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الأحد 9 نوفمبر 2008

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Why Libyan patients go abroad
and why Libyan doctors are not trusted by their patients

The survey I saw on The Alwatan Journal is excellent and show how the health services in Libya is managed very badly and need to be redeveloped and complete change in all administrators who run the services. this should start as soon as possible otherwise the gap between doctors and patient will get even wider and Libyan patient will be suffer from the Tunisian, Egyptian and Jordanian corrupted doctors . It has to be very soon otherwise we will have many disasters.

• I have seen many patients since I start visiting Libya over last three years (more than 100 per year). As I am practicing medicine in Europe and many of my colleagues do so who some of them doing the same free of charge. The Libyan patients need someone can communicate with them effectively, listen to their concern and help them by explain to them the cause of their problem, making the right diagnosis and give correct treatment. On many occasions nothing you can do except offer advice as the diagnosis is correctly made and treatment given and patient just shopping around.

• Doctors are fighting hard to keep up with development of medicine and due to lack of secure and protected environment. This lead too many mistakes and disasters which irritate patient and trust started to fade away. This also due to bad administration and it is always one man show in many places. This led to have poor leadership and corrupted managers who look for their interest and only looking after themselves to secure long place as a manager or directors without giving any attention to develop the place. The Lack of communication between doctors and there patient is increasing due to the lack of training in this very important area. Many doctors have no interpersonal skills and there communication is very poor and the relation between them and their patient will fall out after the first visit as the doctor is furious and has no patience and not listening to his patient. On contrary patients not trusting the doctors due to the lack of social and communication skills and nature of some patients. The patient demand a miracle cure and quick fix is met with angry and frustration from doctors who are victims of the system created by failed procedures and poor leadership. This will cause the mistrust in doctor and lack of continuation with the same doctor very eminent and unavoidable. It is vicious cycle where both patient and doctor suffer. Who is to blame?

• The Libyan patients are setting between two great walls. The doctors from one side and the Libyan government on the other side. The blame lies on the Libyan government who forget the health services over the last 20 years and also forget to develop the personal that run these services. The managers, directors, lack of any leadership and many managers have no management skills how to run even a single clinic or a department in one hospital. The senior doctors holding the managerial positions in many hospital and they have no experience or training to do this job. They will keep this position for many years and they repeating the same mistakes and no one can sack them or do anything as either they are revolutionary guard or belong to family close to the government ...etc... Lack of skilful administrators who can run effective management system for each hospital lead to corrupted and unproductive admin and management departments in many hospitals and poly clinics.

• The nurses either Libyan or non-libyan are poor quality and they have no skills in treating, managing and communicating with patients. There education not more than primary school and most of them have no other skills. Both doctors and nurses cannot work with each other’s due to difference in training and different school of thought. The survey show that very clearly and nurses training is totally forgetten by the Libyan government and only produced unqualified hundereds of nurses and pushed to replace many non-libyan nurses without any training. Who to blame again?

• I have seen many patients seen by doctors in Tunis, Egypt and Jordan. It is very sad to see Libyan patient going to Tunis and come back with wrong diagnosis, unnecessary medication and on top of that no single patient I have seen has any written report about his condition. It is crime to see patient and do not give them a full report about what you think and why you are doing that. Many patients suffering a lot regarding this and no one protect them. I hope every patient should demand from the treating doctor/s to have a medical report when he/she see any doctors either in Libya or outside Libya. It is important document and will protect patient and doctor if it is done in right way. Same from Egypt a little bit better from Jordan. I have challenged many doctors from Tunis to write to me anything about some patient I have seen and changed the diagnosis and gave the right treatment. Some responded other not and non from Egypt and almost everyone from Jordan respond and explain why he/she did that. Libyan patient I met and treat are very good and respected me and I respect them very much and I am very honest with them about everything. I always give them plenty of time and listen to them. They are nicer of many of my patients where I work in Europe. They do not like to go to Tunis or Egypt or Jordan except if it is necessary. They lost a lot of money as result of this shopping between doctors in Tunis and Jordan which put the family in large sum of loans from banks or friends. They lost some of there properties and very importantthey still faced with angry doctors when they come back. I heard many stories about doctors who refused to see patient who went to Tunis or other countries. Why they doing this and patient are have all rights to ask for second opinion and if the doctor confident about him or herself will offer this to patient. we have these sort of patient her and patient is always patient need help and support and assurances. Who to blame again??

• I think the health services in Libya in very poor state and will be worse if the minister of health abolished in January 2009, which will open the door to more corruption and destruction. Who will suffer, will be the patient or/and doctors? Getting help from Libyan doctors practicing abroad may be a good idea as they now gained an excellent experience in clinical medicine, teaching, training and management. It is a mistake not to use them as many other countries use their national. There is a major objection from minority of senior colleagues inside Libya for these doctors to come back and many obstacles put in front of them to prevent them from even seeing patient in Libya. They maragnlised when they visit hospitals and also ignored when come to invite doctors from abroad. It is very important to take this step and I am sure many of them are ready to help and support and to pay back a little bit to Libya.

• There are excellent Libyan doctors in Libya who are working very hard with patient and if the facilities in terms of organisation, equipments, training are available, they will produce more and will develop health services into the highest levels. They are the core of health services and majority are working in very unsafe environment but kept going and saved thousands of life’s and helped thousands of many patient. They trained hundreds of students with very limited resources and very unchanged ways of training.

• Libyan patient need to understand the difficulties Libyan doctor in Libya is facing on daily basis. The lack of leader ship is the paramount of this services and patient need to work very close with doctors to develop these services. Libyan doctors are excellent doctors and none of them failed abroad and you can see them in highest positions when they go abroad and if the same chances given to them in Libya, they will do even better. They do not need to shop around and doctors if they are not sure about the diagnosis or not able to treat, they should direct their patient to another expert on that field without feeling , they failed or not good doctors.

• The changes have to come from inside Libya and pushing to develop the health services has to come from doctors with the help of the patients. Libyan government is responsible for all of this and should work for the change and reform in quick and planned strategy not chaotic planning. Many reports come out about the health services and other sectors, but none of them implemented or even discussed in public. It must start even with a pilot hospital or two and seeking help from Libyan expert inside and outside is very important. The health services are dying and patients and doctors are suffering due to the lack of enthusiasm from the leaders in health services and in Libya as a whole.

• No leadership no progress and no development and the hole is to deep to come out of it. If we do not start covering this hole with fertile soil and plenty of feeding which all available and Libya never short of that.

Libyan doctor practicing abroad

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