The Tribune

By AVA TURNQUEST

Tribune Chief Reporter

aturnquest@tribunemedia.net

WEIGHING IN on the dispute that led to the resignation of the chief of medical staff at Princess Margaret Hospital, ophthalmologist Dr Jonathan Rodgers yesterday highlighted the critical shortage of eye doctors in the country.

Dr Rodgers explained that his support for the appointment of two Indian ophthalmologists - at the centre of the dispute - was rooted in the paradigm that some Bahamians will experience irreversible loss of eyesight as a result of the long waiting list for surgery and appointments at the Princess Margaret Hospital Eye Clinic.

While the ratio of eye doctors to patients, in developed countries, is three to five ophthalmologists per 100,000 people, Dr Rodgers noted that there were currently only four board certified or fellowship certified practising eye doctors in the Bahamas.

He said: “The shortage of ophthalmologists is highlighted by the fact that the waiting list at the PMH Eye Clinic for surgery and appointments is in excess of one year. Because of the long waiting list, undoubtedly there are some patients who have and will experience irreversible visual loss.”

Just four months into his second term, Chief of Medical Staff Dr James Johnson resigned with immediate effect on November 22 after reaching an impasse with the Public Hospitals Authority over its decision to disregard his recommendations on the appointment of the two Indian eye doctors.

Dr Johnson told The Tribune that he decided to step down from the post after it became apparent that the Public Hospitals Authority, namely director Herbert Brown, had already gone forward with the recruitment exercise despite months of back-and-forth discussion over the changes.

He forecast that the disparity in pay and procedure between the new recruits and previous local hires had the potential to create “big problems.”

His resignation was supported by the Consultant Physicians Staff Association, and its President Dr Locksley Munroe, who flagged issues over the tone and insulting manner in which Dr Johnson was treated.

In an email to The Tribune, Dr Rodgers provided a detailed account of the appointment process that began in March of this year - from his perspective.

“The two recruited eye doctors are sub specialists in cataract, corneal, refractive and retinal surgery, are both Fellowship certified, have written numerous academic papers published in accredited ophthalmological journals and have had more surgical experience, at this stage of their ophthalmic careers, than any other surgeon at PMH. Given their qualifications, the request was made that the two Indian ophthalmologists should come on staff as either senior registrars or consultants.”

Dr Rodgers said he inquired about the recruitment process to Dr Johnson in passing shortly after the request was made, and was told that a registrar in the Eye Department and an inactive part-time consultant did not agree with the appointment.

Pointing out that those persons did not have the right to vote on the matter, Dr Rodgers noted that both detractors had not attended the two meetings at which the decision was made, but had received the minutes of both meetings.

Dr Rodgers said he inquired about the recruitment process again while Dr Johnson was on sick leave, and Dr Cherilyn Hanna was made the acting chief of medical staff and head of the MAC. Dr Hanna informed him that the doctors would be appointed as junior registrars and not senior registrars.

“On further investigation,” Dr Rodgers said, “Dr Hanna informed me that Dr Munroe, the former chief of surgery and a registrar in the Eye Department had collectively made the decision to appoint the two Indian ophthalmologists as junior registrars even though the recommendation from the two consultants in the Eye Department was that they should be recruited as either senior registrars or consultants.

Dr Rodgers questioned how the former chief of surgery and an Eye Department registrar could influence the MAC to disregard the recommendation of the Eye Department’s consulting staff.

He said that a review by other members of the PMH consultant staff under Dr Hanna, led to the unanimous decision that the two Indian doctors should be appointed as senior registrars because they were “probably the most qualified doctors who had ever applied for a position at PMH”.

Dr Rodgers said that the two Indian doctors accepted the appointment initially, but then advised that they had been offered positions as consultants and requested an upgrade of the status being offered by PMH. Consultants have the right to engage in private practice.

Citing prior experience with foreign consultants, the MAC advised that it was not prepared to support such a change because this often detracted from their time spent at PMH providing public care. Taking into account the level of expertise and the dire need for their services, Dr Rodgers said the PHA decided that the doctors be appointed full time consultants on a three-year contract without the right to a private practice. He said this decision was agreed to by all save Dr Johnson and an Eye Department registrar.

“Furthermore, (PHA Managing Director) Brown also explained that currently at PMH there were two full time consultants working without the right to a private practice and that both of these appointments had been recommended by the MAC.

“It was therefore strange and inconsistent that the same MAC were now objecting to the two Indian ophthalmologists being appointed as full time consultants and that, perhaps, there was some other underlying reason why Dr Johnson was reluctant to upgrade the appointments.

Dr Rodgers concluded that Dr Johnson and the other consultants were within their right to protest the decision, but noted that the PHA had the right to accept, reject, or defer any decision made by the MAC for the best interest of the Bahamian people.