“Cowboys” in healthcare system warned against prescribing outdated meds, unnecessary medications

…19 new medics told to “stick with the protocol”

As 19 graduates of the Medex Training Programme prepare to support healthcare delivery across the country, Health Minister Dr Frank Anthony has cautioned them against practices that could set back the Government’s efforts to build a world-class medical system.

Dr Anthony warned the graduates against failing to follow updated treatment protocols, prescribing outdated medications, and making unnecessary requests for medical evacuations (medevacs) for patients in remote communities.
Speaking during the graduation ceremony on Tuesday, the Minister emphasised that “what was acceptable in the past is no longer acceptable”.

Supervision
Dr Anthony acknowledged that supervising Medical Extension Officers (Medexes) can be challenging because many work in remote locations, where oversight is limited. However, he cautioned that this should not be seen as an opportunity to neglect their duties.
“You know, sometimes when you’re out in these far-off areas, it is harder to supervise you. And some people, when they’re not under supervision, tend not to work because they feel that nobody is looking at them, nobody is talking to them. So, then they show up at work late, so instead of the clinic opening at eight o’clock in the morning, they turn up at 10 o’clock, right? And then by 12 o’clock they gone home,” the Minister lamented.

Outdated Meds
The Health Minister also pointed to instances where healthcare workers fail to adhere to updated treatment protocols, including guidance on the use of modern medications. He urged the new batch of Medexes to uphold current medical standards and ensure their practices reflect the latest developments in healthcare.
“They got some people; they’ve been in the system so long that they’re using medication that’s gone out of style. So, they still prescribe things like captopril, which we stopped using. So, when they prescribe that and it’s not in the system, then when the patient goes to get it, they can’t get it because we’ve stopped buying captopril because that’s not part of our formulary; that’s an old medicine. We’re using newer and better things,” he outlined.
“We got some cowboys in the system; they don’t use any protocol. That’s not what we want. If we spend time to develop these things and we have seen scientifically that it works, then we don’t want you to reinvent the wheel and try something else; stick with the protocol because it’s working,” Dr Anthony stressed.

Unnecessary medevac
The Health Minister also warned against the unnecessary use of medical evacuations, noting that the Government has been investing in improving hinterland healthcare.
“I hope that you’ve sharpened up your surgical skills cause I don’t want to see somebody with basic lacerations that yall sending out with a medevac. Right, you should know how to stitch it up and so forth. Fractures, you should be able to deal with. You know Christmas coming up and one of the tricks that they got in the system…is that you call for the medevac and then somebody got to accompany the patient and when you come out in December, you spend some time to do the shopping and then you go back in. But in the first place, the call was not necessary, because you could’a fix up the patient right then. So don’t believe we don’t know the tricks,” Dr Anthony cautioned.

Standard care
The Health Minister emphasised that the Government is making the necessary investments to ensure every citizen, regardless of their location, gets access to quality healthcare.
“There was a time when in any region, if you go, especially in the interior of Guyana, the standard of care was very basic. But we want to change that; we don’t want that there are two different standards of care in Guyana. What we want is whatever we can get on the coastland is a similar type of care that we can get in the interior of Guyana. And therefore, you have a big job in helping us to make sure that the quality of care that you are delivering is equal to that of the coastland. We’ve trained you; we’ve trained you well, and as you’ve heard, the Medex Programme has been around for 49 years, but we have upgraded aspects of the curriculum to make sure that is compatible with modern healthcare,” Dr Anthony outlined.
The Medex Training Programme is designed to equip participants with the essential knowledge, clinical skills, and competencies required to deliver primary healthcare services, with particular emphasis on disease prevention, early diagnosis, treatment, and community-based healthcare.
According to a brief statement from the Ministry of Health, the newly trained Medex professionals are expected to play an important role in strengthening primary healthcare delivery, particularly in rural, hinterland, and underserved communities, where access to essential medical services remains a key priority.