會長通訊:新型冠狀病毒 IV | President's Message:WARS IV

HKDU⠀ Published at 2020-05-15

新型冠狀病毒 IV

 

於2020年4月28日,我代表本會出席了醫務委員會的紀律研訊。醫務委員會前主席麥 列菲菲教授(左三)將於2020年7月6日從醫務委員會榮休。

 

 

鑑於2019冠狀病毒病疫情大流行,所有常規的延續醫學進修活動將暫停,直到另行通知。 作為延續醫學進修活動的提供和執行機構,香港西醫工會一直積極透過各種方式提供延續醫學進修活動,鼓勵醫生會員參加並獲得延續醫學進修學分。

我們已於2020年3月向香港醫務委員會(醫委會)申請,為參加由香港西醫工會舉辦的網上直播延續醫學進修活動的醫生授予延續醫學進修學分。我們感謝醫委會迅速並令人鼓舞的的回覆,於2020年4月1日確認本會透過ZOOM和Facebook直播的延續醫學進修的認證資格並即時生效,這是我們通過共同努力而得到的成果。(醫委會的回覆請參閱本月刊第6頁)。從現在開始,我們將為會員提供更多網上直播延續醫學進修的學習機會。我們知道一些會員在參加這些網上直播延續醫學進修活動時會遇到困難,因此我們在前兩期的月刊中給會員分享了一些提示。我們在本月刊第7頁亦準備了一個專欄列出會員參加網上直播延續醫學進修活動時會遇到其他的問題及指引以供大家閱讀。請各會員參考一下,若您仍然在參與網上直播延續醫學進修時遇到困難,歡迎致電2388 2728與秘書處聯繫。


我於2020年4月10日上午9時40分左右在香港電台第1台就第二輪防疫抗疫基金發言。


首先我說我們感謝政府豁免三年的年度執業證書費,金額高達$1,350港元。然而,隨著2019冠狀病毒病疫情大流行的發展,封關和社區隔離的實施,我們私營診所的業務損失高達七成至九成,而一些同業每月更淨虧損$100,000至$200,000港元,並在倒閉的邊緣。我說過,我們已經於2020年3月4日與食物及衞生局交談,要求第二輪的防疫抗疫基金為醫生提供補貼,但徒勞無功。


第二,我還於香港電台第1台說過,我們私家醫生必須通過檢測來遏制該病毒,並與政府並肩對抗2019冠狀病毒病。因此,我們為診所配備了完整的個人防護裝備,每月費用約為$10,000港元,而這筆額外開支應透過政府補貼資助。我說過,政府至少對私家醫生的個人防護裝備補貼資助六個月,我們才會接受。

第三,我談到本會已要求領展減租,正如17年前的沙士時期一樣。我們已經跟領展提及有關在與2019冠狀病毒病的抗疫中處於最前線的公共屋邨醫生的業務損失。我們對領展的租務管理態度感到失望。 我們將盡快尋求其他大業主的幫助。


我也曾與食物及衞生局副局長徐德義醫生及食物及衞生局常任秘書長謝曼怡女士談過第二輪防疫抗疫基金處理強積金的問題。我想知道為何對於65歲以上的自僱在職醫生會存在歧視的問題,他們因無法像65歲以下的一般醫生參加強積金計劃而無法在第二輪防疫抗疫基金中受惠。他們答應會調查這個問題,並儘快給我們答覆。


在過去的兩個半月中,香港和全球在2019冠狀病毒病的抗疫中都遭受了沉重打擊。於2020年4月22日,香港的2019年冠狀病毒的新病例降至零,但現在還不是鬆懈自滿的時候,因為世界各地都在湧現新病例。根據微生物學家的說法,可能會出現第三波新冠病毒感染。


因此,為保護我們自己和市民,醫生同業們應在臨床工作場所使用適當的個人防護裝備保護自己,直到冠狀病毒結束。由於2019年冠狀病毒仍在流行,許多會員亦擔心患有慢性疾病的病人可能無法前往診所進行治療和補充藥物。


然而,醫院管理局的普通科門診公私營協作計劃的諮詢小組已針對慢性病患者的臨時藥物補充作出安排,計劃下經醫生對患者的最新醫療狀況進行遙距審查後,病人便可以得到短期的藥物補充,而無需進行面對面診症。該計劃已於2020年2月25日生效。


本會於2020年3月6日致信醫委會(請參閱本月刊第10頁),詢問該計劃的安排是否適用於私家醫生、是否合乎道德並可以接受的,我們於2020年4月17日已收到了答覆,請仔細閱讀本月刊第11-12頁。


醫委會的回覆大致上指出:醫委會不能取代個別醫生的自主權,也不能向他們發出任何指引,說明在什麼情況下不進行面對面診症的藥物補充才是適當。醫生應該以他或她的病人的最大利益為大前提。此外,醫生應確保他/她處方給他/她的病人的任何藥物都適合該病人的醫療狀況。因此,個別醫生應考慮到每個患者的具體情況、及在沒有面對面診症下作出專業判斷去補充藥物是否合適。


在此,我要補充一點:我們應該考慮到在某種特殊環境下,例如當前的疫症大流行時期的任何個案的具體情況。

請各位老友記保重,維持身體健康和快樂!

 

楊超發醫生

 


 

WARS IV

 

In view of the COVID-19 Pandemic, all regular CME activites would be suspended until further notice. As CME provider and Administrator, HKDU has been thriving hard to organize CME activities through various means, encouraging doctor members to join and gain CME points.

 

We have applied to the Medical Council of Hong Kong (MCHK) in March 2020 for granting CME points for doctors attending CME live activities organized by HKDU. We are grateful to MCHK for their swift encouraging reply for approving our live CME activities through ZOOM and Facbook Live realized through our concerted hard efforts to meet with their Accreditation requirements with immediate effect from 1st April 2020. (Please see page 6 of this Bulletin for the reply from MCHK). From now on, we shall provide more e-CME learning opportunities for members. We are aware that there are hiccups for some members joining these live CME activities, so we have shared some of the tips for members in the previous bulletins. We have prepared a dedicated column to tidy up the remaining difficulties encountered by some of the members in joining these activites on page 7 of this Bulletin. Please do have a look and in case you still find difficulties in joining e-CMEs, you are most welcome to call the secretariat at 2388 2728 for help.

 

I spoke on RTHK 1 in the morning of 10 April 2020 around 9:40am on the Anti-Epidemic Relief Fund 2.

 

I said, first of all, we appreciated the Government on exemption of our annual practising certificate fee for 3 years which amounts to a huge sum of HK$ 1,350.00. However, with the evolution of the COVID-19 pandemic, the implemenation of close border and Social Distancing, the business of our private clinics has dropped from 70 to 90 % and some colleagues are suffering a net loss of HK$ 100,000 to 200,000 per month and are on the verge of closing down soon. I said we had talked with the FHB on 4th March 2020 asking for relief fund help in the Anti-Epidemic Relief Fund 2 but in vain.

 

Secondly, I also told the RTHK 1 that we, private doctors, have to fight with the Government against the COVID-19 by containing the virus through detection. As such, we have equipped full PPE for our clinic operations which costs around HK$ 10,000 per month and this additional sum should be reimbursed by Government subsidies. I have told that at least 6 months Government subsidies on PPE is the least sum we accept from the Government.

 

Thirdly, I talked about our Union asking LINK on rental reduction as in the period of SARS 17 years ago. We have told LINK about the loss of business of public estate doctors who are in the frontline on this battle with COVID-19. We are disappointed with LINK on the attitude of her management. We shall seek other tycoon landlords for help soon.

 

I have talked to Dr. Chui Tak Yee, Undersecretary for Health and Food, and Ms. Elizabeth Tse, Permanent Secretary for Health and Food too on the MPF issue in the Anti-Epidemic Relief Fund 2. I am wondering why there is discrimination for working doctors age over 65 who are self employed and therefore not be enrolled in

 

MPF that they cannot benefit with this Anti-Epidemic Relief Fund 2 as in others below age of 65. They promised to look into the issue and give us reply soon.

 

The COVID-19 struck hard in Hong Kong and the world for the last 2 and half months. On 22nd April 2020, the number of new cases in Hong Kong came down to ZERO but it is NOT the time for complacency yet as there are emerging new cases elswhere around the world. There could be a third wave coming, according to expert microbiologists.

 

So, to protect ourselves and our citizens, colleagues should protect themselves in their clinical working places with appropriate PPE until the WARS is over. As the COVID-19 is still prevailing, many members are concerned about their private patients suffering from chronic diseases who may not be able to visit their clinics for treatment and drug refills.

 

However, the GOPC PPP Programme Advisory Group of the Hospital Authority has approved drug refilling arangement for public patients with chronic illesses without the requirement of face-to-face consultation, upon doctor’s review of the patient’s latest medical condition. This was enacted with effect from 25th Feburary, 2020.

 

We sent a letter to the Medical Council of Hong Kong on 6th March 2020 (Please see page 10 of this Bulletin for the letter) asking whether similar arrangement is ethical and acceptable in PURE PRIVATE SETTING and we got the reply on 17th April 2020 as printed out on page 11-12 of this Bulletin for your perusal.

 

In essence :“The Medical Council of Hong Kong cannot take over the autonomy of individual doctors and issue directive to them on when drug refilling without face-to-face consultation would be appropriate under the Code. A doctor should act in the best interest of his or her patients. Moreover, a doctor should ensure that any drug that he/she prescribes to his /her patient is appropriate for treatment of the patient’s medical condition(s). Individual doctor should therefore make his/her professional judgment on whether and when drug refilling without face-to-face consultation would be appropriate, taking into account the specificic circumstances of each patient.”

 

To this I would add: We should take into account of the specific circumstances of any individual case in such environment, like in this period of Pandemic.


Take care, folks. Keep healthy and happy!

 

Dr. Yeung Chiu Fat Henry