Blue-clad support for interns as health ministry moves to curb exploitation

The Jamaica Medical Doctors Association (JMDA) says its call for individuals to wear blue in solidarity with medical interns achieved a 99 per cent success rate, as concerns mount over excessive working hours and conditions that doctors describe as exploitative.

The show of support came as the Ministry of Health and Wellness moved to address the issues raised by interns, many of whom have complained of working prolonged shifts in a healthcare system grappling with shortages of doctors and nurses.

By mid-morning Tuesday, Health Minister Dr Christopher Tufton and the JMDA appeared aligned in their calls for improved oversight and accountability within the public health system.

“The call was not for individuals to stay away from work. The call was to bring awareness to the condition in which they operate and the exploitative nature of their work,” JMDA President Dr Rene Badroe told The Gleaner yesterday.

She said interns are often required to perform labour-intensive duties outside their remit because of systemic inefficiencies.

“Their work, it's more labour intensive. And there are lots of inefficiencies in the system. For example, sometimes, it looks like there may be a shortage of porters. Sometimes interns have to be a porter. Recently, a doctor, not an intern now, pushed a patient [in a medical bed] and got a herniated disc, from our report. We're trying to follow up on that report…” she said.

According to the JMDA, some interns in certain facilities are working 24- to 32-hour shifts on alternate days, while others have reportedly worked as many as 56 consecutive hours.

Badroe noted that 232 medical interns are expected to be in the system by July 1, including 142 new entrants, while there are trained doctors and nurses who remain unemployed.

“What we're doing is patching a system that needs to be fixed. And because the complaints are not coming in, or probably the complaints are being heard and ignored, we're patching a system that has holes. Doctors are not trained to lift you, and many are doing that, especially when patients need to have imaging examinations, and when they are unable to lift themselves from the bed to the imaging table. So when they do it they are going above and beyond,” she said.

A senior consultant who asked not to be named said the situation facing junior doctors is worsening.

“The exploitation of junior doctors on a whole, interns, by the various regional health authorities is endangering the lives of the young professionals. A tired doctor cannot give  his or her best. Overwork and tiredness will severely impair their ability to deliver proper patient care. This could cause serious errors in judgment as a result of exhaustion.”

He added that hospitals are operating at capacity and dealing with increasingly complex cases.

“This is a sick society. People are sick, and continue to make themselves sicker because of lifestyles. Obesity is causing a whole range of illnesses, which lands in a hospital, despite good clinics in communities. Everybody comes to the hospital, and there are not enough doctors, or nurses to give the care that is needed,” he said.

Meanwhile, the Western Regional Health Authority (WRHA) said it implemented contingency measures after some interns reportedly called in sick yesterday.

Dr Delroy Fray, the WRHA’s clinical coordinator, said senior medical officers at Cornwall Regional Hospital and Savanna-la-Mar Public General Hospital were instructed to prepare for possible disruptions.

“What we did was to put some contingencies in place, where we went to the senior medical officers on Tuesday and asked them to meet with all residents and junior doctors. We told them about what will happen, so they must put things in place, so it does not create a shock on the system,” said Fray.

While no major disruptions have been reported, he acknowledged that delays are likely.

“I have checked with both hospitals, the CRH and Savanna-la-Mar, and we have not had any issue because of what we did on Tuesday, but the issue will cause delays in admitting patients and in investigations, so we hope that this won’t last too long. Because of what we put in place, it won’t create any shock in the system, but it will create some delays,” he said.

Fray described interns as critical to hospital operations.

“The role of the interns is a very important one, because they are like the foot soldiers in the ‘health armament’ area.”

Responding to the concerns, Tufton ordered immediate inspections of intern accommodation facilities and directed regional health authorities and the University Hospital of the West Indies to complete comprehensive audits within 72 hours.

“Any facility found to have structural, sanitary or safety deficiencies, including sewage-related issues or inadequate sleeping arrangements, must undergo immediate interim corrective action,” the minister said.

Tufton also announced that duty rosters will be reviewed, staffing gaps assessed, and a joint monitoring committee established with the JMDA to track remediation efforts on a fortnightly basis.

editorial@gleanerjm.com