WHILE the Health Minister is reviewing the working conditions of junior doctors, may I suggest that the 12-hour shift be reverted to normal working hours?
A 12-hour day is hazardous for a young doctor. The two-shift system is generally used for guards and security personnel and is easy for management to operate compared to the three-shift system, which is tougher to coordinate.
However, it is unsuitable for doctors or nurses although the latter are slightly better off in that they can arrive on the hour even though they do tend to leave an hour after their shift because they need to pass over the cases.
On their part, trainee housemen are often mandated to arrive a full hour before their 7am shift. And although their shift ends at 9.30pm, they are often required to help if the wards are busy or if the specialist or senior medical officer does a late round, often from 9pm to 10.30pm and even 11pm. They are required to come earlier to receive the cases and to help – and the same applies to those on the night shift.
Thus, on stretches called “tagging”, they have to be up as early as 5am and then work till 10.30pm on average, arriving home around 11pm and managing with only five to six hours of sleep.
Currently, there are insufficient quarters for housemen and they often have to drive home fatigued, risking road accidents.
With regard to their day off, they may only be given one day off in a week. After finishing at 11pm through most of the week, the whole day off is invariably spent to recover.
During the rest of the working week, the junior doctor does not see the family at breakfast, lunch or dinner. The only time they may do this is supper.
Imagine a woman doctor who is married and has a baby. She will play a near zero role as wife, mother and daughter or daughter-in-law. Coupled with the unhealthy work environment, she would find the stress hard to bear.
We must remember too that if the culture of bullying exists, as it does in some departments, it is top down and one gets bullied by the senior doctor, medical officers, registrars, specialists, consultants or department head.
Once you are made a scapegoat and labelled a “bad doctor”, your reputation will spread and the whole system will be against you.
In the past, there were fewer doctors and we used to work together as a team. There would be at most two bosses, the medical officer and the specialist or consultant above you. You were given more freedom, opportunities and responsibilities and hence would improve faster.
Of course, junior doctors would make mistakes, but there would be a support system and a positive environment that would nurture them.
Although you may have to work for 36 hours in a stretch if on call, there was always a bed to lie down on when you were not on shift.
Having regular office hours, from 8am to 5pm, would definitely be better than the 12-hour shift.
Many doctors are on contract and those who cannot cope would eventually drop out. The drop-out rate is as high as 20%. In any organisation, if there is such a high drop-out rate, one should study the reasons and the remedies should follow.
It is unthinkable that a student, having spent five to six years of their lives and up to a million ringgit of their parents’ money on their medical course, would quit just like that.
Every system would eventually lose some of their graduates to other fields but when they leave during the training period, the reason for doing so should be studied.
There is the often heard argument by senior doctors that rigorous training would give their junior counterparts a better experience and toughen them up. My answer to this is that decent working conditions mean decent hours, decent bosses and decent work targets.
For a start, would the Health Minister consider reverting to normal working hours?
RETIRED GOVT DOCTOR