On a related note to my last post... we need to look at the other side of this discussion: ourselves.

The hospital has limited resources (doctors, nurses, money, etc). We are demanding the highest quality of service for free (well, in reality from our medical benefits contributions). Again, we can't have it both ways. We need accountability on all sides for this.

Can anyone say if we have access to audited financial reports for the hospital? We need those to be realistic about the quality of care that we should be expecting based on the amount that we are spending.

I would also guess that getting money from the government is a challenge (hence the delayed payments to staff, etc).

Someone needs to open up these facts (not hearsay or annecdote which we tend to consider fact here in Antigua) to the light of day, so we can have an informed, non partisan convo (if that is in fact what we want).

Doctor Powell's main criticisms seem unreasonable by my reading.

Having experienced the standard practices of hospitals throughout the region, I see nothing unusual with the policies implemented by the hospital management. Every doctor I know has slept in at the hospital while on duty. If you havent then please let me know your name because the program involved in your training/emplym ent was obviously not rigorous, and I would like to ensure that my family, and friends avoid interacting with you. If anyone needs proof, simply dial any large regional hospital and ask. Especially in light of the concerns that the public expresses about the availability of timely, quality health care. You cannot have it both ways, you cannot expect a doctor to be at the hospital at all times, if the doctors are not required to be at the hospitals at all times right?

The managements response was equally poor as it failed to address the attendant concerns with the policy: How was the policy introduced? What is the compensation for the duty? How often is each doctor on the rota for overnight on-compound duty? Are the lounge facilities adequate for the doctors?

I had to read portions of the Doctor's original via another media outlet. That is not good enough Caribarena. Looks a "little funny" on your part. Having said that, I can see some level of "spinning" on the part of M.S.J.M.C. KEEP PUSHING FOR YOUR RIGHTS JUNION DOCTORS. There is nothing to fear in this life but fear itself.

What is the issue with that.. It is done worldwide!! 1st there is an issue with the availability of physician. Now they are making them available, another issue. PETTY ISSUES. How about study how you can get $$ to put in the hospital to pay the workers on time?????

Caribarena, Dr. Simon's response is in order - the article above is typical of a Management's Response.

You need to produce better journalism efforts in that you report balanced and fair. The young doctor had concerns that were overlooked and are of much significance but your print (above) makes him look like a bad person.

Please consider securing the full interview from Observer or the doctor himself, and give the people/your readers a balanced report of this situation.

I think this is a basic issue of dealing with challenges faced while implementing a policy. The sleeping in policy is good however it must be implemented with a lot of caution to avoid sacrificing the much needed quality care that the hospital is after. All stake holders which include the doctors must be involved and their concerns addressed if the hospital management expects to achieve its objectives and overall goals. When the drs. are not taken care of that translates to poor service delivery to the patient which the hospital is trying to address.
victimization will only aggravate the situation! I WOULD LIKE TO SEE THE HOSPITAL FOCUS ON THE ISSUE AND NOT GOING AFTER THE DOCTOR WHO IS ACTUALLY HELPING THE HOSPITAL BY VOICING OUT HIS CONCERNS FOR PATIENT CARE.
KUDOS TO DR POWELL. THE SECTOR REALLY NEEDS MORE OF YOUR KIND, GOOD LEADERS ARE HARD TO COME BY!!!!!

DR. LEYLAND POWELL I COMMEND YOU FOR YOUR BRAVERY TO POINT OUT ISSUES WHICH OTHER DOCTORS ARE GOING THROUGH BUT ARE AFRAID TO SPEAK BECAUSE OF VICTIMIZATION. WELL DONE WE ARE TOGETHER IN THIS AS COLLEAGUES .

As Dr. Burleigh said in other countries that are much bigger than ANTIGUA it is being done but in MSJMC A LOT OF THING ARE NOT IN PLACE for instance they don't provide meals or access to meals , as well as the extra hrs they are demanding are not being paid for, and you are expected to continue the following day without a break. The condition of the rooms (2 tiny rooms for approximately five on call house officers and 5 interns)are UNACCEPTABLE. In most hospitals the consultants are stay along with interns and residents, however in MSJMC the consultants are not and there are no residents.

The doctors are overworked/over whelmed as the hospital combines departments such as pediatrics an medicine for one house officer on call as well as combining surgery, orthopedics and ENT for example on trauma prone days such as carnival or new years eve. So indeed ONE WONDERS WHAT QUALITY OF PATIENT CARE wheN THE DOCTORS ARE OVERLOADED,OVER WORKED AND DEMOTIVATED!!!!!
AND AS FOR CARIBENA PLEASE GET THE OTHER SIDE OF THE COIN BEFORE YOUR PRINT.

Sleeping on the job. Why not work and go home to sleep. Are they going to pay the doctors while on duty sleeping? Is Antigua so big that if the doctors leave at night they won't be able to get to work for hours? And what about of the rest of the story the doctors point of view? do they get to ell their side of the story? Please!

I am an Antiguan but American trained doctor and I don't know the full story but will give my little piece from what I read. When u are on call in the U.S u stay in the hospital for the said reasons in this article, however the facilities are made available for u to sleep and get food 24/7 that u are required to be there. By the way u r also paid to be on-call. Typical lounge has breakfast in the morning, snacks, then lunch, snacks then dinner, then snacks for night staff. Tea..........co ffee ............hot chocolate .........water. .......juice/so das. Even if you're on-call you must be still treated like a human being even so one who is required to be full of energy to go save another humans life. The other physicians work as a team not just one loan person manage the depart when on-call...u have interns, house officer(s) most of the time 2 (in some places more) on call with consultant at any given on call rotation. Now the hrs are another issue too much long hours is counter-product ive, since sleep deprivation increases rates of medical errors. Overnight call frequency must be to no more than one overnight every third day, and 10 hours off between shifts.

It is unfortunate that the hospital respondent keyed in on that one aspect of the Doctor's complaints.
If the issue was just about sleeping in then maybe MSJMC respondent would be making sense.
But when you look at the whole text and context of what the doctor said this cop out response is just in keeping with the attitude and actions of Senior doctors ( consultants) and management in that hospital.
I hope Caribarena can reproduce the doctor's original interview with Observer.
The House (junior) doctors work under conditions that make it impossible for them to give their best. But it is convenient for the consultants so nothing is done about it.
Other unnamed doctors have since sent letters to Observer in support of Dr. Powell's arguments. They were just to afraid, of MSJMC system of victimization, to make their names public.
Caribarena should not print the hospitals response without Dr. Powells original interview. It gives a false impression of the young doctor's concerns.