Why wait so long for doctors?

Patient: File photo of a large crowd waiting to see specialists at an outpatient clinic in a public hospital.

IT is very impressive that Health Minister Datuk Seri Dr Dzulkefly Ahmad took the time to reply to an online letter appealing to him to look into long waiting times to see a doctor.

While the contents of the minister’s reply are generally true, I don’t agree with some of the conclusions implied.

Firstly, waiting time to see a doctor, anywhere in the world, will always depend on the availability of doctors and the urgency of the problem. Rest assured that if one is in acute pain, in shock, with severe chest pain or suffering a stroke, one will have immediate access to any emergency health centre in the world.

To see a family practitioner or a specialist, it would depend on the system and availability of the doctor. When I fell ill on a Friday night in Japan, my Japanese colleagues struggled to find a specialist to see me, and finally found a trainee an hour’s drive away by taxi.

An appointment to see a specialist can take as long as six weeks or even more in a busy medical practice in a good centre, even in the United States. If the patient lives in a country in which healthcare is covered by insurance, it depends on the family practitioner whether one can even see a specialist in the first place.

In Malaysia, for self-paying patients, many walk into health centres at 4.30pm and insist on being seen by a specialist.

As for queuing to see a doctor, it depends on the queue system and whether it is by appointment only. Many clinics do not believe in a time-based appointment system, as there are always disruptions due to walk-ins, especially from outstation, who drive in and want to return the same day, or international patients who fly in and want to fly out the same day. Besides, there are always patients who require long consultations that can take an hour or more.

In between consultations, the doctor may be interrupted by phone calls, writing and typing replies to urgent e-mails, and the filling of admission and insurance forms. Most doctors will skip lunch and delay visits to the toilets until all the clinic patients are seen.

There have been clinics that hold consultation hours into the night, both in government and private practice. I have even heard of patients waiting the whole day until 7pm, only to have a nurse tell them apologetically that the doctor is totally exhausted and the appointment has to be rescheduled.

In this day of instant service and demanding customers, the unnecessary stress passes on to the doctor and staff too, when patients bicker in the clinic’s waiting area, demanding to be seen first, sometimes even ahead of a seriously ill patient or even an elderly lady in pain!

It is not true that the doctor, or clinic, does not care and can’t be bothered to solve the problem of long queues.

Some government clinics do offer excellent outpatient services, complete with medications, all for very low prices. Some emergency services in both government and private practice are indeed in tip-top shape, and manned by efficient and caring staff.

Nevertheless, some clinics, whether in government or private practice, do deserve a kick-in-the-butt for shoddy services.

The honourable minister must certainly address waiting times for urgent CT and MRI scans, urgent surgeries, and urgent appointments to see specialists in government clinics, especially when cancer and other time-sensitive and high risks cases are involved.

Such cases can easily be catered to by setting aside vacant slots for them. Waiting to see a cancer specialist, waiting for scans, waiting for a biopsy, waiting for the result of a biopsy and waiting for the radiation therapy took some of my patients months, literally, in the recent past, before the National Cancer Institute came into existence.

In the end, it is all about resources and facilities, and, thankfully, this new government is attempting to stamp out corruption so that money in future budgets are rightfully channelled to improve social services, including medical services.

Until then, I humbly sum up our medical services, both in government and private practice, compared with other countries, with one word: “Bolehlah!”, if not “cemerlang”.


Kuala Lumpur

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