S.Clark_Discussion1
docx
keyboard_arrow_up
School
Wilfrid Laurier University *
*We aren’t endorsed by this school
Course
224
Subject
Medicine
Date
Dec 6, 2023
Type
docx
Pages
7
Uploaded by ClarkdaShark
Recently, residents of Fogo Island, a small island off the east coast of Newfoundland have had
significant issue with access to medical care. Their last doctor quit a few months ago. Recently,
an American doctor offered free-to-charge – his serves until a full-time physician can be secured.
After viewing the following video and reading the articles, is this a case where bureaucracy is
harmful or necessary? Please explain your position using reference to Lesson 3 materials. In
addition, in your opinion, what task-related personality traits (DuBrin, Ch. 2) would an incoming
physician need?
For the last year, Fogo Island has suffered a drastic shortage of medical professionals and
doctors to work at the family-medicine clinic, the emergency room, and to check on the
individuals admitted to acute-care and long-term care hospital beds (Fong, 2022). The articles
have stated that “physicians working in remote and rural areas experience rapid burnout as a
result of overworking, being on-call 24/7, and the lack of resources to support physician
wellbeing” (Fong, 2022). The medical crisis in secluded geographical areas, such as Fogo Island,
will continue to worsen with time as a result of the governments and the College of Physician
and Surgeons mismanagement of the healthcare system. This shortage of doctors has left
residents, largely made up of an elderly population, of Fogo Island stranded without immediate
and reliable access to preventative treatment and care. This shortage requires residents to re-
locate to other areas in order to receive the required level of care they need – with the closest
doctor’s office/emergency room being 3-hours away – or resort to accessing Health Hubs with no
guarantee of getting an appointment (Jones, 2022). These “solutions” to the shortage of health
care access for residents of Fogo Island has been criticized as an inadequate address to the
current gaps in health care services (Jones, 2022).
The College of Physicians and Surgeons rejected Hart’s application to offer three months
of his medical services, for free, to the residents of Fogo Island as he did not meet provincial
licencing requirements. I personally believe that the bureaucracy of this situation can be seen as
being both harmful and necessary. However, for the purpose of my discussion post, I will
primarily discuss that the bureaucracy of this case, is in fact, necessary.
Necessary:
As discussed in the online lesson content, the principle of technical competence, skill,
and talent are the basis of hiring and organizational roles can be used to explain the necessary
components for the College of Physicians and Surgeons in hiring a doctor for Fogo Island
(Dixon, 2023).
Hart had been working in telemedicine for the last 3 years and has not had worked in-
person care during this time (Jones, 2022). Telemedicine is ideal and suitable for routine
follow-ups, minor illnesses and health consultations, whereas in-person care remains
crucial for more serious conditions, chronic illnesses, initial diagnoses and procedures
that require physical examinations and/or specialized tests. Hart may lack the required
skill set to meet the demanding needs of the residents who reside on Fogo Island.
Despite Hart studying medicine in Newfoundland in 1973, the College is unsure if he has
kept up to date on training and education that meets standards and requirements to
practice medicine and care in both the province and the country.
Since Hart worked in the States for many years prior to applying to work/volunteer on
Fogo Island. Healthcare between Canada and the US drastically differ in the way care to
patients is provided. Example: treatments, drugs and testing that might be commonly
used in the US may not be approved for usage in Canada (Jones, 2022).
Hart has not experienced working in rural medical facilities and thus has little to no
knowledge to treating patients with limited access to resources available.
Necessary:
As discussed in the online lesson content, another principle that can be used to describe
the necessary components is the standard operating procedures should be identified and followed
(Dixon, 2023).
Despite Hart beginning his medical training in Canada, he hadn’t previously completed
the required Canadian exam in order to practice medicine, as it wasn’t a required
qualification for his practice in the States (Jones, 2022).
Due to his lack of requirements and qualifications to practice medicine in Canada, he was
unable to acquire malpractice insurance, which he required a provincial medical licence
in order to obtain (Jones, 2022).
If something were to go wrong or if someone feels that they have been wronged at the
hands of this doctor, residents of Fogo could turn against the College of Physicians and
Surgeons and potentially make complaints that the doctor hired wasn’t properly qualified
for the position. The College has certain requirements that need to be met to protect
themselves and the doctor from wrong-doings, complaints, and lawsuits.
If the College allowed one person to by-pass the requirements to work (despite the high
demand and need for a doctor in this area), the College would need to bend the
requirements for other physicians. Many members would submit grievances due to
unfairness in the licencing process.
To answer the second part of the discussion question, upon reading chapter 2, I believe
that the task-related personality traits that an incoming physician on Fogo Island would need is
flexibility and adaptability, passion, proactive personality, and emotional intelligence (DuBrin,
2023).
1.
Flexibility and Adaptability
: Due to the lack of health care opportunities on Fogo Island,
the person is potentially going to be the sole physician on the island and operating all
areas of the system (including the family-medicine clinic, emergency room, and to check
on those admitted to acute-care and long-term care hospital beds) and therefore must be
able to set a working schedule that reflects the needs of the residents on the island, from
clinic hours, emergency room hours and scheduled operations, and on-call hours, while
being mindful of scheduling time for personal wellbeing, which can be extremely
difficult to find a balance between a work and personal schedule as the sole health
provider. The physician must be able to assess the severity of situations and adequately
make decisions on which patient requires immediate care and which situations can be
lower on the priority list. The physician must be able to adapt to various scenarios that
arise without notice and be able to efficiently prepare for future impediments. In the
article titled “for two weeks I was Fogo Island’s only doctor”, Dr. Anthony Fong
expresses that he had to make compromises in care for the residents in Fogo Island due to
the specific and complex nature of challenges that can be found in rural/remote areas
(Fong, 2022).
2.
Passion:
Fogo Island has a large population of elderly individuals that require specialized
care. The physician hired for the position must have a high degree of genuine passion for
working with people and wanting to help others during potentially vulnerable situations.
The doctor must have a sincere desire to practice medicine. In this domain, the physician
must be able to be empathetic to understand and relate to a patient’s feelings. Due to the
lack of additional healthcare professionals on the island, the physicians working hours
will often be 24/7, the person must have a high level of passion and commitment to their
job to work long hours.
3.
Proactive Personality:
In this specific role, the physician is likely to be the sole physician
on staff and is expected to maintain, operate and run various aspects of the health care
system for the entire population of residents located on Fogo Island. The person must be
able to take imitative to complete tasks and must be resourceful in finding solutions and
overcoming barriers for situations both in the moment and in the future (DuBrin, 2023).
4.
Emotional Intelligence:
a.
Self-awareness:
The physician must be able to be self-aware of their emotions at all
times. Being a sole healthcare provide for a large population of people is very taxing,
and if you are not 100% at your best and on-top of your workload, the patients will be
able to see this and can cause a strain in the healthcare provider-patient relationship,
as well as impact the way that the job is performed.
b.
Self-management:
As the sole healthcare provide, the person must be able to perform
tasks and make effective decision and problem-solving with little to no support for
other colleagues. When events become overwhelming or don’t go as planned, the
physician must be able to keep their composure and find alternative ways of dealing
with any situations that arises.
c.
Social awareness:
The physician must be able to have empathy for the people that
they are assisting. The person must have the ability to both observe and understand
the emotions, needs and the concerns of other people. They are required to see things
from other people’s viewpoints and be able to see that there are multiple ways of
doing things and that no everyone will have the same view; they must show the
person that their points are valid, even if they do not agree with them.
d.
Relationship management:
As the sole, primary physician on Fogo Island, you just be
able to strategically manage your interactions and the relationship between yourself
and the patients. This includes communication, collaboration, education, and
engagement of residents, as well as influence, coach and mentor, and teamwork for
promoting the assistance of additional healthcare providers to work on the island
(DuBrin, 2023).
References:
CBC News: The National. (2022, July 28).
Fogo Island without a doctor for first time in 200
years.
[Video]. Youtube.
https://www.youtube.com/watch?v=rKn3tTWvrGg
Dixon, S. (2023). Organizational leadership. Lesson three, principles of bureaucracy. Retrieved
from:
https://mylearningspace.wlu.ca/d2l/le/content/504652/viewContent/3413974/View
DuBrin, A. J. (2023). Leadership: Research findings, practice, and skills. (10
th
ed.): South-
Western, Cengage Learning.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Fong, A. (2022, August 14).
For two weeks I was Fogo Island’s only doctor
. CBCnews.
https://www.cbc.ca/newsinteractives/features/two-week-stint-on-fogo-island
Jones, M. (2022, September 14).
U.S. doctor’s offer of free medical help for Fogo Island rejected
after licensing snag | CBC News
. CBCnews.
https://www.cbc.ca/news/canada/newfoundland-labrador/dr-paul-hart-fogo-island-
1.6577101
Response #1:
Good afternoon, Kyle. I would like to start off by saying that you have highlighted several
important points surrounding why you believe that the bureaucracy on Fogo Island is harmful
and detrimental to the residents on the island and for their access to immediate and preventative
healthcare. However, I posit that some of the points that you made are actually necessary in the
bureaucracy. For example, you expressed that “the bureaucracy on Fogo Island’s denizens is its
impediment to securing a new doctor” and referenced this statement to the article by Jones
discussing the scenario of Dr. Hart, who’s offer of three months free healthcare services was
rejected by the College of Physicians and Surgeons. In my opinion, despite the desperate need
for a doctor on the Island to serve its inhabitants, which is made up largely of an elderly
population, allowing a physician to by-pass provincial licensing requirements and medical
legislation could have damaging consequences to all parties involved (Provincial government,
College of Physician and Surgeons, the doctor, and the residents of Fogo Island).
I do agree when you mention about the healthcare system relying strictly on one individual
to run various aspects of the healthcare system and how that can impact the quality of care that
the residents on the island receive. This could be in part due to the physician’s lack of
knowledge/skills on certain aspects of healthcare to adequately provide preventative treatment,
limited availability to schedule a time to see the physician, and burnout experienced by the
physician. The provincial government of Newfoundland and Labrador need to rapidly and
swiftly develop up to date strategies that encourage physicians and other healthcare professionals
to work in rural/remote geographical locations that benefits both the residents living on the island
and the physician themselves. Until this can be successfully developed and implemented, I
believe that Fogo Island will continue to see a chronic shortage of doctors and medical
professionals.
Response #2:
Good afternoon, Sebastien. Thank you for your contribution to this week’s discussion post!
You have expressed many important points that shows how bureaucracy in this specific scenario
can be harmful to the residents living on Fogo Island. In your discussion post, I feel like you
could have expanded a bit more on why you believe the task-related personality traits you
selected are important and why a physician would need them in order to work on the Island.
I can see from your point of view how bureaucracy can be harmful, but I think that in this
certain situation, the necessary factors outweigh the harmful components of not accepting Hart’s
application to receive his provincial licence to practice medicine in the province of
Newfoundland and Labrador. Regarding Hart’s work in telemedicine for 3 years, it is important
to recognize that telemedicine and in-person care/medicine drastically differ from one another in
terms of care, treatment and response to patient illnesses. Telemedicine is meant to support
patients with routine follow-ups, minor illnesses, and health consultations, resulting in Hart not
having any recent and up to date experience or the opportunity to practice medicine within an in-
person care setting working with patients who have more serious and complex medical
conditions, chronic illnesses, procedures, physical examinations and specialized testing during
those 3 years. Due to his limited work experience during those years, Hart might potentially lack
the required qualifications to successfully meet the demanding healthcare needs of the residents
who reside on Fogo Island. Despite the growing advancement of technology being utilized in the
medical field, there are certain aspects of the practice that require specific skills, knowledge and
experience of in-person care that cannot be obtained through telemedicine employment.
However, there has to be some sort of strategy on how the College of Physicians and
Surgeons can grant Hart his medical licence without by-passing the requirements. Do you think
that there are any possible solutions available that can support Hart to successfully obtain his
licence to practice medicine so he can support the resident of Fogo? (Example: I personally think
that there should be some form of opportunity for Hart to practice under another licenced
physician for a few weeks and take the Canadian medical exam in order to be fully licenced).
Response #3:
Good afternoon, Jill. Thank you for your insightful response to my discussion
post. I do agree that there are many harmful components of bureaucracy in this situation
and that not allowing Hart to provide medical services on the Island due to issues with
medical licencing can being detrimental outcomes. The rejection of his medical licence
does in fact negatively impact the resident’s quality of care and even violates their human
rights of access to healthcare, as outlined in the Canada Health Act.
To answer your question, I do believe that there has to be some sort of strategy on
how the College of Physicians and Surgeons can grant Hart his medical licence without by-
passing the requirements. Examples such as providing an opportunity for Hart to practice
under another licenced physician for a few weeks and take the Canadian medical exam in
order to be fully licenced is a potential solution. I also think that it could be an option for
the College of Physicians and Surgeons to provide a member to oversee Hart’s medical
practice for a few weeks in order to ensure adequate medical care is being provided to the
residents of Fogo. I am also wondering if Hart could potentially obtain reference letters
that speaks to his professional work ethic, skills, and abilities to obtain his licencing. I
think that finding a solution to this situation will require involvement from various parties.
Response #4:
Good afternoon, Tia. Thank you for your insightful response to my discussion
post! I thoroughly enjoyed reading your points on why you disagree with my selection of
bureaucracy being necessary in this scenario.
You made the point in your response to state, “Dr. Hart was doing telemedicine
and did not meet the requirement where physicians need to have worked 120 days within
the three years of application date”. Something that I had missed while examining this
case is that Dr. Hart, like many physicians during the same timeframe, were working in
telemedicine as a direct result of Covid-19. Due to the pandemic, a majority of healthcare
services were transferred from in-person care to telemedicine care to prevent the
exposure and spread of Covid-19. Telemedicine was predominantly used in areas such as
family medicine, in-patient and out-patient services, specialist appointments and
consultations. I think that the College of Physicians and Surgeons should take the surge in
the use of telemedicine for the purpose of preventing Covid-19 into consideration before
rejecting his application for a medical licence to work on Fogo Island.
To answer your question when you ask, “do you think that the citizens may have
already turned on the College?”, I personally believe that the residents are already
frustrated with the lack of availability and access to healthcare and that this situation is
continuing to fuel their frustration, dissatisfaction, and discouragement on the various
levels of the healthcare system (College of Physicians and Surgeons, both provincial and
federal government). I think that the residents will not be adequately satisfied until the
crisis for healthcare on the island has drastically diminished (Example: there is more than
1 doctor and additional medical professionals working on the island, they aren’t waiting
weeks to get an appointment and be seen by a physician, and more resources become
available to be treated on the island without having to travel upwards of 3 hours to
receive intensive and complex care).
Final Submission:
For this week’s discussion, we were instructed to examine various media outlets that posit
the chronic shortage of doctors in remote/rural geographical locations, specifically, on Fogo
Island. In summary, this discussion has yielded a majority consensus that bureaucracy and the
profound effects it has on the residents of Fogo Island is in fact harmful. Students listed several
points to highlight the growing list of multifaceted challenges and barriers to accessing adequate
healthcare for those who live on the island as a direct result of bureaucracy. However, I was the
only participant that opposed the idea that bureaucracy is harmful and concluded in my initial
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
post that bureaucracy in this scenario is necessary. Many participants were able to sufficiently
see my perspective, facilitate meaningful discussion and contribute positively to my post that
challenged my initial thoughts on the complexity of the situation.
Participants in this discussion have emphasized several unique and important task-related
personality traits for an incoming physician. The most commonly discussed traits were flexibility
and adaptability, emotional intelligence, and passion.