Health Care

With what is happening now in Tunisia during the pandemic, it is clear that the health care system is in dire need of a deep radical reform. All health care areas are hemorrhaging human lives and colossal sums of money. Today I am tackling the subject of medical consultations within different medical specialties. It is regular medical practice to consult with other departments such as medicine consulting surgery or surgery consulting with cardiology or gastroenterology. As I mentioned in previous post, in the US, employed physician salaries are a mix of a base salary and wages received at each procedure performed by the physician including consultations. For self employed physicians there is no base salary but wages are received at each procedure. This operating mode incentivizes physicians, does not place a limit to their earnings and improves the quality of service. Patient becomes a client a source of revenue and consequently survival. In Tunisia, the mind set is completely differen...

The important subject of health care professionals (interns and residents) education is very deer to me and needs to be discussed. While working out the health care system in Tunisia during this equivalency, I cumulated enough experience to criticize the current state of affairs. I spend a large portion of my day recuperating patients’ lab results, taking imaging studies appointments for patients, asking for standards x-ray readings. These tasks are usually accomplished through a computerized system. I do not remember having to go the labs even once during my residency in the United States. All laboratory results are accessed through the electronic hospital portal. The only time I had to go to the labs was to meet a physician that works there to discuss a research subject. Time spent outside of clinical duties is time lost of medical education. Le mandatory activities for physicians are clinical activities. Here are few examples of clinical activities that I do not see carried out in T...

My mind is fogged by the number of subjects I want to touch on. Today, there is one pressing subject that my train of thoughts is following. I am reporting on the lies during daily work in the Tunisian public health institutions (I have not gotten the honor to discover what is happening elsewhere yet). During this equivalency period, I am discovering that deceit and lies are the way people operate hospital wards and manage personnel: physicians, other health care professionals, medical students etc. In morning report, a specific physician claims two of my patients have hyperactive reflexes and a Babinski sign. This physician has done this on two separate occasions. I remember one patient in particular I would call her N. N is about 20 years old works in a local factory and was admitted for viral meningitis. This particular physician said:” your patient has hyperactive reflexes and has a Babinski. You need to present her to radiology in order to have a cerebral MRI done”. I was ...

  Apres une pause estivale de quelques semaines, je suis bien heureuse de reprendre la rédaction. Je discuterai plusieurs questions qui relevant de la vie quotidienne dans les institutions médicales en Tunisie et je discuterai mon expérience dans ce système durant cette équivalence. Aujourd`hui c`est le sujet de la vaccination contre le virus Covid 19 en particulier et toutes les autres vaccinations en général qui se pose. Je cite l`exemple de cette médecin qui est spécialiste en médecine interne dans les hôpitaux publics Tunisiens depuis plus de 10 ans. Ce médecin prétend que si la vaccination contre le Covid 19 deviendrait disponible, elle ne va pas la prendre parce que les vaccins ne lui plaisent pas puisque les Français ne se font plus vacciner. Les professionnels de la sante doivent accepter ou rejeter un traitement en se basant sur l`évidence. Si un vaccin ou un traitement est nocif non bénéfique, il doit être rejeté. Avec la situation actuelle du Covid et l`incertitude qui v...