My take: Paying for call, Muslims in medicine

1) A reader writes: “How about getting paid for taking call by hospitals? What’s your take on that? Almost every night that I am on call for the hospital I get to admit another unfunded patient. I understand my civic duty but it makes me not want to cover call anymore.

Pretty much all of the internal medicine doctors at my hospital have the option to opt out of taking admissions and virtually all of them have opted out. The general surgeons and OBs don’t have that option.”

Supply and demand in action. Without separate pay for call, there is no financial incentive to take call, and plenty of malpractice risks disincentives. No wonder why doctors are dropping call in droves. Surgeons and OBs aren’t so fortunate.

This trend will continue, as hospitals need coverage 24/7. Forcing doctors to take call as a condition of privileges is an option, but then you’ll see doctors resigning from the hospital altogether.

This movement is an encouraging sign that physicians can and will exert some form of independence, and will not be taken for granted any longer.

2) A reader writes: “How about a discussion of coming changes and problems associated with Islam in medicine?

I read somewhere that the majority of medical personnel training in the UK are now Muslim females. Given the problems that have surfaced already, e.g., requirements to maintain hijab at all times, including in operating theaters, refusal to minister to patients of the opposite sex, refusal to practice antisepsis, deference to the orders of religious rather than civil/medical authorities, this seems a fertile area for discussion.”

Haven’t thought about it much, as Muslims are not a majority of trainees Stateside.

My initial reaction is that patient care should not be jeopardized. So, refusal to practice antisepsis (if that is indeed true) would be an issue.

Religious beliefs should be respected, but it becomes a problem if patient care is compromised. If you’re practicing medicine, patient care is paramount and sometimes may supercede a doctor’s religious beliefs.

I’d like to hear what others think.

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  • Dr. Val

    If it’s true that Muslim doctors are refusing to observe sterile protocols then they should not be allowed to practice medicine. If I refused to use sterile technique in the O.R. I’d be immediately banned from the O.R. without a second’s thought.

    If your beliefs prevent you from caring for patients safely, then you should find a different profession. If you want to be a doctor, then you have to observe sterile protocol. This is not about religion, it’s about patient safety.

  • Anonymous

    This isn’t a Muslim in Medicine problem but a Narrow Minded Fundamentalist in Medicine problem. If people don’t profess Hippocratic Ethics and values then they shouldn’t be allowed in the profession based on them. It would be the same with people from any other religion who don’t put patients first. I had a religious prohibition against working on Sunday that I didn’t carry to medicine, although I still practice it in other areas of economic life.

    I don’t know any Muslim Doctors here like that. It is a UK problem?

  • STLstrike3

    My hospital in an underserved rural area has an administration that has fairly openly said they do not want to “set a precedent” by paying primary care physicians to take call.

    The problem is there are a lot of the Old Guard in this community who have been taking their own call for years (and let’s take a look at their compensation packages while we’re at it). So this enables the hospital to question, and I’m using their words here, the “work ethic” of the younger physicians.

    Here, like most places, will never change unless doctors really do threaten to leave, and keep good on the promise. Not enough have been willing to do so.

  • Guy

    my town is building a competing hospital down the road, I think then the current hospital will have to start paying for call or there won’t be enough people left to take call.

  • redrabbitslife

    Muslim docs refusing to practise antisepsis? What sort of fear-mongering nutball started that rumour.

    My medical school (in Canada) had a large number of Muslim residents for whom religion certainly did not interfere with their ability to provide top-notch care.

  • Carol

    My understanding of the issue with Muslim medical personnel is not that they won’t wash their hands but rather that they won’t use the ubiquitous “hand sanitizers” because of their alcohol content. Their religion prohibits contact with alcohol and many members of the religion who are fervent observers hold to the belief that this prohibition extends even to the dilution in these sanitizers.

  • John S

    To pick the most common commercial brand, it’s 62% ethyl alcohol.

    Generally it would be fine with me to avoid that stuff; actually washing hands should ordinarily be sufficient.

  • Anonymous

    I don’t remember where on the web I read it, but it seems that in the UK muslim women in OR (docs, I think) were refusing to bare their arms (up to the elbows) to do the required scrub. There have been other reports (again, I don’t remember the site) of male muslim doctors who have signed off on psychiatric commitments of “troublesome” Muslim women.

  • Anonymous

    On-call physician availability problems are yet another symptom of the illness affecting our healthcare system. Insurance WILL NOT solve this alone as remuneration is typically inadequate. It will take massive infusions of cash and reform of our emergency departments. I anticipate only one or two high volume centers per city offering a full range of tertiary services for the true emergencies. Other emergency departments will morph into a mode similar to urgent care clinics due to a lack of available medical staff.

  • Anonymous

    I am a Muslim physician, and i am religious, there are no interference between Islam and medicine than affects then patient care badly, and half of what is said in this article about Islam isn’t true especially about antiseptic, instead of that Islam added a lot of good things medicine especially ethics wise.

  • Dr. A

    This paying for call thing is just a symptom of an unfortunate movement that is happening. Hospitals are not willing to pay for call, but more than willing to pay to bring in a hospitalist service, then hire an OB house physician, surgical house physician, etc.

    This is further diluting the delivery of health care in small communities like mine. We’re subjecting patients to an outpatient physician (me), then an inpatient physician (local hospitalist), maybe some house physicians, then if they are transferred to a tertiary center, an entirely new set of physicians. I hope patients (ie, voters) rise up and let legislators know how they feel about this fragmented system.

  • Rudster

    Here’s the link to the article about Muslim females to which the original poster is probably referring.

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