Health Coun­cil rec­om­mends fresh grad­u­ate doc­tors do a six-month at­tach­ment at Thim­phu Hos­pi­tal

Business Bhutan - - Nation - Lucky Wangmo from Thim­phu

The Bhutan Med­i­cal and Health Coun­cil (BMHC) dur­ing in­ves­ti­ga­tions on com­plaints from the public found out that there is a need for fresh grad­u­ate doc­tors to do at­tach­ment in Jigme Dorji Wangchuck Na­tional Re­fer­ral Hos­pi­tal (JDWNRH) for at least six months.

It was one of the rec­om­men­da­tions by the pro­fes­sional ethics com­mit­tee com­pris­ing se­nior doc­tors at the Thim­phu Hos­pi­tal.

So far, fresh grad­u­ate doc­tors af­ter a month of ori­en­ta­tion were trans­ferred to dis­trict hos­pi­tals across the coun­try.

The Regis­trar of BMHC, Sonam Dorji, said that it is im­por­tant for doc­tors to be ori­ented with the kind of dis­ease pathol­ogy in the coun­try.

“With stu­dents study­ing in dif­fer­ent col­leges across the globe, they learn about the dis­ease pathol­ogy of that par­tic­u­lar coun­try and the kind of med­i­ca­tions that are ad­min­is­tered,” he said, adding that some med­i­ca­tions that are ad­min­is­tered in other coun­tries are not the same in Bhutan.

A se­nior med­i­cal spe­cial­ist at JDWNRH also feels that the new doc­tors need to ac­quaint them­selves with dis­eases that are preva­lent in Bhutan and also check on med­i­ca­tion ad­min­is­tered to pa­tients. “Some an­tibi­otics that are given to pa­tients suf­fer­ing from cer­tain dis­eases in In­dia are not ad­min­is­tered in Bhutan,” he said.

Ac­cord­ing to the Sec­re­tary of Min­istry of Health (MoH), Dr. Ugen Do­phu, fresh doc­tors need to get some idea about Bhutan and its pathol­ogy be­fore go­ing out on their own.

For in­stance, on 24 May, a 74-year old farmer was brought to the Nor­bugang BHU in Pema­gat­shel af­ter suf­fer­ing a snakebite. The man was then re­ferred to Nganglam BHU, but died due to com­pli­ca­tions. The fam­ily of the vic­tim al­leged that the death oc­curred due to the neg­li­gence of the doc­tor on duty. But af­ter­wards, an in­ves­ti­ga­tion re­vealed that the doc­tor was very young, had al­ways worked in dis­trict hos­pi­tals and there­fore was un­sure whether to ad­min­is­ter the med­i­ca­tion.

The BMHC in­ves­ti­ga­tion find­ings re­vealed that though the man­age­ment by the doc­tor and nurses on duty were up to a rea­son­able stan­dard, spe­cific type of care the pa­tient needed was not given.

Talk­ing to Busi­ness Bhutan, Sonam Dorji said that the in­ves­ti­ga­tions also re­vealed that a lot of time had been lost while re­fer­ring the pa­tient from the first BHU to BHU grade I.

“Fur­ther, the pa­tient was not brought to the hos­pi­tal im­me­di­ately. Time was lost per­form­ing lo­cal treat­ment,” he said.

Sonam Dorji also said that while re­view­ing the case, the pro­fes­sional ethics com­mit­tee which com­prise se­nior doc­tors from JDWNRH re­vealed that the death was caused by not only the snake bite but due to other un­der­ly­ing causes.

There­fore, the pro­fes­sional ethics com­mit­tee rec­om­mended that the doc­tor in this case be placed in a re­fer­ral hos­pi­tal un­der the su­per­vi­sion of a se­nior doc­tor for six months so that he can learn the re­quired skills and pa­tient man­age­ment that are rel­e­vant to Bhutan.

The pro­fes­sional ethics com­mit­tee also found the nurse in­charge and nurse-on-duty at fault for not hav­ing done the doc­u­men­ta­tion prop­erly. The nurses are rep­ri­manded for six months, which could af­fect their cer­tifi­cate of good stand­ing which is im­por­tant for pro­mo­tion or to pur­sue higher stud­ies.

In the case of the doc­tor, he will be un­der su­per­vi­sion for six months and will be work­ing on con­di­tional reg­is­tra­tion. At the end of six months, the se­nior doc­tor will have to write a let­ter to BMHC stat­ing his be­hav­ior.

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