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Tue 1 May 2007 10:44 PM

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A reign of confusion

Joanne Bladd on why UAE doctors need clearer information... and a payrise wouldn't go amiss either.

As managers, as parents even, we are constantly reminded of the importance of boundaries and communication. (Bear with me, I'm going somewhere with this.) Clear guidelines, we are told, make for happy staff and secure children.

In their relationship with the government, UAE physicians - not to imply any childlike qualities - are confused. And, as an onlooker, so am I. This week, for example, saw Abu Dhabi's Health Authority announce that compulsory malpractice insurance is on the cards for private physicians. Great news. While, yes, it's an added cost - and, if we take America as a case in point, can mean outrageously high premiums for doctors in riskier roles - at the end of the day, it's a barrier between you and bankruptcy. Or is it? I, and apparently a large chunk of the physician population, don't know. When I polled a handful of doctors, not one could tell me the process for medical complaints in Abu Dhabi, Dubai or Sharjah. Each knew colleagues who had been criminally charged - with the requisite ‘name and shame' front-page tabloid splash - while other cases had been quietly brushed under the carpet via governing bodies. With no guidelines, how can physicians be expected to protect themselves? "It's nerve-wracking," one physician said. "You don't know where you stand."

In a nutshell, this is the approach I have come to expect. Changes in legislation are typically signaled by high-profile statements, with little if any infrastructure to back them up. We are told that "plans are being finalised", but no information is communicated to doctors, who are left to practise medicine in the dark.

It's a ‘push-me, pull me' approach to management, which leaves a trail of bewildered physicians in its wake.

In almost the same breath as the malpractice announcement, a second senior government official accused public sector doctors of failing to keep abreast of medical advances. Pointing to hospitals "with state-of-the-art facilities," he said: "and yet we have doctors who have not attended a single medical conference in 20 years."

While I can't vouch for the first decade, doctors under the Ministry of Health haven't received a pay rise in the last 10. Between unit closures, desperately understaffed wards and long overtime to fill the gaps, you can see why their conference attendance might be slipping.

Frankly, it seems clear that we're failing on the fine print. Not to be judgmental (managerial rule number two), but it's not enough to make sweeping gestures - à la malpractice rulings - if nobody understands the finer points. Equipping clinics with shiny new equipment, and demanding "more CME, better education" is just not going to cut it when you're not doing the basics. Start small. Pay your physicians. Success is in the details.

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