PESHAWAR: The medical consultants of Lady Reading Hospital, Peshawar, have expressed reservations about the duty roster issued by the administration according to which one specialist will perform 100 hours per week duty at its Covid-19 Complex.

According to them, the new rota has created unrest among doctors, who have informed the LRH dean in a letter that they are mentally and physically exhausted and cannot contribute to this rota and want to continue old rota, which has worked well for almost six weeks.

The letter said it had become clear that with the current state of affairs, the doctors were going to either infect themselves or die of the virus trying to save others and achieving the ‘impossible bar of excellence built on misconception and faulty system’.

It added that some patient would die due to unavailability of clinical care by the consultant again mainly due to the faulty system and operating procedures.

The consultants said the LRH administration had formulated the new duty rota for Covid-19 patients excluding all faculties and assigning the task of Covid-19 patient care only to the medicine department.

Each of them will work 100 hours a week at Covid-19 Complex

They expressed astonishment at the ‘abrupt replacement of tested model’ without taking into account their suggestions

According to new rota, the medical faculty alone will bear the burden of coronavirus patients which will expose them to a deadly disease with tremendous mental and physical strain in the absence of any help from any other specialty in contrast to the worldwide approach of merging different specialities, including surgical for Covid-19 care.

The consultants said in the letter that in the midst of crisis, opting for a total alien untested model will play havoc with the doctors apart from adversely affecting patient care.

They reminded the administration of its past decisions made without their input and said they had cooperated to improvise to make it work but strongly warned against the enforcement of the new rota for the sake of patient care and safety of doctors.

The consultants said the initial roster made towards the end of April included the internal medicine, allied medical speciality consultants, faculties of paediatrics, ENT, psychiatry and dermatology with four consultants per day.

They added that the pulmonology and internal medicine faculty worked as lead consultants and later, ENT and psychiatry were rightly removed and roster went smoothly.

The consultants added that suddenly, one day before the start of Eid holidays, Prof Nausherwan Burki, chairman of the Board of Governors, LRH, had exempted all others except internal medicine and pulmonology consultants.

They said the Internal Medicine faculty was also running the acute medical unit along stay medical wards and might be OPD services in the coming days.

The consultants said it was almost a herculean task for the internal medicine and pulmonology faculty, who after examine 40-50 patients in the Covid-19 Complex have to document the same in both hard file and then in HMIS besides completion of proformas, admission and daily progress notes, filling four-page on line swab form, three-page mortality pro-forma, two-page Excel sheet, and two-page on line discharge and death reports etc.

They added that the issues were raised in meetings with Covid-19 focal person and dean, but to no avail.

When contacted, LRH BoG chairman Prof Nausherwan Burki said the new roster gave them only 24 hours and not 100 hours a week.

He said with the current patient load, there were more than enough internists and pulmonologists to easily cover workload.

“Obviously, paediatricians, psychiatrists and dermatologists would not be able to provide adequate care for these patients. Please note that the backup physician is only on call from home if the patient numbers in the non-ICU areas exceed 15 - this has not happened to date, and I understand that should that begin to happen regularly then the roster will need revision,” he said.

Published in Dawn, May 24th, 2020