|
Anaesthetic
Meeting on the Future Status of Dr. Bachan Singh |
| Venue: | Tea Room, Operating Theatres, South Tower, SJMC. |
| Time & Date: | 18:15 h to 18:51 h, 28th December 1999. |
| Present: | Dr.
Bachan Singh
Dr.
Charlie Chan Dr.
Dalina Dr. Tan Poh Hwa |
| Absent: |
Dr.
Mary Samuel (on leave) Datuk
Dr. Radhakrishna Dr. Anne Wong |
The meeting started with Dr. Bachan Singh giving a summary of the recent events concerning his status in SJMC in view of his affiliation to Sunway Medical Centre.
About a month ago he decided to inform Dr. Jacob Thomas, our Director Medical Centre, of his affiliation with the Sunway Medical Centre (SwMC) and of his plan to eventually practice almost full time there. This was before he had started any sessions or any other work in SwMC. However, he also expressed the wish to maintain 1 or 2 sessions in SJMC. In particular, he mentioned his desire to keep the Saturday afternoon list.
Dr. Thomas was of the opinion that this would be difficult as there may be times when Dr. Bachan was required here while he was working elsewhere. Furthermore, while Dr. Dalina required more OT sessions, the OT sessions had been reduced recently.
Dr. Bachan Singh then further inquired as to his status in SJMC and had suggested that he be changed from Category A to Category C based on the change in his practice in SJMC. Dr. Thomas, however, said that this would not be possible and that Dr. Bachan Singh would have to be changed from Active to Courtesy Status. If the hospital needed his assistance, he would then be called in on a locum basis.
In any case, Dr. Thomas said that Dr. Singh would have to give one month’s notice if he intended to go over to the Sunway Medical Centre. The matter would then be referred to Datuk Dr. Anuar Masduki and the Medical Advisory Board (MAB).
Concerning the situation in SwMC, Dr. Singh revealed that 2 of the OT’s there were already fully functional with the 3rd OT to be opened after Hari Raya (8th February, 2000) and the 4th OT after Chinese New Year (5th February 2000). However, the plans were only tentative and dependent on the availability of OT staffing, ICU beds, ward beds and surgeons. Dr. Singh was slotted to cover the 4th OT and therefore expected to go there around March or April 2000.
In SwMC, the one on 1st call would have the 1st choice of which list he wanted that day, the 2nd on call would have the 2nd choice, and so on.
Dr. Tan Poh Hwa felt very strongly that we
should vigorously oppose any attempt to convert Dr. Singh’s status from
Active Staff to Courtesy Staff. He should only be dropped from Category A to
Category C. This was strongly supported by all the other anaesthetists
present.
Dr. Bachan Singh further pointed out that as he
held a weekly pain clinic session, under the contract, he would automatically
be classified as Active Staff.
Dr. Tan then further elaborated by pointing out
that surgeons were allowed to operate in other hospitals and to hold clinics
in other hospitals as well. In either case, when their operations or clinics
over-ran there was always the possibility that they would be late for their
cases here, as has often indeed happened. This would result in a loss of
income to both the anaesthetists and the hospital as a fully staffed idle OT
represents a large loss of investment by the hospital.
The hospital cannot have a separate set of rules for
the surgeons and another set for the anaesthetists. All rules must apply
equally to all medical staff. If surgeons are allowed to operate and hold
clinics elsewhere, then the anaesthetists must have the same rights. There is,
therefore, no justification for converting Dr. Bachan Singh from Active
to Courtesy Status. However, he should rightly be changed from Category A to
Category C.
Dr. Tan Poh Hwa also pointed out that the
hospital may try to impose the change in status on Dr. Singh based on the
fact that while the hospital could bring in as many surgeons as they liked,
they could not do this with service oriented specialties like anaesthesia and
radiology.
Dr. Robert Liew pointed out that Radiologists
were slightly different from anaesthetists as they had a basic retainer fee
with moderately lower professional fees for work done. They were therefore,
actually employees of the hospital. We do not receive any retainer fee or
salary and as such the hospital had no hold over us in our free time.
The main concern of the hospital appeared to be the
possibility that a delay in a case done outside the hospital may result in
delay in the commencement of cases in SJMC. Dr. Robert Liew suggested
that Dr. Bachan Singh should try to avoid the problem altogether by
giving up the whole day’s list in SJMC whenever he wanted to take up any
cases outside of SJMC. He would then never delay cases in SJMC.
Although the anaesthetists felt that we had a right
to do anything during our free sessions, including doing lists outside of
SJMC, there was general agreement that the above proposal would avoid any
friction between the anaesthetists on the one hand, and the hospital and
surgeons on the other. The hospital would then not have any excuse to not
allow us to work elsewhere on our free sessions.
On the issue of whether we were obliged to inform the
hospital of our intention to work anywhere else, Dr. Singh pointed out
that our contract was silent on the issue. However, Dr. Chan and
Dr. Ngun both agreed that it would be basic courtesy and also a necessity
for the proper implementation of the Medical Staff Services Program to keep
the hospital informed of our work practices.
Dr. Chan asked whether Dr. Dalina was
willing and able to take up the extra sessions when Dr. Singh reduced his
commitment here in SJMC. Dr. Dalina assured us that if needed, she would
be able to take up the extra sessions.
Dr. Ngun said that as Dr. Singh currently
has 9.5 sessions, if he dropped them all, the 7 other anaesthetists (not
including Dr. Mary) could easily take up 7 of these lists and Dr. Dalina
could take up the remaining 2.5 sessions.
He also reminded everyone that Dr. Alan Wong was
always available as a backup to cover any shortfalls especially when we wanted
to take leave. In the event that the OT sessions were increased further, and
if the current anaesthetists could not cope, we could always ask Dr. Alan Wong
to consider changing to Active Status. Only if he refused should we consider
getting a new anaesthetist.
In conclusion, the following points were agreed upon.
1.
We
shall resolutely resist any attempt to change an anaesthetist’s Affiliation
Status from Active to Courtesy Status based solely on the excuse that we are
practising in another hospital.
2.
If
an anaesthetist chooses to reduce his commitment here in SJMC there should not
be any objection if he chooses to do so in stages rather than in a single
step.
3.
To
avoid the problem of a possibility of delaying the cases here in SJMC, any
anaesthetist with commitments outside of SJMC should preferably give up all
lists in SJMC on the days that he has an outside commitment.
4.
Furthermore,
when an anesthetist has a scheduled list in SJMC, he will not make any further
commitments to do cases in other hospitals. This applies equally to fixed,
open, daycare and emergency sessions.
5.
Based
on the current sessions covered by the anaesthetists, we do not foresee any
problem in the current group of anaesthetists covering any and all of the
sessions that Dr. Bachan Singh may be considering giving up.
6.
If
SJMC is able to increase its OT sessions in the future, and if the current
Active anaesthetists are unable to cover all of the new sessions, we propose
that Dr. Alan Wong should be given first preference to take up these
sessions before the hospital considers getting another anaesthetist.