Sunday, March 19, 2006

THE QUESTIONING OF A DOCTOR'S INTEGRITY

PLEASE DON'T CALL US QUACKS!

I know that I am supposed to be away from active blogging. But after having read a thought provoking (feeling provoking was more like it!) by someone, I felt strongly complled to pen down my thoughts; my sincere, humble and sad thoughts.

This person's brother was hospitalized for injuries incurred in an unfortunate motor-vehicle accident. Sadly, many incidents and predicaments that ensued after his hospital admission were uncalled for; treatments deemed unfit for the standards of our country's health service. The main culprit in this series of unfortunate events was the doctor. To be specific, he was the orthopedic specialist looking after the 'broken' guy.

I know he was just venting out his anger. Him being away overseas and unable to lambast at the rude, heartless doctor; all these proved to be too much for him. Thus he needed a venue to let off steam. That I truly understand.

BUT to equate we Malaysian doctors as quacks?? Isn't that overdoing it?? Calling us doctors quacks, bomohs or witchdoctors is just like telling us that our six years of slogging in medical school and years of practice are worthless effort; that we are actually a bunch of idiots given the license to prescribe our 'potions' to our so-called patients.

I am sorry that there are some 'black-sheep' amongst us. Doctors whom perhaps due to many reasons are not practising medicine wholeheartedly. These could be doctors who took up medicine for the wrong reasons like fulfilling their parents' desire etc.

But making a blatant generalisation and calling us quacks?? is it fair for us who work day in and out, tight down with a ridiculous schedule and a meager salary to match?

Do you know how I plowed through my one year of housemanship? As we were short of housemen that year, i had to endure a full year of doing alternate day calls. This literally means that I had to work continuously for a full 34 hours in a stretch!! Imagine!! And this means that I was virtually away from home and my kids, most of the time.

Let me tell you how a houseman's calls are like. We have to make rounds before anyone else does. We have to memorise each case, bed by bed. Their blood results, their values. The patients' latest findings, complaints and wellbeing. These should be at our finger tips. Or we'll be at the specialist's whippings (and you wouldn't want to be in those shoes, I tell you!). Then we have to draw bottles and bottles of blood and perform all the procedures ordered prior. When the MO comes, we accompany him/her for another round. The specialist comes, another round. And that's only for the morning!! And we have afternoon and night rounds too! Not mentioning, some specialists love ad hoc rounds whenever they fancy.

After office hours, HOs are the only active beings around. You are accountable for everything! The patients complaint of headache, call the HO. The patients can't urinate, call the HO. Even when the patients can't sleep, the HOs are being sought after! Never mind that the HO him/herself is not getting a single wink!

And this trend doesnt stop there. It continues even after an HO becomes an MO. The cycle repeats itself. Only that an MO gets to ask the HO to do it first!!

The point that I'm driving at is that Malaysian doctors are overworked and underpaid!! So what happens when a doctor is overworked?

1) He/she can't concentrate and mistakes can happen
2) They become grumpy and insensitive
3) They opt out for private practice, the first chance they get


Most importantly, the main message that I want to get across is that
despite everything, we doctors try our best to embrace compassion as
an embodiment of our work ethic. It is the spirit of healing. Monetary returns shouldn't be our goal. To our budding doctors, please know that being a doctor is never about glamour nor high-status. It is all about sacrifice and hard-work in the line of preserving good health for the public.

To all our budding doctors out there, Hiyoshi, Ayumi, iFos, Sarah, Muhammad, Hannah, Haneem and the rest, please take heed. Rise up to this call. Prove to them we are not quacks!

Wallahu'alam!

This is what Crimsonskye has to say:

Sometimes I don't get what's with all the high-profile-status-high-salary' hype related with the medical field. Don't get me wrong, because here is where I can see clearly that to become a doctor is to have something even more than just good results, a special kind of passion and focus- and I freely admit I don't have that.

Like I've mentioned in the entry, this is one profession that I respect and look up to not because of its status or the like, but because doctors deals so much with the human lives while making a lot of sacrifices on their own part. And that's truly something to be admired.



This is what iKelah has to say:



Adakah doktor di malaysia tiadak beretika?
Mengapa?


Biar saya mulakan dengan seminggu kerjaya seorang doktor.
Saya masih ingat setelah belajar 6 tahun gaji permulaan bulanan adalah RM1360 denga kenaikan RM60 setiap tahun. Seorang jurutera selah tamat belajar 4 tahun akan memperolehi gaji yang sama tetapi dengan 2 tahun senioriti.

Pada waktu itu saya ditugaskan
di Hospital Kuantan sebagai Pegawai Perubatan Sementara(houseman). Kami berlima mendaftarkan diri dalam keadaan tergamam. 5 houseman untuk 6 department!!! Penempatan pertama saya adalah di unit perbidanan dan sakit puan. Terdapat 1 doktor pakar, seorang registrar, 4 Pegawai Perubatan dan 2 houseman termasuk saya. Seorang pegawaiPerubatan junior terpaksa membuat call houseman.

Dalam seminggu ada 168 jam dan saya bekerja sebanyak 136 jam seminggu(2 consecutive days on call, next day normal hours, no off day)

. Houseman tidak layak MC, cuti tahunan 28 hari biasanya tidak akan dilayan, cuti umu tidak dilayan, weekends/ahad sama seperti hari bekerja. Untuk semua ini dibayar RM1360 sebulan atau RM340 seminggu.

Masa bekerja adalah 136 jam seminggu dengan bayaran RM340 bersamaan RM2.50 sejam.
Kerani rendah dengan gaji RM500 sebulan= RM125 seminggu bekerja selama 44 jam seminggu bersamaan dengan RM2.84 sen sejam. Beliau boleh menerima cuti sakit, bercuti pada cuti umum dan berhak menuntut 14 atau 20 hari cuti tahunan.

Gaji siapa yang lebih besar dan siapa yang diainaya! Belum dibandingkan dengan gaji jurutera atau pegawai tadbir.Walaupun demikian kebanyakan doktor menganggap tangungjawab dan kewajipan adalah lebih diutamakan. Tidak dinafikan terdapat segelintir doktor yang mementingkan diri dan kemewahan seperti didalam profession lain juga. Justeru itu tidaklah adil untuk menghukum secara menyuluruh.



25 comments:

Em said...

Salaams and Olas

Im glad your back..Im sad that your feathers are ruffled...

Dats just his opinion...

I hope you will feel better soon...Take care..

crimsonskye said...

To be honest if one just skims through the entry, he or she might get the impression many of the practicing doctors in Malaysia are simply unsatisfied that the heavy workload does not match the pay.

But I understand that this is another issue altogether. I've actually have written a whole entry on this back in 2004, when I was still receiving disappointed responses from people who couldn't believe I've never even considered medic with my SPM results.

Sometimes I don't get what's with all the high-profile-status-high-salary' hype related with the medical field. Don't get me wrong, because here is where I can see clearly that to become a doctor is to have something even more than just good results, a special kind of passion and focus- and I freely admit I don't have that.

Like I've mentioned in the entry, this is one profession that I respect and look up to not because of its status or the like, but because doctors deals so much with the human lives while making a lot of sacrifices on their own part. And that's truly something to be admired.

abdullahjones said...

darah panas. :)

Izhal said...

hi everyone, I'm the guy responsible for this entry :)

Dear Dr. Roza,
i knew i'd provoke some people especially the blogging doctors out there...

sory if my entry hurt you... it was not supposed to... actually i didnt equate doctors=quacks... i put a question mark behind the word quack didnt i... "doctors=quacks???"

i might have got carried away calling the doctor at putrajaya a BOMOH and apologize to have said so...

you wrote, "I am sorry that there are some 'black-sheep' amongst us. "
:: dont apologize for them. these are the people i was venting about. a profesional doctor talking like a mere respectless punk to my sick family member in an official government medical institution really upset me. after reading your entry, to come and think about it, theres quakcs in every profession. quacks are just people that complain a lot, hurt others in the process and dont get their work done... are you a quack? am i a quack???

you did write, "But making a blatant generalisation and calling us quacks?? is it fair for us who work day in and out, tight down with a ridiculous schedule and a meager salary to match?"
::i didnt generalize at all saying that all doctors are bad but i gave specific accounts of doctors not working right. did i not? i know you wrote this sentence in defense to all doctors and that you were feeling a little or perhaps alot irritated during the time. i even gave specific names and not once did i generalize about all doctors being quacks :) oh,except for the putarjaya BOMOH sentence...
im also underpaid but i would never complain as long as my family is eating well. i feel that i am still better off than the overworked and underpaid fisherman, padi farmer, police officer... the list is too long but i guess you know who else is underpaid... minimum wages in malaysia is below the human living par. mmm, i dont want to go through the hardship ive been through just to rebuttle your paragraph here. might make people cry :) lets just say that i got lucky to get where i am now, Alhamdulillah... however, im sory, i really dont know the working schedule of doctors and what they are making... sincerely, im sure its not what they deserve... my bad here...

the minister of health did once say a doctor is not a glamorous job... if thinking of riches do not be one becuase doctors are selfless people that would have to study extremely hard, meet sick and dying people all day get down and dirty in the office, but sometimes rake in the benefit of seing a sick get healthy... he should have included teachers in his speach as well, dont you think?

i understand the reason for your posting, and respect that you knew i was venting out my disguss. but not at the whole institution as a whole as i have explained...i'd like to take full responsibilty of your feeling bad after reading my blog that day and I sincerely apologize from your head to toe... Minta Maaf jika terkasar atau tercalar dan terguris perasaan Dr. Roza ya... 'adat berkawan, kadang2 terlawan'

call it a truth??? :)

p/s-
just FYI...
now my brother in law is feeling ok and is sent back to KL. the real culprit is the hit and run van... he managed to bribe the police and now my family members cant even find the sargeant that has the plate number of the offender. we're just giving up on that issue becuase unlike government medical service, the police legal system has very slim chance of doing right, especially for the no$$$ people :) we're just thankful to ALlah that boboy is recurperating fine... but still needs to go to the specialist for a CT scan of the brain... i'm also releaved and thinking straight again... NBB (http://nurulbahiyah.blogspot.com/) has been giving me some medical advice...her efforts made me feel stupid and a little guilty of my posting because she gave me advice after reading it :P

and to em,
please read my entry again if you have, you''re entitled to your own opinion too :) olas

Karam Singh said...

Membuat penilaian secara kasar dan menyatakannya dengan penuh emosi bukanlah satu perbuatan yang sangat wajar di zaman serba moden ini. Disebabkan burung burung pendatang yang telah kehilangan habitatnya oleh perbuatan segelintir manusia tidak bertanggung jawab dan kita juga yang bertanggung jawab membeli rumah yang dibina di kawasan habitat mereka, burung burung ini telah berpindah randah dan menyebarkan penyakit selsema burung. Akibatnya semua ayam ayam dan unggas unggas lain juga telah terpaksa dibunuh beramai ramai oleh pihak berwajib. Fenomena yang berlaku di negeri Cina juga mula berlaku di Malaysia. Yang berlaku kepada lembu juga berlaku di Sarawak. Adakah lembu juga akan dibunuh beramai ramai? Ibarat marahkan kelambu nyamuk di bakar...saya Karam Singh Valia TV3.

Queen Of The House said...

I remember going in and out of the NICU for three weeks, and sometimes we saw the same faces morning, evening, night ... for 3 or 4 days in a row. Which made me think, don't these MOs ever sleep?
Just as in other professions, there are those in it for the wrong reasons. We really shouldn't generalise and let some bad apples spoil the whole batch.

OOD said...

oh dr house,
when my mom was hospitalised, i saw same doctor faces in out in out for days in a row. Some days they looked so bad so tired so fatigued i worry for them.

And one doctor once told me, whoever chose the profesion either their heart really baik or they are really stupid.

It is the one profession that you have to become it. It cannot be 'just a job'. Kalau tak, susah nak ikhlas because the working hours are ridiculous and the pay doesnt compensate the risk+load+time.

You know my topi is always off to you lot.. If doctors become careless or cranky because they are too tired to remain being superperson, i will blame it on management. What ever that means.

And halo us all, isnt it fardhu kifayah also? Deknon2 yang tgh sekolah kenalah belajar rajin2 and hati kena lah bersih bersih so there will be more doctors and doctors all can start working reasonable hours, ya?

lifecuppa said...

dont worry dr roza,
I think people can differentiate a true doctor from a 'fake' one..

Mat Derih said...

Wei Karam, orang citer lain la.

Karam Singh Valia said...

Itu tadi lain cue ka?

Has said...

ha ha ha karam singh valia, you're a real star!

Has said...

and for DITH, tu ler, jangan dok gi ronda merata tempat, bawak balik geram jer.

Jiwa Rasa said...

I concur with drroza. do not generalise. Doctors are just like any other professions. There's always black sheep in any professions.

I've known many goodhearted specialists who do not charged for operations done. I've known many as well, who have been sued by the patients, for being kind.

I've known patients and relatives who shouted abuses to doctors, even when their beloved lives were saved..

easylady said...

wa..ha..ha
Karam singh walia's response very amusing.

In every situation in a hospital, everybody insist to be treated first..for them what they are suffering are the worst among patients in the hospital. It is a normal reaction. Who wants to be sick?Who wants to die?Who wants to suffer?

Most doctors will try their very best to treat their patients under pressured situation with lacking of equipment:patients ratio, understaffing and overworked. Partly the grumbling that came from patients is because of poor doctor patients relationship.This makes the patient feels they are neglected.The doctor with their wxperienced usually will prioritize sending urgent cases for further test while the not so urgent have to wait.But all in all its not so easy to satisfy everybody.

NBB said...

kalaulah disuruh mengulang kembali zaman semasa houseman, mati idup balik saya tak mau!

dr in the house said...

To everyone:

Thank you for your kind and sincere comments. i really appreciate them. You are good people.

To Izhal

This entry was not meant to condemn you but more to educate the young ones that this profession is nothing glamorous and full of hard work and sacrifice. That's why I didnt mention your name.

Yes, it's definitely a truce, :p

Anonymous said...

Last night I watched the Doctor House series in AXN. It`s one of my favorite other than Lost and 4400. Dr House is an irritating doctor in the series, sarcastic, rude, won`t treat minor ailments, let patients wait outside, avoid meeting patients and tries hard to just provide consultation from behind the screen. Probably that`s a doctor house. The hospital doesn`t fire him because when other doctors are in a blur over an illness, they shall ask doctor house before sending to berubat kampung.

pycnogenol said...

So I was right in my interpretation of the hidden message in this entry of yours.
(see my comment to hiyoshi's latest short entry.)

Enjoy your sabbatical !!

Restless said...
This comment has been removed by a blog administrator.
drroza said...

Pycno- yes, I think I must immerse myself back in my sabbatical leave as I see an anonymous blogger who is irritated by my presence, :))

Izhal said...

To everyone you are good people... Izhal tak good people??? :P tak aci ni...

ayumi_of_mirkwood said...

Salaam..
I'll keep it in mind, Dr. Roza.. but yeah, I guess, sometimes the bad ones are the minority, but they are prominent in the news. After all, if newspapers only write good things, it won't sell as well. What ikelah had commented about is logical too. Many people think that when houseman doctors had a say about their low salary, they're just being selfish. But they forget just how demanding the job is. And they forget that as much as a doctor should be a healer and trusted person, they are humans too. They have family and other responsibilities too. I think this applies to teachers. Some people are angry at the fact that their teachers can't speak English. But they fail to understand that the changes were sudden, and the teachers have been teaching in BM all their lives. You can't expect them to perform a miracle by speaking fluent English after an overnight. At least give them credit if they are making an immense effort to master the language.

Trust said...

Sebenarnya ianya tidaklah salah untuk menggelarkan doktor malaysia (melayu, selalunya) sebagai bomoh sebab doktor melayu lebih percaya kepada perubatan kampung dari perubatan adipati.

Terlalu ramai sudah saya berjumpa doktor melayu yang menggesa saya supaya mencari ubat kepada migraine saya dengan cara kampung. Agaknya minyak kepala dan hembusan air liur lebih mujarab dari ubatan farmasi yang dihasilkan dengan kaedah eksperimentasi mantap dan kukuh nilai statistiknya.

Mungkin juga ada ruginya bila doktor Melayu ini beragama Islam. Sebab doktor Melayu lebih mudah beralah bila berhadapan dengan satu-satu keadaan ("dah takdir, nak buat macam mana").

Sikap serta psyche sebegini sebenarnya yang meruntun kualiti serta pedoman doktor Melayu. Tiada nilai etika yang benar-benar mantap, semuanya disandarkan pada takdir, percaya kepada benda-benda tahyul dan begitu mudah berasa puas dengan keputusan dan hasil kerja yang mediokriti.

Sekian terimakasih.

Trust said...

Minyak kepala pulak. Minyak Kelapeeee.

Anonymous said...

Very nice site! »

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