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Thursday March 8, 2012

Give housemen a life

LATELY, there has been a lot of discussions on the plight of medical house officers being compelled to work long hours. The most important asset of a country is not its natural resources, but rather its human resources.

This is especially true in a knowledge-based economy, which, of course, will be the trend in the future, if not already the trend in most Western countries.

When noble professions are discussed, the first that comes to mind is medical doctors. The big unsolved question is, are we giving enough importance to this profession?

Stress and burnout are concepts that have sustained the interest of house officers and researchers for several decades. These concepts are highly relevant to the workforce in general, and house officers in particular.

Despite this interest and relevance, the effect of stress and burnout on patient outcomes, patient safety, and quality care is still accorded low priority when it comes to solutions and action plans.

The Employment Act 1955 (EA) mandates that overtime pay at double the normal wage-rate and triple the normal wage-rate must be paid when employees work on rest days and public holidays, respectively.

I am aware that civil servants do not come under the purview of the EA; and doctors, housemen and the medical fraternity in government service are specifically excluded due to “work, the performance of which is essential to the life of the community” [EA Section 60A (2)(b)].

The utmost important issue to be addressed here, apart from payments and incentives which have always been debated, despite the rise in the cost of living, is the quality of life that these house officers have.

The issue that crucially awaits justice is what can be done to improve the lifestyle of these house officers.

The flow of life force energy through physical and emotional bodies can become imbalanced or blocked in instances of lack of rest.

Although the hazards associated with the prolonged hours worked by resident physicians and house officers have been documented in numerous studies, limited attention has been paid from the administrative point of view on how to curb this problem.

It’s distressing looking at the percentage of house officers seeking psychiatric consultation – an alarming 60% in 2008. I can safely call this a crisis that screams for immediate remedy!

The development of trust in a proper patient-doctor relationship is part of the healing process.

A major element necessary for patient trust is an individual who is able to respond to the patient with focus and diligence, gathering information from the slightest reactions exhibited by the patient; and this is only possible when one’s mind and body is in sync.

How can one even try to develop this professional relationship with red, puffy eyes and a haggard appearance, and lack of mental clarity, not to mention an aching body?

Medical studies have shown that stress causes our bodies to produce more Cortisol.

This “stress hormone” is normally only released into our bloodstreams in emergency situations.

When we are scared or excited, Cortisol is flooded into our bodies to help us deal efficiently with the situation.

Too much of this hormone can and does cause adverse health conditions, which can include, but are not limited to, cardiac problems, stroke, obesity, lowered immunity system, and insomnia.

An overworked house officer is prone to mistakes that can cost the life of a patient, and as a result a huge blow to his or her career.

Based on current empirical evidence on stress and burnout in house officers, it is highly recommended that these issues be looked into to enhance patient safety.

May the relevant authority ensure that these public service doctors are happy and capable of providing the best service to the nation.

Kuala Lumpur.


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