Who will diagnose doctor absenteeism?

On Wednesday afternoon, Dr Agnes Binagwaho made a surprise visit to University Teaching Hospital of Kigali (CHUK). The Health minister then took to social media to share her findings. “I visited CHUK #Rwanda today. Many doctors were not at their work. Explanations are needed with sanctions for those without reasons of absence,” she tweeted. To some, the tweet was perceived as an unwarranted threat to doctors while others saw it as a step toward dealing with absenteeism at hospitals, especially public facilities. There are also others who argue that a thorough investigation should have been carried out to ascertain the reasons the doctors were not in office before issuing threats of sanctions. The tweet exposes a disconnect between the doctors and the Health ministry – players expected to be on the same side, some people argued. The New Times visited CHUK and randomly spoke to patients and hospital staff about the availability of doctors. A nurse who spoke on condition of anonymity told The New Times that, indeed, some doctors do not respect their schedules. “There are doctors who also work at private hospitals or clinics to get extra income and they tell us to call them in case of an emergency,” the nurse said. The nurse added that this places a burden on them as they have to do most of doctors’ work or the patients have to wait longer to see them. “The problem is that patients always blame us yet we are stretched because some of our colleagues show up late or not at all. Something needs to be done if we are to provide quality healthcare,” the nurse said. One patient shared an experience of when a doctor who was supposed to carry out a routine morning check-up of admitted patients was late for more than an hour. “The nurses try to help but some cases need doctors and when they are not around, patients are at risk,” she added. Another patient said, when he checked in the past weekend, it was difficult to get a doctor; he was told by other patients that since it’s a weekend, most doctors would come in late or would not altogether. “Doctors come in late or don’t even show up but they are quick to leave when their schedule is done. This shouldn’t be tolerated because patients lose hope in receiving quality healthcare,” the patient said. The Director-General of CHUK, Dr Theobald Hategekimana, said the hospital is investigating the case of staff who absconded duty without permission. “The minister came at around 4pm and found some doctors missing. We know that some doctors were doing exams but we also know some could have absconded and that’s what we are trying to find out,” he said. Profession to review standoff The issue is also under review by the Rwanda Medical and Dental Council. According to Dr Emmanuel Rudakemwa, the council president, there are many factors they have to consider before deciding the proper measures to deal with doctors who were absent without permission. “We will try to ascertain if her visit was over administrative or ethical matters. Then we will also try to find out how many places she visited, if any of the patients were affected by the absence of the doctors and if indeed the doctors were absent or if they were doing hospital rounds,” he said. Dr Rudakemwa said absenteeism is a serious issue that requires disciplinary action, adding that doctors are supposed to be in the right place, at the right time and with the right people; patients or students. However, some doctors said the minister’s decisions to put such issues in public was uncalled for and they believe that this will further undermine their profession. They said the ministry should also take blame for such poor working methods because there have been big gaps within the profession that have not been addressed. “This issue goes beyond what the minister tweeted. First of all, doctors are undermined by the ministry. The working relationship between the medical fraternity and ministry is weak,” said a doctor, who spoke on condition of anonymity. A recent government directive proposed a grading system of doctors that would determine salaries but nothing has been communicated to the doctors yet. Ministry officials declined a follow-up interview to shed more light on the issue. editorial@newtimes.co.rw

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Who will diagnose doctor absenteeism?