Monday, March 17, 2014

T&T Medical Malpractice Problem a Function of Protected Monopoly Status Bestowed Upon The Medical Board

As a general rule whenever consumers face market abuse it is because they are forced to transact in a marketplace where the producer or service provider has an artificial advantage. The unfair advantages are never organic but are usually the result of government granted and enforced restrictions on consumer options. The Trinidad and Tobago medical care marketplace is a prime example of this.

The T&T Medical Board is responsible for licensing and enforcement. However only doctors that engage in activity that may embarrass the profession due to massive media attention can expect some sort of faux disciplinary action if any. All this is done only to show the public that the board is aggressive in enforcing its regulations, in protecting the public.

As many are finding out the medical board, like any good fraternal organization, protects their doctors. But still the major unspoken mission of the medical board is to protect doctors from market competition under the guise of protecting the patient. They can do this as their members have been granted collective monopoly status over the provision of medical care in Trinidad and Tobago.

Once granted this position of privilege by the state via the Medical Board Act they proceed to seek their own interest rather than the interest of the patient. Prime examples include their rigid control of medical school enrolment and limiting the entry of foreign trained doctors thereby making the number of doctors low in order to keep fees high, all at the expense of the consumer and taxpayer.

Ironically, doctors themselves especially those in the public sector also suffer as they are often stuck being overworked –working long hours, producing stress and greater opportunities for minor or major blunders. Moreover, doctors must conform to the wishes of the board or the board "leadership" in any and all respects and must close ranks when required to protect the fraternity even against their moral conscious. 

Why? Because attaining an MD degree represents a great deal of work and a considerable monetary investment. License revocation means not only loss of the doctor's income, but a devastating blow both socially and professionally. Few doctors will entertain such a possibility and instead go a long to get along so as to avoid blow back and intimidation.

In sum because of this government-granted protected monopoly the Trinidad and Tobago medical system is in effect an undercover dictatorship that restricts the art of healing to a small class of practitioners. This in addition to public hospitals which ensures there is no substantive motivation for practitioners to provide service to customers / patients means that patients are extremely vulnerable to abuse and ill-treatment. This phenomenon will continue unless the current system is overhauled and replaced with a more open market system where competition is encouraged.


  1. You are wrong in your statement that" the medical board controls medical school enrolment. " Enrolment at the UWI medical school is at an all time high and medical board controls simply do not exist! You should check your facts first

    1. Thanks for your feedback.

      Consider the Medical Board is nothing more than a glorified trade union existing firstly to seek the interest of it members.

      Although the UWI Med school enrolment may be an all time high simply ask: Why isn't enrolment higher given the tremendous shortage in medical care?

      Higher enrolment means increased competition and cheaper medical care. This is not something the gov't privileged gatekeepers would intentionally promote.

      The board therefore is asserting gov't granted privilege over their future competitors even if its under the guise of protecting patients. As always the best protection mechanism for patients would be more choice i.e. more doctors which is not in the interest of practicing doctors.

    2. This analysis may seem at odds with conventional thinking but it explains the 'lack of care' in T&T Health Care system.

      At the heart of this problem is a lack of competition in the medical field. We have a health care system that is largely not focused on the customer.

      There wont be a good remedy to this problem until we address the core issue.

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