I wonder if there is a citizen who hasn't asked himself the same question at least once, when he couldn't get an appointment with a specialist doctor for himself or his loved one? If there is, I would gladly spare him the burden of my acquaintance.
About 10 days ago, towards the end of my shift, around 06.45:117 a.m., while packing my backpack, I witnessed a verbal argument between my dear colleague and a patient. On that working day, XNUMX. Visibly irritable. Taken aback. Not because of low-quality service, which most people at the bar table would like to hear, but because of the colleague's intention to perform a physical examination before prescribing therapy, which he demanded, miraculously. At the end of the discussion, and of course the examination, I heard her say to herself, is it worth working in healthcare today? This made me ask myself the same question, in order to come to several conclusions, which are related to human resources and affect the whole community. And the ruler, I hope.
Human resources are the most important resources of the health system of every country, and from this comes the fact that planning the development of human resources in health care is a fundamental tool that ensures the availability of quality health care, which directly affects the health status of the population. Strategic planning of human resources in the health care system is one of the most significant challenges for many countries and their ministries of health, especially in countries where there is a shortage of certain health professions. There are many challenges.
In the last few years, in addition to numerous problems, the lack of medical personnel, which has escalated with the corona virus pandemic, has been identified as the leading one. The dominant reason is the outflow of professional staff. It is noticeable both external and internal migration of healthcare workers, the departure of doctors to other professions, as well as the transfer of staff from the public healthcare system to the private sector. External migration is most often directed towards Western and Scandinavian countries. This process, of all the ones listed above, contributes the most to the deepening of the problem of the lack of health personnel, because this procedure completely loses the personnel from the health system of a country. On the other hand, no less significant problem is internal migration. It is reflected in the transfer of healthcare workers from rural, less populated and developed areas to larger medical centers, which endangers the principle of territorial accessibility of healthcare. Furthermore, the transfer of doctors to the private sector threatens the economic affordability and availability of health care, and creates a poor distribution of it. When it comes to the two last mentioned problems, the comforting fact is that this staff is still, to a certain extent, available to the population of Montenegro and contributes to the Montenegrin health system.
Larger and wealthier healthcare systems face the same problem. In Montenegro, the number of medical doctors per 1.000 inhabitants is lower than the European average. Currently, there are about 2,77 doctors per 1.000 inhabitants in Montenegro, while in European countries the average is about 3,4 doctors per 1000 inhabitants. Appreciating this data, it is necessary to take certain steps in order to create, preserve and improve the health workforce, and the creators of health policies should focus on this issue the most. However, this problem has wide scope because health concerns not only the medical profession but also the entire society of a country. Without a healthy individual and community, there is no progress in society or the state. Only a healthy individual is capable of working, and only a capable society can be a generator of the economic development of a country. Quite often, the process of retaining doctors in the health system of Montenegro takes place in the wrong direction. A linear salary increase, regardless of the performance and complexity of the services provided, demotivates ambitious doctors and responds to mediocrity. Attacks on doctors in the workplace and non-sanctioning of the perpetrators, jeopardizing the safety of doctors in the workplace, overload, unfair competition, influx of diplomas of dubious quality from educational institutions of countries in the region, frequent criminal charges for negligent provision of medical assistance, influence of politics in the profession, staffing and promotion on the basis of personal acquaintances and political preferences and suitability, and not on the basis of competence and knowledge, are only some of the reasons that contribute to the outflow of doctors from the public health system.
Unfortunately, attacks on doctors, both verbal and physical, are more frequent. We witness this almost every day. To our even greater regret, such attacks in our society are relativized and justified. It is a disappointing fact for the entire civilized world, when society condemns an attack on a doctor for any reason and without the slightest hesitation or dilemma, because of which the doctor "deserved" something. If the dilemma is integrated in the moral being, it is worrying where we are headed as a society in the absence of it. In this context, I would like to point out the decision to remove the criminal offense "Assault on a doctor while providing medical assistance" from the Criminal Code of Montenegro, which eliminated the criminal-legal responsibility of the abuser and denied protection to Montenegrin doctors at the workplace, and thus the quality of healthcare provision services, including the smooth functioning of the health system. Such and similar decisions contribute to negative patterns of behavior becoming acceptable in society.
Because of everything mentioned above, the entire society, led by the people who create health policy, should work on creating a more efficient and better quality health system that is more attractive for, I emphasize, competent medical staff. I emphasize this because the quality of the health service directly depends on the amount of knowledge and skills of the doctor.
Until at least some of the above-mentioned, pressing reasons are eliminated, Montenegro will continue to face, in the coming period, an already serious problem that does not tolerate delay and improvisation. Time is a limit to everything, including possibilities. And human cognition. Only desire and will defy him.
Bonus video:
