Friday, May 14, 2010

The Reality of Malaysian Medical System


Being a medical student and struggling for almost two years in Indonesian hospitals, my thoughts are always about coming back to Malaysia and serve my country with pride. I heard about people leaving their country for a better offer abroad, but this gives me a shock. I never thought there was another reason.
Why we left and why we will continue to leave...
Posted by: MS Mohamad

I read an interesting article today about a few prominent figures addressing their concern over the increasing UKM and UM medical graduates who have left the country to continue their medical practice overseas.

After reading the news for 3 times, I called a very close friend, an MD (UKM) graduate to ask his opinion on how the news might have affected him. He has been working in Singapore for more than a decade as a Consultant Surgeon with a certain sub-specialty

"Why be a slave in your own country, when you are a king in another?" He replied.

By the word slave, the writer does not exaggerate. He came out with his own experiences.

I still remember the days when I was doing seeing patients and rounds as an MO, while the staff nurses would mind their own business, having breakfast in the pantry, or having gossip chats at their own leisure. My House Officers would then have to do merely all the labour-work, up to the extent of setting intravenous drips, and serving medications. If I am to expect the nurses, my patients would have been dead, or the work would have been too slowly or incompletely done.

When I was a House Officer, I had to run down 4-5 floors just to review a blood investigation of a dying dengue patient. The ward staff would either be nowhere around, or will say that he is busy (busier than the doctor?) or the answer I got at that time:

"Doktor nak cepat, doktor turun sendirilah, gaji doktor lagi banyak dari saya"

Even when I was a Specialist, the staff nurses had to be called again and again just to make sure the management plan for the patient would be done. I was already used to answers from them:

“I’m busy with something else"

“My shift is already over"

...it was routine for me.

One time when I was a District Hospital Medical Officer, I was conducting a delivery of a baby. An MA insisted that I remove my car which was block-parking his car. I answered through the phone that I was busy.

He came to the labor room and yelled "Semua orang pun sibuk jugak, macamlah doktor seorang yang sibuk!”

This maybe just a few people, and the writer is unlucky enough to meet these kind of people over and over again. I myself had only experienced working and interacting with the non-goverment medical servants and they gave a good impression on me. So this might be biased, as for sure a 2 weeks experience cannot be compared with a two decades. Suddenly coming back to Malaysia (which is already a scary idea looking how unprepared I am to be a doctor) seems so terrifying.

The state health or Hospital Director would just give another inspirational talk (of bollocks) on team effort and beauty of teamwork.
Ooh, now I know how I got the wrong news.

The author also stated some comparisons with other countries including Indonesia:

A few colleagues who graduated from UK choose to serve there:

"The pay is more, and we get the respect we deserve"

Another works in Brunei:

“Here the staff nurses respect Malaysian doctors, and they are very co-operative" (He ended up marrying one)

A few are consultants in Singapore (working with me):

"Here we are treated well, we spearhead the management, and every else do their work to the best of their capabilities".

A few even enjoys working in Indonesia:

“The work-load is horrible since there are a lot of patients, but we are well respected by every hospital personnel" (They have migrated there for nearly a decade)

Now I might even consider staying in Indonesia. (On a second thought, no, no. Maybe not.)

I find that Malaysia is the only country that is making doctors' lives miserable and treated like rubbish. It was never about the pay in the first place. It is about the treatment we are getting and the false political-based promises. Do you know that the so-called circular about doctors can have the day off after working 24 hours straight released JULY 2009 is not yet implemented? Do you know that the raise of UD 41 to 44 does not involve every doctor in the government service?

I did not found this surprising, knowing our country and it's full of 'janji manismu', it's likely to happen. Yet, most of the bad treatments from fellow workers such as nurses, medical assistants, and management officers made me feel sad. And if we were not bound by ethics to serve our best for patients and to save lives, would we become like them too? We can bare the hardships and exhaustion for the good pay (eventhough still lower than other countries), could we when it's not as sweet as it used to be?

Instead of doctors demands for respect, we must first give to gain. Maybe this is where the problem first started. The respect must be recovered.

See here to read the full article. Credit to Apai who linked it at Facebook.


-IMAN NAILAH 2010-

12 comments:

syurga tinggi _(o'.'o)_ said...

sakitnya membaca artikel ni..
sakit lagi doc2 y bekerja..
lepas ni kene 'basuh' nurses kat semua hospital dlu sblom diorg keje.
tapi, nurses ni xde ethics ke bekerja?
ishh2

emann said...

kena bwk gi ESQ ni...perbaharui iman.
nurse mmg bertanggungjwb bantu doktor, tp it would not sound too unethical if u don't help a doctor compared to if u don't help a patient rite?
that's doctors dilemma.sigh.

Anonymous said...
This comment has been removed by a blog administrator.
Anonymous said...

kalau tak suka, ubahla. bukannya lari ke negara lain...Kalau lari maknanya lebih pentingkan diri sendiri.

Cita2 jadi doktor nak membantu kan. Jadi bantulah, treat nurses better, train them in a proper way. be smart in handling those nurses. Lower your ego, and don't be too arrogant.

Resam kat mesia, ego/berlagak akan dibalas dgn kurang penghormatan.
Kat Malaysia, it is mostly about being rendah diri.

p/s: Cth post yg terbaik yg menceritakan ttg selfish dr..sigh..

remember, dr yg kerja di hird world counries, africe, and etc..lagi worst their environment and lack help from the nurses (mcm ada nurse je kan).. do they complain? lol

niks said...

yups. tgk niat dktr tu la kan. ada dua. either bantu orang susah/miskin yg sakit atau orang sakit shaja.

Kalau stkt org skit shj , tmpt kejenya kat private hospital, singapore ke kan. tmpt2 yg mana org kaya sikit dpt belanja duit utk kos perubatan. kat sinila selalunya nurse2 terlatih dn environment bagus.

Tapi, kalau niat nak bantu org susah/miskin yg mostly kat hospital public, jgnla expect jadi "king" (as quoted) la kan.


so berbalik kepada niat.

emann said...

@anonymous: Kebanyakan doktor mmg pilih keje ni for wealth. Hidup senang. For them, kenapa nak bersusah payah kalau boleh senang? Balik kepada komen Niks jugak la, balik kpd niat.
Boleh tau maksud contoh post yg menceritakan ttg selfish?

@niks: Niat mmg sgt penting. Dengan niat yg susah boleh jadi senang. Sy setuju sangat tu. Ingatkan diri balik...

Kenyataannya doktor sangat2 perlukan nurse. Mmg banyak doktor yang kerja kat 3rd world countries whom are independent, but still most of them have their assistants who provide them with medications and instruments. And they are supported by NGOs and medical organizations. So basically they are not alone. To live in the difficult environment is their choice, that are the sacrifices they r willing to make.

The difference with the hospitals, is that we work as a system. So every unit plays an important role to make everything walk smoothly. If one unit don't want to coorperate, it would be difficult for the other to work. It's not that doctors want to be the boss, but it's the job description that seems like doctors are the boss. It's like a family where the father will ask the wife to do this and that, but in the same time they have respect for each other, and even love. So in this case, again I said maybe the respect has been lost. Both ways.

It's just that we as newbies, who were just graduated were already stressed out with adapting, learning new things, being lectured by senior doctors everyday, then this, bad treatment from nurses. Not everyone, but we have to swallow the fact that more or less it will happen.

Anyway, we're ourselves who chose this career at the first place rite?

Anonymous said...

ost yg bagi contoh seorng doktor lari ke tmpt lain (singapore) utk diri sendiri senang.
kdg-kdg kalau dh tak suka , kita akan nmpk semua benda tak best.

cthnya, kat mesia tak best sbb gaji sket. tak suka gaji rendah kerja byk.

Tak nak nmpk mcm org yg pentingkan diri, buat alasan lain sbb pegi tmpt baru. Alasan nurse tak treat dgn elokla apala dan lain2. di exaggerate cerita.

Padahal, mcm awak sendiri kata penglmn awak baik je.

p/s: skeptikal dgn post tersebut yg mcm totally mnylhkan keadaan hospital di mesia dan nurse. Padahal pindah mungkin sbb duit semata. Hanya Tuhan yg tahu..

aPai said...

1. Ooo..ko ltk rp nye post ak kt sini.
2. Mslh dgn nurse 2 ble settle klo kite communicate dgn baik.kt perlu kn nurse dan die perlu kn kt.
3. sape yg x frust klo da kj pnt2 tp x dihargai.
4. Sape x nk duit..tp jadi kn duit 2 motivasi bkn matlamat.
5. Yep..ni sume slh sistem.
6. Yep..padan muka sape srh jadi dokter.
7. Wow..ade comment yg kn delete..

emann said...

@apai:
1. ye aku letak kt sini.hehe tq tq sudi menjenguk.

2. communication IS important. Tapi masalahnye kite semua akan sangat penat dan emosi. Kat situ yg kena pandai tackle dan kontrol diri.

3. semua nak dihargai. nurse pun. cuma depa xleh lari cam doktor. sian juga kalo pk balik...

4. betul tu...

5. ...yang dibentuk oleh org2 tertentu. akhirnye salah manusia juga. huhu

6. padan muka aku.

7. tu komen aku la, tersalah username, takut org salah faham. jadi jgn salah faham ye, sy tidak mendelete komen org lain sesuka hati melainkan dengan permintaan org tu sendiri...

Anonymous said...

salam, just drop by to say few words.

ni untuk share pendapat. x salahkan.

Yes, it is true that we might treated as so-called slave but I think You met with those HO who unfortunately being treated like that. not every nurses or MA like that. yes, people likes to blame others. we ourselves should play a role as a doctor. what happened when a senior staffnurse gives her advive about our treatment like drug dosage?...most of the HO think that they smart or good enough to neglect the better experience person than us..and being rude to them..we actually build that boundaries between us and other health professional. why? because we think we smart enough.

if 100 of fresh graduates think like those in this article, or nation will lack of dr. what happened to the poorer community who solely depends in government hospital?...nothing to lose of we work harder than other HO in other countries...

Yes...most of us might think our monthly payslip might not pay our hardwork..yes, it is true..it will never pay our hardwork because that is priceless...the salary just meant for us to keep living to continue serve people..if muslim like us think that we cannot fit ourself in this situation..don't talk about sacrifice yourself in this religion..

yes it is true we need to be respected.. but the reality out there we have to start respecting people around us and work together...

sorry if any of these words might hurt anybody...

UKM graduates

TheDreamer said...

Salam Iman.

Hope you r fine. Sangat menarik article ni.
I dont quite understand how it works in the Malaysian hospitals but from what I've heard, it just like what you have said. Doctors graduating from overseas are reluctant to go back home not that they are not patriotic and don't want to serve the country but for them maybe it is just not worth all the difficulties and hardships working in Malaysian hospitals.

The same goes for engineers. In Japan,Europe and America etc the engineers gets better pay for one. But the most important thing is that they tend to get more exposure and gets respected for their hard work more. As humans, at the end of the day the satisfaction of being appreciated is what truly matters the most I think.

Nway, just keep doing what you think is right. There is always pros and cons wherever you may be. That why there is a saying
A"Hujan emas di negeri orang, hujan batu di negeri sendiri" It is up to the individual to make the choice.So, choose wisely. I have chosen mine iA.

TheThinker said...

define 'patriotic' Mr dreamer,
then you can justify the Drs are patriotic or not.

from : http://www.brainyquote.com/words/pa/patriotic200137.html

Patriotic:
---------------
Inspired by patriotism; actuated by love of one's country; zealously and UNSELFISHLY devoted to the service of one's country; as, a patriotic statesman, vigilance.


Lol...funny if one who's called as a patriotic Dr. will feel "not worth all the difficulties and hardships working in Malaysian hospitals." (TheDreamer).

Isn't weird if a patriotic person, who wants to make contribution to his countrymen , doesn't even live in his own country (working abroad)? But he/she keeps saying that he/she is patriotic repeatedly while he/she gets paid from non-Malaysia agency/company/gov.
Talk is cheap.


Want to be appreciated, want money..and neglecting your country' needs. Man, that is just selfish. No patriotism, I would say.