Medical Institutions Heads must ensure Discipline, Monitoring and Accountability of their staff

Failure to do so will invite the Bureaucracy
or other agencies to take up this responsibility

ISLAMABAD: Medical Institutions and healthcare facilities heads must ensure discipline, monitoring and accountability of their staff. Make sure that neither punctuality nor teaching, training, patient care and Out Patient services are compromised. If they failed to do so it will invite bureaucracy or some other agency to take up these responsibilities. If anything goes wrong, it must be immediately investigated, those responsible held accountable and appropriate action taken before it is too late. Failure to take immediate action has many a times created lot of unpleasant situations and on public protest, the authorities are forced to take some action which the healthcare professionals do not like. Hence it is extremely important that one should take preventive measures to make sure that such a situation does not arise.

We have always promoted the concept of self-monitoring and accountability by medical profession through professional specialty organizations, healthcare administration so that the situation does not go out of their hands. However, once they fail, then someone has to take action which is often not palatable for those involved. A concept is often floated and rightly so that medical institutions and particularly healthcare facilities should be headed by those who have experience and training in hospitals administration which is in itself an important discipline. It is said that they are in a much better positon to administer these institutions than the clinicians who are too busy and have lot more responsibilities should not be over burdened with administrative responsibilities and they must be allowed to concentrate on teaching, training and patient care rather than getting involved in administrative meetings which is of course not liked by some but if the institutions are not being run and managed efficiently, there is no end to complaints, the government is forced to step in and take some actions.

There are often complaints of consultants not attending the Out Patients Departments, coming late or leaving early, not taking ward rounds which is left to the juniors to complete the formality. However, sometimes the faculty members, consultants do have to attend some meetings, conduct workshops or are invited to deliver a lecture at some other institution hence if it is all monitored and information of these movements outside the institution are in the knowledge of the institution administration which is strictly monitored by the institution heads, there won’t be any problem and bureaucracy or any other agency won’t have an excuse to intervene. They come into the picture only when the institutional administration fails.

It is not a secret that those who try to enforce discipline have never been popular as they could not afford to please everyone, ignore unethical practices or could not tolerate indiscipline. The cases of Prof. Eice Muhammad and Prof. Amir Aziz can be recalled. When they tried to enforce discipline and check some of the unethical practices, they had to face lot of opposition from their own colleagues. In fact, it is the institution heads attitude to keep everyone happy which results in promoting indiscipline. Past is a witness to the fact that whenever the medical profession failed to ensure discipline, take decisions on merit or were forced to take some decisions under pressure of their own colleagues, it has provided a golden opportunity to the much maligned bureaucracy to step in.

Remember there was a time that in Punjab, it was the medical institutions through its various committees which used to decide on induction of postgraduate’s for residency training. They were in a much better positon to select postgraduates based on their interest, preference but when the young doctors started misbehaving with the members of the selection committee, senior faculty members refused to take up these responsibilities with the result that the central induction policy was introduced wherein the decisions are now taken by the health department through bureaucracy and medical profession asked for it. They cannot blame others but itself for creating a situation which provided an opportunity to take away these functions from the medical institutions.

Even now the situation is not good as regards discipline, punctuality and upholding professional ethics. It is generally observed that all those who are involved in such unethical practices enjoy the patronage of some influential bureaucrats, politicians or others in power corridors but it brings bad name to the entire medical profession. Hence great responsibilities lie on the shoulders of heads of these institutions which includes Vice Chancellors of medical universities, Principals of Medical & Dental Colleges, Deans of medical institutions, Medical Superintends of healthcare facilities to wake up, realize their responsibilities and improve their performance, otherwise get ready to face music as the bureaucracy is all the time ready to deprive them of their powers and authority.