A few days ago, Iván Sandoval, a fellow columnist for this newspaper, summarized in his writing the worrying state of our public health by pointing out the need for intensive care for IESS hospitals. Dr. Sandoval recalled the golden years of our hospitals, when all the effort was focused on the well-being of the patient and the doctors practiced their profession and teaching in an atmosphere of tranquility. I remember the mother of a college classmate telling me about the luxury of being hospitalized at the Teodoro Maldonado Carbo hospital. Top doctors, impeccable hygiene and excellent food for both patients and staff. Those were the main characteristics of the HTMC in its early days. Sad to say, our medicine has not only been decades behind, but is gradually regressing.
Between bad administrations, corruption, laziness, lack of national postgraduate courses and the absence of many young doctors who, after their training abroad, have preferred not to return to the country, Ecuadorians have been left with a reduced number of material resources and medical professionals. health, with which we have to survive. We must also consider the lack of honesty, inexperience, negligence, and poor preparation that our average general practitioner has, which, together with the dehumanization of the profession, have reduced patient care to basic prescriptions and not always adequate.
While medical science advances by leaps and bounds in therapeutics, our list of basic drugs is little or nothing renewed. Obsolete medicines are still prescribed that have already been surpassed by better, more effective and less harmful ones. Our patients keep on pilgrimage between different offices, with different doctors and different drugs each time. Clinical reasoning and common sense have been lost, the teaching of the older generations towards the younger ones is scarce. Doctors work under pressure, they have to attend as quickly as possible because there is an excess of patients and the data must be registered in the system. Patients get complicated and do not improve, because, after so many trips seeking relief and health, they end up confused with so many drugs. The medical consultation, if obtained, is a few minutes, regardless of whether it is the first consultation or whether it is a subsequent one. Patients report that they are limited to answering questions and that the physical examination is often overlooked. The lack of medicines is a never ending story. What is available is prescribed, something like “à la carte”, and the doctor is prohibited from suggesting to the patient any necessary drug, but which would have to be bought in particular. As Sandoval says in his text: against doctors “the shortage of equipment and medicines conspires.” Of that, the only loser is the patient.
The stories of patients who resorted to public hospitals and little or nothing improved, ending up with effort in private practice, are depressing. (OR)
* To be continue.