Friday, September 16, 2011

Doctor-Doctor Ethics

This essay is a Call for the Practice of Ethics by Nezer A. Soriano.

Ethics has been one of the common venue of discussion between medicine and theology. This is especially true in matters of medical ethics where the doctor and the patient relationship is at stake. But for today, let me focus in one aspect that is often relegated to the sides by most doctors. Relegated? You might ask. YES! Because most doctors throw out their ethics when it comes to doctor-doctor relationships.

Human pride is one of the pitfalls of human nature. But this is not an excuse to disrespect others. That is why a physician is virtuous enough to know what to do and how to foster good relationship with ones colleagues. Yet, young doctors and even their mentors get drunk of their title as doctors that they forget their ethics.

In the Ospital ng Maynila, the doctor-doctor relationship is amiss. I pray that this is the only place that ethics is an issue. But the reality is, even in PGH, Western Visayas MC and SPMC, ethics of doctors towards fellow doctors are problematic. (Often times a referral from a municipal health officer faces the same issue - added). Maybe these hospitals being government run is a factor to the problem. But that issue warrants another article.

At one time, a patient came in with a referral letter from a family physician for the pediatric patient to be admitted because of Dengue. The pediatrician refused the patient to be admitted because she did not see any indication for the patient to be admitted. The pediatrician may be right and she has all the right reasons for refusing the request for admission. What went out of bounds was her remark against the referring doctor. She commented that the referring doctor is ONLY a family physician and his decisions should not be accepted. Here, the pediatrician is obviously insinuating that the other doctor is inferior to her. More than that, she shows disrespect by maligning the knowledge and the decision of her colleague. Hers is one example of utter DISRESPECT that have plagued the medical practice in hospitals. We, as doctors, have forgotten the basic principle in our code of conduct - that we should work together in harmony and mutual respect.

Another example of disharmony in the workplace of doctors is the referral system in government hospitals. (For more ethical issues young doctors encounter, click here). I will emphasize the government hospitals, because these things rarely happen in the private setting. A surgeon refers his diabetic patient to the internist for control of the blood sugar and clearance for surgical procedure. The internist delays seeing the patient, as a retaliatory act to what he claims the surgeon is doing whenever he refers also for surgical clearance of his patients suspected of having surgical abdomen. The patient is the one suffering from such behavior of doctors. The patient, of course, complains his surgeon to the hospital authorities for not being able to refer and resolve his case quickly.

The most common problem perhaps, leading to the numerous malpractice suits, is the side comments doctors make to their colleagues. An example is the Internist who saw a Pulmonary TB patient who sought second opinion after being seen by a private doctor. The Internist comments to the patient, "do not seek consult to this doctor again. Did you know that it took him several years to finish medicine because he flunked his subjects. Look, he did not even recognize that you have tuberculosis. And why did he give you pulmonary medicines that can compromise your liver. That doctor will just make you more sick." Such comments are unwarranted, but in reality, such comments exist. What virtuous doctor in their right mind, would comment such derogatory remark about their colleague?

In the quest to advance the practice of medicine, doctors have forgotten about their virtues and ethics. Ethics has been neglected for a long time. It is now the time to check the virtues of our doctors. A virtuous doctor can never and will never intentionally hurt his/her fellow human being, regardless if he/she is a patient or a colleague. We can never go wrong with a virtuous doctor. I encourage you to push and demand for our doctors to check their ethics, and be virtuous!

No comments: