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Thread: Education Quality For Medical Professionals

  1. #1
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    Default Education Quality For Medical Professionals

    As the punch line implies i'm curious about the education quality. Before I start allow me to clarify I am asking this question for honest anwers and am being objective as possible with the statements.

    I am rather concerned; Over that past 6 years I have known this culture and the langauge something always bugs me and it's medical delivery and education. I know some things have been improving but some things are degrading and really raise peoples eybrows. What education quality do Dominican doctors receive ? i'm sorry but the amount of antibiotics that are prescribed and unessisary surgical procedures are manic. There has been so many instances of people dying from anesthesiologist errors as well as doctors. The other thing that really iritates me is the business perspective; prescribing medicating not needed or charging different prices for the same service; look, I know people need to make money but as medical professionals taking care of your community how can you entertain to lie to people and have no empathy regarding human life. I have many doctor friends in my home country as well as D.R but in respect to even the way things are conducted on a personal basis are remarkably different mainly involving logic and critical thinking I do not see so much impulsivity here and if there is they loose their right to practice medicine but in the D.R how do you deal with these things? and what are peoples opinion on the level of education received?

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    Many Dominican doctors are as good as anywhere on the planet.

    Many private clinics are excellent.

    But those doctors attended the best Dominican medical schools and did their internship and residency offshore in the US, Mexico some SA countries and Europe, especially Spain.

    The public system is a different story altogether.

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    Patient A (Patient A - because person hasn't given me permission to post about them) presents at an emergency room on their own 2 hours after a moto accident. Patient has clearly visible cuts, abrasions and contusions on their hands, legs, arms, feet and nose.

    Patient A has showered, cleaned and dressed their own wounds. Knew they were going to be sore so went to Emergency for piece of mind and hopefully a prescription for pain medication.

    Patient A interacted with two doctors, two nurses and an x-ray tech.

    No one asked if patient was wearing a helmet, no one showed any interest in the cut on patients nose. No doctors palpated for internal injuries or bleeding despite some serious bruising on arm and torso. Most were really impressed with the patient's colourful self-adhesive wraps and quality gauze pads used to dress the worst of the road rash type injuries.

    X-rays taken for one arm due to bruising. Nothing broken. No head, torso, leg or feet x-rays done.

    No treatment for patient's hands or feet despite despite cuts and abrasions being present.

    After treatment, patient A did not get a prescription for pain killers despite asking. Patient was asked to sign an extra blank insurance claim form. Back at home patient A replaced all of the poor quality bandages applied at the hospital with quality medical supplies... and taped two broken toes together.

    The initial exam was nonexistent. No examination for head trauma, no exam for internal injuries, no questions to determine level of alertness or awareness. No questions about the specifics of the accident and an apparent lack of interest in any abrasions less than the size of a silver dollar.

    Patient A reports they were the only person in the emergency dept at the time so it's not like the facility was busy, just a gaggle of medical people chatting up the attendants at the front desk.

    Granted, this is just one story on one specific day. You should be able to determine if Patient A received the minimum acceptable level of medical care for the type of scenario that precipitated their arrival at hospital.

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    Doctors here seem to be extremely reluctant to give any kind of decent pain killers - no matter how much pain you're in. At best you might get something with codeine in it. I don't think the farmacias even carry anything stronger(?).

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    A friend of mine had bladder cancer and had to undergo an extremely complicated surgery where they replaced his bladder with part of his intestines.

    He went to one of the top surgeons in the US for this type of cancer and surgery. He got his medical degree here in the DR. Like CB said, he did do his internship and residency in the US though.

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    Quote Originally Posted by cavok View Post
    A friend of mine had bladder cancer and had to undergo an extremely complicated surgery where they replaced his bladder with part of his intestines.

    He went to one of the top surgeons in the US for this type of cancer and surgery. He got his medical degree here in the DR. Like CB said, he did do his internship and residency in the US though.

    That seems to make a world of a difference, but from what I have seen ones who have completed their intership in the D.R don't have the best mentors to ask questions to, could be perhaps because all the good medical professionals leave? and we're left with the "passing" ones, but at the same time like the other member stated; the level of initial care offered is horrendous.

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    I don't have any insight to offer but could ask a family member who worked for many years at a very popular pharmacy is it perhaps expensive in the D.R? could be social stigma or false beliefs to go along with handing them out pain-meds.

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    I took my son to the a clinic on the north coast he was around 1.5 years old at the time. They determined in 10 mins that he should have anti-biotics without doing any additional work and instructed he take the pills until complete( atleast they said until complete) but then said come back tomorrow for a feces collection reason why this made me upset is because an infant needs to develop their immune system and kids and general and antibiotics should be reserved for when needed and plausible cause. another one, my partners aunt was operated on due to an autoimmune disease ( was 15 years ago) died in operation of undetermined causes. Recently as some of you may have heard there was an accident near puerto plata involving a motercycle collision with a cow. He was not wearing his helmet unfortuantley but did most of the time, collided with the animal had internal bleeding and hemmoraging in the skull, broken rips and ruptured spleen I believe; ambulance brought him to the clinic where he was in life threatening condition where hours later he died I imagine of internal bleeding. Fact of the matter is the whole sensitve situation was not dealt with properly and a lot of distrust in the hospital for delays. Personally the situation sounded overwhelming for even an American or Canadian team but, the way everything was dealt with inbetween is wrong I just mean simple logical steps and empathy for human life.

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    some doctors are good, many are very bad. the good ones - that i know - all studied abroad. many did residencies or specialties abroad, few in the USA and most in spanish speaking countries like mexico, spain, peru, argentina or cuba.

    one thing that should be noted is that the treatment in DR matches the patients, so to speak. in the pharmacy we had many clients who came from the public hospital consult and handed us a piece of paper thinking it was a prescription while in reality it was a diet plan or general instructions regarding food/exercise for those with high sugar and/or blood pressure. each time the client was royally pi**ed they were not given pills but some stupid garbage advice and they tossed the paper directly to the trash. if you have patients like that no wonder the doctors cannot be bothered with any advice further than "take this medicine". not to mention people demanding we give them antibiotics for every affliction from cold to headache and red rash on the ass.

    on a side note, hard core pain drugs are available in DR to general public upon special prescription in selected pharmacies only. some are limited to treating terminal patients or for hospital use.

    North Coast Moderator

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    Do these doctors come back to the island? I imagine if so they go for the capital or Santiago. I can understand that I suppose, people in D.R tend to think the pill will fix everything and there is no effort on their part, iv'e been laughed at so many times and cheapy shamed for being vegetarian and exercising it really amazes me that if someone walks or runs they are labeled as poor I've never really understood this from a logical perspective but it's a shame culture and I think you are kind or reflecting your frustrations as well with different clients, I think this comes down to education again though in context of patient demands etc.

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