Abdus Salam Khan, MD FACP September 2019
It is said that if you are not the part of the solution, then you must be part of the problem. It does hold true for the emergency care in Pakistan. Our fragmented system of health care has always been seen as broken and needed to be fixed. Access to care is one of the big issues and then quality of health care is also equally important. Overall it is complex problem, where intertwined issues result in whole system dragged down and as the result dismal quality of care is provided which is mostly unreliable.
Emergency departments are seen as the last refuge for all patients in the entire World. Any problem that patients feel can’t wait is brought to emergency department. People who have no access to care otherwise also come to ED when needed. That’s why ED’s are equipped well to deal with all Spectrum of disease and all sorts of problems. Unfortunately in Pakistan, the emergency department are there but with compromised quality, capabilities and care, so rather than becoming a solution, it is the part of the problem. Looking at the present scenario in Pakistan we could see that although not much has changed on ground but there definitely is a change of hearts regarding emergency care and emergency department. If we look at the events of last few years with uproar about medical negligence and sloppy quality of care, it can easily be noticed that it was tough for the Physicians working in emergency departments and critical care. The reason can be traced back to compromised care. It was a system failure but blamed on doctors and nurses.
At the same time people also witnessed emerging Emergency Medicine training, conferences and better quality care provided to patients. These two factors are setting the stage for change of hearts. It is evident that all negative press about emergency care in Pakistan is not without merit, and at the same time it is also becoming evident that better triage and quality care has the potential to decrease the bad outcome.
The residency training in Emergency Medicine and the dedicated propagation of Emergency Medicine in all forums have shown that newer surge of modern emergency care can prove to be the game changer and will become part of the solution.
We believed that trained doctors, nurses and paramedics are able to sort out patient’s quickly through effective triage and then provide quality care to patients based upon clinical urgency. This will prove to be safe for all sort of patients, and their safety will mean safety for doctors and also for hospitals.
Pakistan Society of Emergency Medicine in association with college of Physicians and Surgeons and overseas Physicians of Pakistani descent has arranged a Summit in Emergency Medicine. The stakeholders of the Summit include government officials, training programs and partner NGO like WHO, Rescue 1122, Child life Foundation and Hands. The task at hand that day would be to device a clear road map of the future of Emergency Medicine and emergency care in Pakistan. The Summit will bring people on the same page and will certainly result in better understanding and thus better solution for the patients coming to emergency department.
The time is right for the people to join hands and work for the solutions that will eventually benefit the patients. As emergency physicians we know the value of right intervention at the right time by the right person in right setting. The challenge is to implement this solution while we are in transition where old system will slowly replace the newer system. We plan to utilize all the man power available whether new or old and equip them with the tolls that help deliver the safe and quality care. Due to the benefits of globalization and living in the information age, the transition will be interesting phase in the history of Emergency Medicine in Pakistan.
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