I AM one of the thousands of JPA sponsored doctors who came home to serve after spending five years learning the trade overseas.
The change is sizeable I must admit, from the patients’ disease spectrum, expectations, understanding and social background to my colleagues and seniors’ working attitudes, clinical competence, career progression, team support and ethics.
I see little benefit in discussing the quality of housemanship, insufficient training resources for post-graduates doctors, or even the national healthcare system when we are not doing much to address the core component of the problem – politicking policy-making.
The major difficulty in delivering good healthcare is the lack of the will to address the flaws rather than not having a good system.
Our policymakers are mostly not feedback-friendly and take negative comments on the system and policies in place as mischievous and uncalled for.
Nothing saddens me more than to hear a senior personnel brushing off a complaint of our inadequacy with: “That is how the system works”, or “Please work within the system”, and then paradoxically advising us to “Express our discontentment via the channels in place”.
In Malaysia, five out of 10 decisions are “flip-floppy” mainly due to the over politicking policy making.
I am being very nice to give that figure of five in 10.
Inconsistency is the most consistent feature in our system.
Two years ago, the Health Ministry came out with the system that all peninsula doctors who agreed to serve in East Malaysia, where doctors are most needed, would be granted priority in transfers back to their peninsula hometown after their two- year stint and new doctors from the peninsula would take their place and the cycle continues.
A very well-intended system to address the issue of getting healthcare to places that needed it most. Well done.
But what happens in reality?
The transfers happen to a certain extent, but it is not all according to plan.
The sadness of our Malaysia system, like in all other sectors, is that those who refuse the transfer and have powerful connections or know how and who to complain to will be able to defy the system.
When there is no replacement, there is little choice for the local administration but to make sweet promises to the current batch to work a little longer.
There is a saying among the rural doctors: “Don’t make your life more difficult in exchange of making those who sit in office’s life easier.”
We doctors pledged to give equal treatment to all, not to the selected few who are educated or who have money and it is only fair that we be treated the same by the system.
We must strive to have a system in place where everyone will have to follow and happily respect the system, and there is no cutting of corners, jumping queues or different queues for different people. That should be our aim.
For my esteemed policymakers: Your job does not end with the issuance of a “pekeliling” (circular) of your carefully crafted well-intended system: You must make sure it is adhered to: fully and not only to those who are willing to follow.
Will the patient be anymore happy having a sad, angry and unmotivated doctor compared to having no doctor at all?
Of course in the politics of policy making, numbers are more important.
There are a lot of us who are willing to serve wherever we are needed.
But it saddens me when some are here and stuck due to a Janji tidak Ditepati.