My colleagues and I were the fifth batch of students who graduated from University of Malaya’s Faculty of Medicine.
Most of us are just less than two years short of five decades in active clinical practice.
Unlike most of my colleagues, I had opportunities for career change during this time.
In looking back, I am thankful that I did not take on these opportunities which were tempting, to say the least.
The advice of Prof T.J. Danaraj, Foundation Dean, in his speech to the University of Malaya Medical Alumni Association, on July 27, 1985, still remains in the memories of many of my colleagues who were his students i.e. “Individually I ask of you: first, that at all times you practise the best caring medicine as well as scientific medicine.
“Secondly, you must ensure that all segments of our population receive good medical care.”
All patients are similar
My practice has included patients from Asia, Europe, Africa, the Americas and Australasia.
They came from all walks of life – the powerful and the underprivileged – the unemployed, the poor, and the unwanted.
They were all individuals with individual problems. However, all of them shared similar traits. They exhibited the same emotions of concern, anxiety and at times, fear.
Sometimes these emotions were expressed; at other times, they were elucidated. All needed comfort and reassurance.
Whatever their backgrounds – race, religion, gender and social status, they were all the same to me.
The physical problems were less problematic than the mental and social ones.
I tried to manage their problems as best as possible in accordance with the exhortation of Ambroise Pare, physician to King Francois I: “The art of medicine is to cure sometimes, to relieve often and to comfort always.”
Patients’ decisions have always been respected even if contrary to my recommendations, in which case documentation will be in greater detail.
I was guided by the unwritten code of professionalism that requires doctors to ignore our personal feelings and continue to provide care for our colleagues and patients regardless of their race, religion, gender or views.
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A diverse workforce
Malaysia has a diverse population with healthcare seekers of different ethnic, religious and cultural backgrounds with its microcosm stated in Tourism Malaysia’s tag line “Malaysia Truly Asia.”
There is global data that supports the belief that diversity in healthcare and cultural competence impacts the quality of care and patients’ outcomes.
Many countries are endeavouring to ensure increased diversity in their healthcare workforce to ensure that no one is left out in healthcare.
The more diverse the healthcare providers are, the better they can respectfully and knowledgeably provide quality and safe care to their patients.
When there is no or less diversity, it makes it more inhibiting for patients to seek healthcare.
When everyone is the same, there is an increased risk of being boxed in by short-sightedness and narrow-mindedness, both of which are impediments to quality and safe healthcare delivery.
Cultural competence is the ability to collaborate effectively with individuals from different cultural backgrounds. Such competence improves patients’ experiences and outcomes.
Measures that improve ethnic diversity and cultural competence of the healthcare workforce help to alleviate healthcare disparities and improve healthcare outcomes.
No place for racism
In a media statement published on the Health Ministry’s Facebook site on May 23, 2021, the Health Minister stated: “Penelitian itu dicadangkan bagi memastikan graduan perubatan, khususnya dalam kalangan Bumiputera, dapat berkhidmat secara tetap dan seterusnya mengurangkan kadar pengangguran bidang profesional di negara ini...” (“The study is proposed to ensure that medical graduates, especially Bumiputeras, can be employed permanently to reduce the unemployment rate among professionals in the country...”).
This was also reported by an electronic news channel.
I was at a loss for words when I read the Health Ministry’s statement. Never in my wildest dreams could I imagine that any individual or organisation could propose that race be a criterion for appointments in the Health Ministry.
The Health Ministry has since clarified that appointment to permanent posts is based on merit and performance.
It did not, however, explain how the proposal was included in the Minister’s statement.
Except for few reports, the Malaysian healthcare professions have always carried out their duties in a harmonious manner.
Patients have been treated with the best possible care by a multi-ethnic, multi-religious and multi-cultural healthcare workforce.
It is time that the government find a solution to the dilemma of the young doctors, dentists and pharmacists in the Health Ministry, instead of entertaining discriminatory proposals.
The young healthcare workforce has contributed much to the nation in these difficult and challenging Covid-19 times, notwithstanding that healthcare is the only essential service in which large numbers hold contract positions.
Surely, they deserve better than having to face so much uncertainty?
What will healthcare delivery be in the Health Ministry without these contract doctors, dentists and pharmacists?
There has to be definitive and transparent pathways for postgraduate specialisation and training.
Transparent and easily available criteria and selection for appointment to permanent posts will avoid perceptions of bias.
The terms and conditions of service for contract staff should be the same as those in permanent positions when they are doing the same job.
Dr Walid Alyafi, consultant anaesthesiologist at the King Abdul Aziz Medical City in Jeddah, Saudi Arabia stated that the first of seven lessons he learnt from Prof Danaraj was: “Don’t judge people by their looks. Don’t be a racist.”
Nelson Mandela, who took South Africa out of apartheid, stated: “We must ensure that colour, race and gender become only a God-given gift to each one of us and not an indelible mark or attribute that accords a special status to any.”
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email firstname.lastname@example.org. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.