, the teachers in medical school do not in any way participate in deciding who presents for treatment, procurement of supplies and support services and overall quality of care. Thus, to indemnify trainees on the assumption that the working and/or training environment is in a way that favors best practices is sheer naivety.

So who should take responsibility in indemnifying against unwanted treatment outcomes? My considered opinion is that the training facilities ultimately should bear overall responsibility. They are the custodians of quality and all attributes of quality, processes, staffing and procurement processes. In addition, they define the nature of patients who patronize their facility. Hence it cannot be that having envisaged possible shortcomings in their quality assurance, the training institutions would rush to demand legally unfounded indemnity

That said, the training facilities act with absolute discretion to determine what to demand and what not to demand for. Furthermore such single handed decisions are passed to training institutions who are arm twisted to pass it to trainees without raising queries due to loosely crafted memorandum of understanding. The same MOUs allow universities turn a blind eye when hospitals mistreat, discriminate and intimidate their students due to fear of unspecified consequences

Finally, there is one entity that should define this ranging debate on PIs as prerequisite for application and short listing for post graduate training. This is the courts! The regulatory bodies such as Medical Board and Poisons Board lack locus standi to dictate to other state agencies and training schools and hospitals on what to list as minimum requirements for application. At best these interested regulators can provide an opinion what may be adopted on ignored by the universities/training hospitals. And that is my opinion

Why Dont We Appreciate Our Doctors?

Sociologists world over have argued on the critical role played by praising anything good done. Conversely, reprimanding wrongful deeds have their own role(s). These two mirror images constitute what is called positive and negative reinforcement respectively. Positive reinforcement encourages and motivates repetition of actions that are good and generally accepted while negative reinforcement acts are a deterrent to repetition of such undesired habits. This forms the core of socialization process.

It is human nature to expect that one is acknowledged and appreciated after they put emotional and mental effort to achieve a certain desired good. Moreover, some professions deal with key fundamental services that determine the overall well being of the society.

Such sector is health sector. Any time there is a catastrophe, every one, all and sundry look upon doctors to alleviate human suffering; to treat and heal the afflicted. It ends there whenever all is well until another disaster happens. This cycle of ‘recognition’ at the height of stress and suffering and aloofness at good times should concern many consumers of health care services, both preventive and curative.

It thus shows why the lack of positive reinforcement has adversely affected the morale and commitment among medical practitioners. This unfortunate phenomenon is not a Kenyan or African one. The glaring lack of recognition spans across the borders even to the most developed nations

In Africa, this couple with poor direct and indirect remuneration of doctors has contributed to immense proportions of brain drain. The continent loses its most qualified health workers every day. And sadly, all the health indicators keep point southwards.

Why has there been no initiative to identify the trail blazers in health sector and recognize them? Why doesn’t the public systems and recognition awards ever isolate a doctor who has spent decades toiling with a sole purpose to improve health of the masses? How comes every day we inherit the look warm attitude towards doctors who literally superintend over our individual and collective well being?

Is it possible just to say thank you to our doctors even without solicitation more so at times when things are still? Who exactly is supposed to introduce this revolutionary culture of “saying thank you”? We stand accused as a population, as professionals, at middle class. And as decision makers

A time comes where the public and the players in the sector comes up with a scheme to “say thank you” to our iconic ladies and gentlemen, the ever hard working doctors, the literal custodians of health and wellness.

It shall be done… in the near future.

And during our times.