BEING a doctor is a calling. It is a profession that serves and requires sacrifices. We often hear of doctors being on call for more than 24 hours to help save lives and keep patients in good hands.
Being on call is part and parcel of many medical disciplines as people do get ill at any time of the day. On top of that, many are required to be on standby when they are not in the hospital since they might be called back.
On-call duty comes at a price, as doctors are humans too. Attending to unstable patients, overnight work and sleep cycle disruption contribute significantly to physical exhaustion and mental health disorder. Having to be at work also means doctors would have to pay or arrange for someone else to care for their family.
All of these factors tend to drive young doctors to pick disciplines that are less taxing and do not require much on-call work, for example primary care, rehabilitation, psychiatry, public health, pathology (which are important disciplines too) or even administrative work, when the bulk of care in this country still hinges on major disciplines like internal medicine and surgery.
The current on-call allowance for doctors in government hospitals is only RM200 for weekdays (after office hours from 5pm to 8am) and RM230 on weekends (8am to 8am). That would come up to around RM10 per hour of work. In contrast, a doctor in a government outpatient health clinic is eligible to claim RM80 per hour for after office hours locum work.
In other words, doing locum of three hours, seeing relatively stable patients, would earn more than sacrificing an entire weekend on call (which includes seeing critically ill patients) and missing sleep.
All medical disciplines are important, but workload is not the same across them. Certain disciplines are just busier with higher patient loads and require more on-call shifts. If you are a doctor in a busy discipline, there is actually higher motivation to switch to more “relaxing” disciplines. The time lost and extra effort to find a carer for the family is just not worth that little financial remuneration. Yes, many become doctors due to their passion for the profession, but passion itself does not take care of the family.
Hence, I suggest that on-call allowances for doctors be increased, and for time off to be given the following day for on-call doctors if the medical service is not disrupted. Money may not be a solution for everything, but it would help to relieve some of the burden for them.
The last revision of the on-call allowance was made when Tan Sri Dr Chua Soi Lek was health minister, and that’s more than 10 years ago. It’s safe to say that living expenses and inflation have increased significantly since then.
It is time to properly recognise the contributions of doctors in our government healthcare system who do on-call duty. More should also be done to encourage young doctors to pick high burden disciplines with on-call duty to meet the healthcare needs of this country.