GPs are adversarial, says veteran physician
A VETERAN local GP has come out in defence of the Hospitalist Programme a week after a group of his colleagues condemned the new system to the Mid-Ocean News.
The physician, a well-known Bermudian who preferred to remain anonymous, criticised those GPs who spoke out against the programme as 'adversarial'.
"Not all GPs are on the same page," he said. "Some have embraced the new system and turned over all management to the Hospitalist Programme. The issue is those who want to manage their own patients, but have not learned to use the system to their advantage."
The local physician questioned the assertion in last week's Mid-Ocean News that a GP caring for his or her own patient at KEMH must relinquish the support of house staff.
"What do they mean they do not have house officer support?" he asked. "They can if they follow the system. A GP may consult and/or refer his or her patient to a Hospitalist at any time during their stay and may continue to also see that patient in conjunction. In the case of a patient becoming critically ill, the Hospitalist will automatically see that patient, stabilise them and notify the GP to discuss further management, whether by a GP or Hospitalist."
He went on to question whether all patients merit daily check-ups by a doctor ¿ one of the main bones of contention for the group of GPs currently appealing to the Bermuda Hospitals Board.
"In one statement in last week's Mid-Ocean News, one GP stated that patients are not seen daily. Which GP is actually looking at each chart daily to confirm this? Do all patients really need to be seen daily? Were all GPs doing this prior to the start of this new programme?"
The GP admitted that his colleagues had a valid point in their condemnation of hospital nurses for unhelpful 'back talk'. He agreed with the group of his fellow physicians that too often doctors are occupied with simple daily tasks when nurses or junior staff could easily step in. However, he said that this was not a new phenomenon.
"With respect to physicians doing simple tasks like drawing blood and doing EKGs when support staff should be doing it, this was going on long before the Hospitalist Programme and no-one complained," he said.
"With respect to 'back talk' from nurses, this is being addressed. Nurses need to understand that orders can be taken over the phone and a patient can be seen within 24 hours, depending on his or her condition, of course. This is already in the bylaws."
He went on to question the assertion that some local GPs are not well versed in hospital medicine ¿ a claim made by one of the disgruntled doctors in last week's Mid Ocean News.
"It has been mentioned that some GPs are not comfortable seeing hospital patients or not qualified to do so," he said. "What quality of care have they been providing all these years? How did they get a licence and how did they apply or obtain hospital privileges?"
The GP believes his colleagues' complaints are premature, adding that the Hospitalist Programme may be experiencing 'growing pains'.
"Why complain about a new system when it has only been in place for a short time?" he asked. "Anything new has growing pains. Which GPs are really monitoring the plan? Did they ever monitor themselves prior to this program? No. So what will be the 'before' and 'after' picture?"
The physician went on to condemn his fellow GPs for taking their grievances to the media.
"Any issues and concerns can be addressed in-house cordially and not by taking an adversarial approach," he said.