doctors protest 311.
(photo credit: Marc Israel Sellem)
As an observer of the ongoing interruption of medical services due to striking
physicians I, like many others, feel great sorrow at the suffering of patients
and their families. However, unlike most, I blame the physicians themselves. The
attitudes and behaviors of the physician unions and their supporters in the
Knesset remind me of the story of a man at a party who grabbed the food from the
plates of all the other guests, and after having gorged himself had the audacity
to complain that because of them, his belly hurt.
Effective patient care
is dependent on the collaboration of physicians, nurses, multidisciplinary
therapists, social workers and myriad support staff. Patients and their families
depend on the teamwork of all these highly trained, competent and caring
clinicians, each recognizing professional boundaries and respecting the
expertise of the others.
Unfortunately, Israel’s medicos all too often
overlook, to the detriment of patient care, other health-care
A central theme of the current strike is that physicians
are overworked, especially in medical/surgical wards. Unrecognized, however, is
the fact that the physicians are merely reaping what they have
Physicians have shut out other health professions, usurping their
duties (and often performing them at a less-competent level), all while
bemoaning increasing workloads.
CASE IN point, immediately before the
current strike: Channel 2 aired a documentary in which a film crew followed two
young residents during their long shifts in an internal medicine ward and ER in
a large hospital. I imagine most viewers felt the frustration and concern of the
poor resident as she stood alone in a room with an acutely ill patient in need
of respiratory support, or felt pity for the young physician who, while
exhausted, woke up after a short rest to take routine blood from patients on the
I felt no pity for the physician, as I know something most don’t.
Her being overworked is her own fault, and the fault of her colleagues. Why in
the world is the resident taking routine blood? That isn’t her job. That is the
function of a phlebotomist.
No self-respecting western hospital requires
physicians to take routine blood.
Are you tired, doctor? Maybe you should
ask your hospital administrator why you have taken the job of a technician. Ask
your medical director why he or she requires you, a physician, to wake up and
perform a task that’s not yours.
Why is the resident alone with the
acutely ill patient? Because the medical unions and their supporters have
blocked the efforts of other highly qualified healthcare professionals to share
the load and improve patient care. The resident was alone in that room because
the respiratory therapist – the expert in airway management and ventilator
support – had her patient-care role stolen, leaving her to deal only with
maintenance of ventilators and tubing changes.
Instead of having a fully
qualified professional assist you and improve the level of care afforded your
patient, you chose to be alone.
From the registered nurse in the med/surg
wards, you took physical assessment, care planning, case management and critical
thinking, IV care, Peripherally Inserted Central Catheter (PICC) insertion and
wound care, patient and family education, leaving the RNs on these wards to
function at the level of unlicensed support staff.
You, with the
complicity of the nursing unions, have retarded nursing in Israel so that we are
generations behind the rest of the western world.
Because of you, there
are no clinical nurse specialists, no nurse practitioners, no doctoral programs
in nursing, no Certified Registered Nurse Anesthetists (CRNA). You even have the
gall to cry about the lack of anesthesiologists, and how operations are
postponed because of this, while hypocritically closing the door to any
development of a CRNA position to assist in operating theaters.
the Physician’s Assistants (PAs)? You won’t allow them.
Who suffers? The
When a rape victim arrives at an ER at two in the morning, why
is she examined by a sleepy surgical resident? Where is the Sexual Assault Nurse
Examiner (SANE) who has dedicated her career to the competent care of sexual
assault victims? I asked that question a few years ago to the director of a
leading rape victim assistance program in Israel, and was told that physician groups
opposed the development of a SANE licensure program.
Who suffers? The
Hey doctor, you complain of being overworked? You say patients
suffer because you are so tired? How about looking around at the well-trained
and eager hands of your paramedical colleagues? Stop shutting us out. Let’s work
together. Until then, reap what you have sown.The writer is a
hemodialysis nurse, a clinical instructor/nursing educator and paramedic.