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| Journal of the New Zealand Medical Association,
03-June-2005, Vol 118 No 1216
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Doctor-bashing
Recently the New Zealand Herald published an
obituary1 that does a monstrous injustice to
the memory of Professor Dennis Bonham. He had his critics, but did more good for
the health of New Zealanders than any of them. I hope that one day the good will
be properly recognised.
Hospital-bashing and doctor-bashing have become increasingly
popular pastimes during the past 20 years. I have no wish to excuse error or
incompetence, but there are now better means in place for dealing with them.
More important than any disciplinary function is to ensure as far as possible
that they do not happen again, and this is not necessarily helped by a public
reaction that is too often excessive and may in the end do more harm than
good.
Why there is so much negativity is unclear to me, but part
of the explanation may be found in comments on a quite unrelated matter reported
by the Herald the day before the obituary appeared.2
It quoted Justice Wild on the Berryman bridge saga:
“[It]
is a neat demonstration of several characteristics of New Zealand and New
Zealanders, some of which are good, some unfortunate. First, it demonstrates the
admirable tendency of New Zealanders to rally behind people they perceive to be
the underdogs....This is a good characteristic of New Zealanders, provided those
they are supporting are worthy underdogs. Second, it demonstrates the tendency
and ability of ‘underdogs’, and those advocating on their behalf, to
manipulate public opinion by carefully selecting facts favourable to their
cause, and ignoring or obscuring unfavourable facts....A third, and regrettable,
New Zealand characteristic demonstrated by ‘the Berryman bridge
saga’ is the tendency of many New Zealanders to bash institutions which
are important in our country....’
In this instance, the bashing was of the Army and courts,
but the comments apply even more strongly to hospitals and doctors. In mail the
same week came the annual report of the Medical Protection Society, which is of
course a group based in the UK but which looks after professional interests of
some 200,000 health professionals in over 40 countries, including New Zealand.
From its wide international perspective it had this to say about our
country:
“New
Zealand continues to be one of the most hostile medicolegal environments in any
of the places in which MPS operates....Our three medicolegal advisers...receive
proportionately more requests for assistance than we see
elsewhere....”
This would be entirely understandable if our doctors are
proportionately worse than those elsewhere, but does anyone seriously suggest
that this is so? Even in this case, the problem is likely to get worse rather
than better as more of our best students choose to study fields other than
medicine, and our best doctors migrate overseas for better pay and conditions as
well as less hostility. Is this what the country wants?
Over the years our community has become influenced
increasingly more by show than by substance. The perception of Professor Bonham
reflected in the Herald obituary is a classic illustration. If this continues,
the substance itself will fade—for example by the loss of the best doctors
and potential doctors—and finally with it even the show, as people come to
realise there is nothing behind it.
Having retired and being now a ‘consumer’
(horrible word) rather than a provider of health services, I feel especially
strongly. I am alive today only because of an aortic valve replacement carried
out 6 years ago by the recently reviled Green Lane Cardiothoracic Service, by
one of the world pioneers in this surgery. I can walk only because of the good
offices of an orthopaedic colleague in replacing a hip. And there are other
colleagues and health workers to whom I and my family are similarly
indebted.
The benefits of health services are felt in every home in
the land, even if unrecognised. They are especially evident in services for
reproductive health, due in no small measure to the work of Dennis Bonham. In
the absence of modern care, at least two mothers in my own family would have
lost their lives in childbirth, and a 31-week preterm grandson, now developing
well, would either not have survived or have survived disabled.
Surely it is time for the community, while not being uncritical, to count its blessings. Time too, for those who have directly benefited, to make their voices more loudly heard. Ross Howie
Retired Associate Professor of Neonatal Paediatrics, University of Auckland and National Women’s Hospital, Auckland (h.r.howie@xtra.co.nz) References:
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