Australian GPs and a severe pandemic

Today a story is circulating around the cyber flu community about another sector that will likely suffer a dangerous level of “job abandonment”.

From News.com.au [excerpted]:

GPs refuse to treat bird flu patients

By Tory Shephard August 05, 2008 12:01am

BIRD flu will hit Australia but some GPs will refuse to treat patients – preferring to keep themselves and their families safe, research shows.

Others say they are unprepared to deal with the “horror” situation and hope it never happens, although experts say it is a matter of “when”, not “if” disaster strikes.

Research in the latest Medical Journal of Australia shows only one of the 10 South Australian GPs surveyed felt prepared for a pandemic.

The report’s authors said the doctors “felt their responsibility to themselves to stay healthy and to protect their families outweighed their responsibility to continue working”.

Australian Medical Association state president Dr Peter Ford said most doctors had received no formal training in dealing with a flu pandemic.

I have touched on this issue several times (as have others around Flublogia).

Pandemic Dominoes: HCW’s stand at the Apex

For the Greater Good

For the Greater Good II

I have also previously quoted this from the AMA:

AMA policy document “Physician Obligation in Disaster Preparedness and Response” adopted in June 2004:

National, regional, and local responses to epidemics, terrorist attacks, and other disasters require extensive involvement of physicians. Because of their commitment to care for the sick and injured, individual physicians have an obligation to provide urgent medical care during disasters. This ethical obligation holds even in the face of greater than usual risks to their own safety, health or life. The physician workforce, however, is not an unlimited resource; therefore, when participating in disaster responses, physicians should balance immediate benefits to individual patients with ability to care for patients in the future. (AMA 2004)

The above bolded sentence cannot be any plainer.

The article Australian article further states:

The report’s authors said the doctors “felt their responsibility to themselves to stay healthy and to protect their families outweighed their responsibility to continue working”.

Everyone who provides a critical service to, and interacts with, the wider community, doctors, nurses, firefighters, EMT’s, police, to name the most obvious, will have to make the choice about whether or not to work should we suffer a severe pandemic. Those that make the choice to work will no doubt make that choice each day the danger exists.

It will be a tough decision for most, but certainly not all.

It is important to realize that doctors and nurses did not “sign on” to risk their lives wantonly when they chose their professions. I would hazard the bet that most chose their professions out of a deep respect for health and life, even their own, most especially their own, if they are worth their parchment.

To expect someone, anyone, to step into harm’s way we assume an obligation to make them as safe as we can while they do so. We do this with our first responders via training, equipment, and their fellows who valiantly stand at their sides (or backs) while danger presents.

During a severe pandemic (should we have one) who will equip our medical workers to stand in the face of infection? Who will “stand beside them”?

Until we can answer those questions, and provide the means and materials to those answers, we have no right to expect anyone to aid strangers at the risk of their own lives. Keep that in mind as you read the following, also from the Australian article:

Australian Medical Association state president Dr Peter Ford said most doctors had received no formal training in dealing with a flu pandemic.

[…]

Vaccine expert Professor Nikolai Petrovsky, Flinders Medical Centre’s director of endocrinology, is working on vaccines to protect against bird flu. A lack of funding and of political will means the whole health system is unprepared for a pandemic that is already “overdue”, he said.

“The reality is that we will be hit by an influenza pandemic at some point. But we don’t know if it will be this year or in 50 years’ time so governments are loathe to spend the money and the effort when they don’t know,” he said.

Those last two paragraphs could be applied to any number of countries, not just Australia. And, equally as damning, to most states, counties, municipalities, and districts (or a country’s equivalents).

I wish I had an easy answer to offer up, unfortunately, I don’t. There are no easy answers, and there certainly aren’t many inexpensive ones either. We must have the wisdom and foresight to prepare those we will hope to see in our moments of greatest need by providing them the means to be there safely.

Even if it costs money.

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I’ve said it once or twice before, and I always suffer an internal cringe when I do:

As the mother of a police officer I have moments of very selfish “not my son” when I think about the possibility of his being hurt in the line of duty and not receiving medical care. When I am being brutally honest with myself – and with you – I admit that his life is far more valuable to me than yours.

My son “signed on” accepting the “normal” risks his profession carries, something his father and I are both appreciative of since we both wore the uniform ourselves. We, as his parents, understand that what can be done to guard and protect him is being done, or will be done, should the worst happen, and yes, we understand – and accept – that a positive outcome is not always guaranteed. However, things change when not everything that “could be done”, is not.

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Before we blissfully assume others have a self-sacrificing “obligation” to risk themselves we need to ask what we are “obligated” to do in return. If you’re honest with yourself, as honest as I have been with you, you will know that we, the collective “we”, have done pathetically little, nor have “we”, the electorate, demanded anything from those in positions to effect what needs done.

“We” just blissfully assume all will be well and fine because someone else has an “obligation”.

Please think about what I’ve said here.

Please consider adding your “voice” to the chorus against dangerous assumptions; ask that we adequately protect those we want to be there during our times of need.

Please.

SZ

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One Response to Australian GPs and a severe pandemic

  1. Joel says:

    An interesting wrinkle to this issue are the laws in MD and SC that require medical personnel to work in a declared health emergency. In my work as a pandemic planner I have encountered some people who feel this compulsion (and its included threat of prosecution) are sufficient preparation to avoid having medical personnel opt out of reporting, which is clearly not the case. The stick only goes so far…