|Category: Health Care
||Date: 19 Aug 01
In the blockbuster film
Men in Black, a powerful but shadowy organisation was able, through its
control of information, to silently wield power over an unwitting
Here in Trinidad and
Tobago, our Men in White Coats in the medical profession appear to be
represented by organisations that operate in a similar manner.
This week, I was going to
get into a draft Patients Bill of Rights as promised. But the deeper I
waded into the quagmire of the two bodies that represent the medical
profession, the more complex it got, with many false trails and political
and financial agendas, with a cadre of doctors of the old guard who are
terrified of change and who prefer to deal with the issues raised in this
column with personal and sexist attacks at the columnist, rather than with
serious discussion that would propel their profession forward.
But this obfuscation only
redoubled my determination to find the answers to my questions: “Who
will take responsibility for the medical profession, and who will bring
I am aware there are
hundreds of highly-qualified, dynamic doctors in this country who live the
code of ethics and follow the patient’s charter as a matter of course;
that every day, doctors see and bring relief and hope to hundreds of sick
people and their families; that there is compassion, and lives are saved;
that the excellent doctors among us have either practised abroad with
systems like the patient’s charter and code of ethics or continually
upgrade their skills.
But I am also aware of the
Men in White Coats. They are the ones who are
in it for the money, power, social standing; who close ranks, protect
their turf and can’t be bothered to upgrade their skills. Neither group
will deny what I am calling for is systems.
Even if one patient dies
under the care of a doctor, it is too many. Even if one doctor regularly
breaches the code of ethics, it is too many. Absolute power for a few is
terrible for the profession and inevitably can corrupt absolutely and
tarnish the entire profession.
In my quest for answers, I
sent out letters early this week requesting basic information and comments
from Dr Omar Ali, secretary of the Medical Association and Dr K Mungrue,
secretary of the Medical Board; these were copied to the Minister of
Health, Dr Hamza Rafeeq and Lennox Grant, Editor-in-Chief of the Trinidad
The following is an
extract of the letter:
Please find enclosed four
columns, an editorial and a viewpoint by Professor Syam Roopnarinesingh
regarding the perceived need for checks and balances in the medical
fraternity. Included in one of the columns is a patient’s testimony of
I would be grateful if you
commented specifically on the following questions raised in the columns.
If you are unable to give me a comprehensive response by Friday, a brief
initial comment and an idea of when the full response will be delivered
will be appreciated for this Sunday’s column.
“Could you give me a list
of the names and contact numbers of the members of the Board of Medical
“How often does the
Association/Medical Board meet? Are the Association’s Board/Medical
Board’s minutes available for public perusal?”
“We understand that a code
of ethics for doctors is in place. Is it possible to get a copy?”
“What is the complaints
procedure if there is a perceived breach of the code of ethics?”
“Does the Medical
Association/Medical Board deal with malpractice issues? If the answer is
yes, what is the formal procedure through which the Association handles
claims of malpractice?”
“For the years 1997, 1998
and 1999, how many complaints have been received and what were the
findings, and what were the disciplinary procedures if any?”
“What are the functions of
the Medical Association and how do they differ from those of the Medical
“Is there a patient’s
charter of rights in place? If not, why not? If so, why doesn’t anyone
know about it?”
I also requested comments
on my suggested Code of Conduct, Malpractice Board, a Medical Ombudsman,
and Data Bank on doctors.
The official response from
the Medical Board three days later was:
“Dear Ms Mathur,
I acknowledge receipt of
your letter dated 22nd August 2000 and will refer your request to the
Council of the Medical Board of Trinidad and Tobago.
Sincerely, K Mungrue,
The official response from
the Medical Association two days later came in the form of a phone call
from the secretary, Dr Omar Ali.
He said: “Last night the
matter was discussed at our council meeting and is under consideration.”
But, I protested, could he
not give me answers to the basic questions like how often they meet? I was
prepared to wait for a substantive response to my suggestions outlined in
“I am guided by
council,” he responded.
Even when I suggested the
Medical Association was acting like a secret Lodge, and wondered how if I,
as a journalist, am having so much trouble with getting information, how
would a patient get through to them?
The answer came, doggedly,
solidly blocking all entry: “I am guided by council.”
However, I was able to
contact Dr Fuad Khan, vice president of the Medical Board, who openly
spoke out against his own organisation, referring to it as a “toothless
bulldog” and added the “Medical Association is practically useless
because it has no legal powers.”
The following is a summary
of his comments:
The Medical Association of T&T is not a statutory body
and therefore has no legal powers, and its Code of Ethics (also not a
legal document) is at least 30 years old and has not kept up with the
needs of patients.
The Act under which the Medical Board operates dates back to
the 1960s and provides no protection for the Board when they have to deal
with disciplinary issues; the doctors who they are trying to investigate
slap them with an injunction. Currently, the Medical Board faces expensive
lawsuits from doctors.
The Board has no power to investigate or comment on
malpractice complaints. So patients have no recourse but litigation. The
Board is therefore limited to writing warning letters to doctors or
holding back registration.
The proposed Medical Board Act that deals with patients’
rights issues raised in these columns, has been tossed to and from the
Ministry of Health for the last four years, but nothing has come of it.
The Board is aware of cases of persons parading as
specialists who do not hold the necessary qualifications.
I also spoke to two
council members of the Medical Association who agreed it has no legal
clout or inclination to discipline doctors, or educate patients.
It operates more like a
union in the interests of the doctors (by closing ranks when complaints
came in) than an independent body interested in upholding standards of the
The patients of this
country wait with bated breath for a response from the Medical
Association, the Medical Board and the Ministry of Health.
We can’t afford to
exhale just yet.