Friday, December 26, 2008

It is not a Bed of Roses


The debate on fresh doctors in government service had not ended. The letter sent by the Perak State Director of Health, reproduced below, adds fodder to the debate.



Not easy being a doc


I would like to refer to the recent letters about housemen and sick doctors. The job of a medical officer is very demanding and carries a heavy responsibility, especially now, as patients are more aware of their rights, have high expectations, are medically more knowledgeable and more litigation conscious. Housemen, their parents and those who aspire to be doctors should realise this.
Housemanship requires psychological and physical endurance. If one is unable to cope with the demands during this period, then one may succumb to stress, and the possibility of making medical errors is higher.
Many want to be doctors without realising that they have to make a lot of sacrifices.
A medical student is responsible only for himself, but once he graduates and becomes a doctor, he is responsible for the life of his patients.
The medical profession is rather unique in that although a doctor may have obtained a medical degree, he still cannot practise because he still has a lot to learn especially the practical skills of medical management.
In fact, the medical degree is just a licence for them to start learning how to practise medicine. Medical doctors will not be given full registration unless they pass their housemanship training. Housemanship is the time when newly-graduated doctors are trained not only to manage and administer the medical management under supervision to patients but to withstand the endurance of working long hours, day and night, weekdays and weekend.
There was an incident when a new doctor entered the ward for the first time, and a paediatric patient collapsed in front of her. She was stunned and unable to respond whereas the nurses tried to revive the child. Unfortunately, the child died.
The doctor did not come to work for three days. On the fourth day, she came to see me and said that she had chosen the wrong profession, and subsequently left the hospital. As mentioned in your papers, there are doctors who get “sick”.
A doctor can be held liable in an action of negligence if he fails to exercise that degree of care and skill which is expected of him. Medical errors do happen when doctors misdiagnose, delay treatment or administer the wrong dosage.
As such, a houseman who examines more patients, spends longer hours in the wards and handles more procedures will become a better and more confident doctor.
Housemen should not complain about the long working hours and being scolded by their seniors and specialists. Teachers and lectures have been scolding students since ages because they want their students to succeed and be better than them.
As part of their training, housemen have to report for work long before the official hours and work through lunch and dinner if need be, and know every detail of their patients.
They should love their work and enjoy the satisfaction of seeing patients under their care recover. No patient should die because of a houseman’s incompetence. Inexperience is not a defence.
So housemen should go to work with the right attitude and acquire knowledge, skills, stamina and patience so that they can be confident of working alone anywhere in the country.
DATUK DR AHMAD RAZIN MAHIR,
Pengarah Kesihatan Negeri, Perak.

Well said, Dr Razin


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