A Doc's Life

assalamualaikum

in the name of Allah the Most Gracious the Most Merciful

Tomorrow is my on call day, and every single doctor in Malaysia in the public sector feels it, the pre-call syndromme. The mood seems to hit the lowest the night before, and it matters not that you have worked for 10 or 20 years. Now that I am no longer in comfort zone, having 8-9 calls per month can be quite taxing.

Pre call, then post call comes afterwards. How do I feel then?

It has, honestly, not once but more that I need to constantly chew and drink to keep myself awake. In the recent years, the workload has tripled, if not doubled. Really, before I started this job, the registration recorded for 2008 was roughly 35k in Kulim Hospital. Came 2009, it shot up to 90k.

For a smaller hospital with less facilities, Banting too recorded 90k patients last year alone. The effects of rising cost of living are prominent. The workload has increased proportionately, and the admin people seem unable to understand the requests from the grassroot for more staff.

You can't help but to feel sorry for the late Dr Lee, the House Officer who passed away a few days ago. I don't believe he had 5 consecutive calls, back to back, as 1 of the reasons cited. In this new system, it is not possible. Whereas, I've already had my shares. In June 2010, I had 17 on calls including 5 calls back to back.

In Malaysia, the tradition is the juniors are not allowed to complain. The seniors will always be ' we went through worse'. This attitude helps a lot, doesn't it? Foolish. You went through worse, so don't even spend thousands for your kids, and please make them go through whatever you had before. Don't worry if your kids suffer, they will become a better person in the future. More resilient, tough and clever, 100% guaranteed.

This issue has to be dealt objectively. If previously you had 3 HOs in 1 department, if 1 created problem, the effect wouldn't be too damaging. Nowadays, if you have 3 problematic ones in a group of 10, the impact is more felt, though the ratio remains the same. With the increasing number of patients, you will want everybody to be functioning.

Nevertheless, the declining quality needs to be acknowledged. I reckon this issue needs more attention in comparison to others. How do you ensure the supervision is maximum when there are 10 junior doctors that he or she needs to look after?

The emphasis now has to shift into producing more specialist doctors, and retain them. Sponsor their MRCPs etc. Pay them with what they deserve.

I had the opportunity to pursue my 1st degree overseas. I can compare these 2 systems. It is unfair to judge, but I can confidently say we can do much better to improve the system. I witnessed this twice, that Junior Doctors went on strike for 2 days, i.e. never came for work for 2 days, after their demand for a pay rise was turned down.

In Malaysia, you would be deemed as weak and bad doctor if you did this. Can you see now the difference in the mentality?

till next time,
assalamualaikum