This number was compared to a national unemployment rate of 7.1 per cent when the report was being prepared in late summer. In B.C., the number of unemployed specialists was slightly higher than the national average at 16.5 per cent. The findings are counter-intuitive, given patient complaints about accessing timely care and surgery. aNever in my medical career have I even heard of unemployed doctors, until now, so this comes as a real surprise,a said Dr. William Cunningham, president of the B.C. Medical Association. Cunningham has been practising medicine since 1986 and works in a hospital emergency department on Vancouver Island. The report doesnat address the issue of whether there are too many specialists for the Canadian health care system, in which operating room time and budgets are fixed. But it makes it clear that doctors are competing for resources, including operating rooms, hospital beds and money to pay their fees. The report also pinpoints reasons why newly certified specialists are having trouble finding work: older doctors are delaying retirement; established surgeons are protecting their precious (often only one day a week) operating room time so young doctors arenat getting the hospital/surgical positions they covet; and a lack of cohesion in medical resource planning and coordination between medical schools, governments and hospital or health care authorities. As well, there are relatively new categories of health professionals encroaching on doctorsa territory, such as advanced practice nurses, nurse practitioners and physician assistants. Respondents to the survey were graduates of Canadaas 17 medical schools and/or Canadian residency training programs in fields such as cardiac surgery, neurosurgery, nuclear medicine, ophthalmology, radiation oncology, urology, critical care, gastroenterology, general surgery, hematology and medical microbiology. The report does not include data on family doctors.
Hospitals lack emergency medicine specialists
However, a bad outcome of medical care is not always a result of medical malpractice; it may also occur due to aincidenta or amedical errora, which should not result in liability for the medical specialist. An incident occurs when a medical specialist acts in compliance with medical standards and objectively could not foresee or prevent the negative impact of his or her actions. A medical error, like malpractice, is associated with erroneous actions of the medical specialist; however, it lacks negligence. If the medical specialistas actions were reasonable based on the circumstances, he or she could be found not guilty. However, if the injured patient has evidence that the medical specialist was negligent and therefore failed to meet the professional standards expected, the specialist may be held liable for malpractice. Further, there is no developed unified doctrine of compensation for poor-quality medical services in civil legislation. For instance, there is still a debate over the legal nature of civil liability for medical malpractice (tort vs. contractual) as well as the applicability of strict (no-fault) liability for medical specialists under the laws on consumer protection. In addition, the legislation does not clearly provide for limitations on professional medical liability (e.g., when a patient cannot make a full recovery or when a patientas actions contributed to the harm). Legal regulation is also required for compensation of damages caused by aincidentsa, i.e., when actions of medical specialists result in personal injury but are not per se erroneous and negligent. Low-Quality Medical Examination Another major reason for the inefficient malpractice liability system is the underdevelopment of forensic medical examination in Kazakhstan.
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Medical Malpractice Liability: Kazakhstan Law and Practice
Pakistan Institute of Medical Sciences (Pims) spokesman Waseem Khawaja explained why emergency consultants were needed in hospitals. At times it becomes difficult for a casualty medical officer on duty from the cardiology department to fully understand the problem of a patient with severe gastro problems. There have been incidents when a doctor referred a patient complaining with chest pains to a gastroenterology department, said Waseem Khawaja. If we need to improve health services, we need to move beyond a duty doctor simply giving pain killing injections and referring the patient to the department concerned. What we need is an emergency consultant who can give analytical medical services, and manage patients with acute and urgent illness and injury before forwarding the patient to the next department, said Dr Khawaja. Dr Shoaib Shafi gave similar views saying emergency medicine specialists were trained in basic minimum emergency medicine. He said specialists were required in all private and public tertiary care hospitals, which received and dealt with major emergency cases. The College of Physicians and Surgeons Pakistan, however, had been pushing for recognition of Emergency Medicine in all hospitals. So far it had sold the idea to two private hospitals in Islamabad and Karachi. Understanding the need of the discipline, both Aga Khan Hospital and Shifa International Hospital have set up posts for Emergency Medicine specialists. But they can only accommodate a few postgraduates, which is not enough, Dr Shafi said. He explained how the field of Emergency Medicine had not just developed importance worldwide but its specialists were also one of the highest paid doctors. The CPSP has already developed curricula and designed a degree in the field of Emergency Medicine started awarding fellowships in this discipline.
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