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Once noble, now miserable


IN recent years, the medical profession has taken a plunge in its status, from noble to miserable, at least from the viewpoint of those in the profession.

During the 2016 National Health Service strike in Britain, the doctors held placards which read, “Devalued, Demoralised and Depressed”.

A recent British Medical Journal blog by Clare Gerada ventured to discuss in a recent post, “Why the medical profession has become a miserable one!”

To quote her post, two recent studies of American doctors, in 1986 and then in 1997, show that overall, physicians were less satisfied in every aspect of their professional life in 1997, compared to 1986. And the article states that this is a worldwide phenomenon.

As one voice representing Malaysia, at one time a national chairman for government doctors, and now a president for private medical specialists, I can confirm and echo the sentiments that this so-called noble profession is getting truly miserable in the eyes of the doctors, young and old.

In all my early years as a doctor, I have always affirmed that it has been a great privilege and honour to be a doctor, to serve the sick, the community and the nation. We have always been very appreciative of the opportunity to be trained as a doctor and specialist, both locally and overseas, and we are indeed very thankful that this career has provided a more than comfortable living for many of us.

Why then this frustration, depression, demoralisation and feeling of being devalued?

As quoted in the surveys, we too in Asia feel the attacks or infringement if not invasion from all directions – from the authorities, from the management and employers, and from the customers whom we serve.

Beginning with the customers whom we serve, we are literally expected to do no wrong, to be error-free, to respond instanta­neously all around the clock and to provide cheap if not charity service.

Patients and their family members have become very impatient, rude and disrespectful, expecting and demanding the best service without the gratitude and appreciation of the past. A doctor comes to save lives and gets reprimanded by patients almost on a daily basis throughout the nation. The slightest mistake or delay can invoke a threat of a legal suit.

And, indeed, litigations are on the rise, and we have yet to see the worst, as medical indemnity insu­rance continues to go through the roof, with many specialists ha­­ving to pay as much as RM200 a day just to practise medicine.

A family practitioner’s consultation fee of RM30 is miserable, if compared to a massage, a barber’s supercut and dinner out at a fine restaurant. The family practitioner’s fee is the basic comparison with all other professions, and some corporations even insist that their panel doctor go as low as RM5 – take it or leave it!

Next come working conditions, and terms with employers and management, whether the Government or owners of private hospitals. After six years of sweat and tears, and spending between RM400,000 to RM1mil in fees and cost of living, the doctor may have to wait a full year before he gets a job, and even then, just a contract that has no security for the doctor.

Working conditions for the ju­nior doctors include an environment of long hours, under often tough situations, and difficult bosses, some of whom are tyrants. There is no longer the comfort of nearby, in-house hospital quarters, and on-call rooms for the doctor to lie down and rest or sleep during calls.

They work shifts and that means there is no allowance for breaks or rest. Suicides, traffic accidents and sudden deaths among doctors may just be a small percentage. However, a high resignation and dropout rate as high as 20% for house doctors in the recent past needs to be explained.

The private medical specialists too are feeling the crunch, as they are being “managed” and “monitored”, if not “controlled” by paymasters and management, and li­terally forced and limited by fees schedules, and other rules imposed on their practice.

Finally, the authorities with their various rules and regulations under the recent laws make the setting up of a practice a challenge. In the past, with the medical degree, all the doctor needs to do is find a shoplot and “open shop”.

Not anymore now. There are so many regulatory bodies and institutions the solo medical practitioner has to deal with, apart from having to negotiate corporate bo­dies, manage care organisations and, at one time, even the thugs controlling the streets. When he has finally made some hard-earned income, the taxman knocks at his door.

In conclusion, private medical practice requires one to be an astute businessman, under trying and demanding situations, while governed by ethics, morals and the Hippocratic Oath.

These are just some of the reasons why the medical profession has become a miserable one too in Malaysia in recent years.

DR K H SNG

Kuala Lumpur

Letters , doctors

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