Журнал «Медицина неотложных состояний» 5(52) 2013

What should we do, if issues are raised by the person, who found an amusement rushing from pillar to post? People of this type are often satisfied only if he “hits the white” once again.

Respond to, but found among physicians "culprits" in order to calm or that citizen, especially if the involved specialists see this candid absurdity, entails more problems. After creating a precedent for this person, like other citizens acted the same resources, and further, for no good reason.

Managers should react. But they should not look for “guilty physician” only to satisfy one or another person, if other colleagues find this absurd and this may follow more problems. After all this create wrong example for this and other people to follow same route without necessary authority. Management expects no issues in managed domain, while healthcare professional want him “to leave alone”. This often develops in the situation, when latter agreed to be penalized (to sign necessary paper, to ask for an excuse or even to be dishonored) and to fall in line with anyone, who exceeds authority. The reason is his fear, that guilty in any incident will be assigned among line staff.

Hence weakness and failure to act of some healthcare professionals results the other suffer and systems continue working with same faults and demerit, strengthened by bad example.

"Not all appeals are impartial"

Each month in media one can find news on criminal actions against physicians, offence and valance and sometimes have tragic result. All that is natural consequence of climate of impunity for «sacrifice physician hunters» and lack of rights for healthcare professionals. Readers understand that the news reflects only a tiny fraction of the vast number of cases that actually occur. Many were doctors themselves are silent, because we all know - there is no one to complain to us, and what does it mean? In addition, we ourselves can do to blame! So life is easier for bosses!

The author highlighted this topic to the commission of the Department of Health of Kiev in his recent attestation report for the period from 2010 to 2012.

Are there any doctors in the exercise of their profession to avoid problems, complaints, and any commissions! Of course, NO! Any work with people involves the occurrence of such cases, as in medicine, each of us is called to work constantly on themselves. Ethics and deontology for us is the elementary component revisions of our own actions.

In any case, we, the medical profession, often going "extreme", at least for us to say "of course the patient conflict, but it is probably something you were wrong!"

This is often only assumptions, while we would like not taught how to live and think, but help professionally. You may create objectivity; create commission to determine the neuropsychiatric status of such people today - "conflict", but at any moment "dangerous" physically, and do that under legal constraints in the country!

Work in public health institutions in Ukraine shows that the average physician can easily become the center of attention of management: where did he catch? What violations can bring him? For years, you did not notice, whatever gratitude and positive feedback at your side no matter received, and now ....! So, how to work? According to official instructions, as required by the medical profession, or at the behest of such patients?

We, physician, not only must, but also have the right to perform its tasks as required by the medical education and professional knowledge along with the experience and knowledge of the global medical community. Legislation, particularly of the World Medical Association, requires the same approach.

The Law of Ukraine "On Emergency Medicine" from July 5, 2012 clearly defines the main tasks of healthcare professionals in emergent medicine, but almost equals the healthcare profession to the status of the rescuers. Ambiguously perceived by physicians various security methods which officials expect to set-up in Kiev for ambulance staff (we hope that this concept also includes emergency department staff). For many practitioners the most effective protection would be a life and health insurance physicians, as well as the introduction of administrative and criminal liability, such as that which now threatens an attack on law enforcement officers.

With this article I want to emphasize the importance of our constant readiness in professional, medical and legislative aspects. Physician of each subject should be remembered that from the professional execution of their duties depends on the health and life of the patient, so must be clearly aware of their actions or negligence and their consequences.

Physicians providing emergency medical care, knowing their rights and duties, must act without attachment to any instructions. The physician is independent and professionally (confidently and without hesitation) must take the necessary (on your own) emergency decisions based primarily his personal erudition and medical training, patient interests (sick or injured).

Policies, requirements, orders from the management should to be in writing, within the job description, but even in this case, the physician should carefully consider their professional actions.

Health care reform involves every professional in the process launched by the Government. For this we have to stop keep silence!