Why this is important

To prevent deadly fraud

South Africa’s public hospital overtime system allows senior doctors to get paid for work for that they don’t do, or even earn a second salary in private practice while being paid by the state (see SAMJ ARTICLE).

In many cases what the senior doctors are supposed to be doing is supervising junior doctors. If junior doctors can be persuaded not to comment when senior doctors don’t do their jobs, those seniors get free money. Junior doctors are left working alone, taking decisions and doing procedures that they may not be properly trained or experienced in. It is patients who suffer the ultimate cost.

For our profession

An aggressively hierarchical, patriarchal professional culture should not be acceptable in South Africa in 2017.  My other comments at Addington were about racism and sexual harassment. When feedback is shut down, problems do not get dealt with.  One of those problems is discrimination. We cannot continue to be a profession in which our society’s worst forms of repression are given free rein.

It’s also about reminding ordinary doctors that we all need to improve. Particularly in the public sector, medicine is not a caring profession. We are treated callously by our employer, and too often we treat other staff and our patients the same way. But people work and heal better when they are part of institutions that value them and respect their human dignity. Improving our professional culture will help us to fix human bodies more efficiently and more sustainably.

For our junior doctors

This is about supporting and encouraging junior doctors who continue to work in insecure positions that make them extremely vulnerable to abuse. After releasing my YouTube video in 2016 I was contacted by large numbers of doctors, mostly women, who’d had or were having similar experiences. We need to ensure their situation is not completely hopeless. One of the most horrifying parts of my Addington ordeal is that other junior doctors at this hospital have continued to suffer extreme levels of victimisation. This should not be allowed to continue indefinitely.

For our society

Doctors have power over people when they are at their most vulnerable, and our elite status gives us a related social power. We have a responsibility to wield this social power in a way that strengthens our constitutional democracy and its Bill of Rights. At the very least we shouldn’t be working in the other direction.