Commercialization of Medicine to blame

Commercialization of Medicine to blame Health Minister Datuk Seri Dr Chua Soi Lek’s warning to doctors to resign if they do not want to attend to patients when called to do so is timely. The ministry should take a serious view of this issue of doctors refusing to attend to patients, even those critically ill. I agree with Dr Chua that doctors are burdened with more work due to the increasing number of patients at government hospitals but this is no excuse for failing to be present when needed. We must understand that while the number of patients may have increased drastically but the number of doctors and specialists have also increased proportionately over the years. Patients’ expectations are also much greater these days. We have now reached a stage where medical officers and specialists should be made stay-in when on call, especially in urban areas, where traffic congestion makes it impossible and dangerous for them to rush back in time for emergencies. Comfortably equipped rooms and proper food should be provided for those on call. In the seventies and eighties we had very much fewer doctors and specialists. Major clinical departments then were run by 1 or 2 specialists and a couple of medical officers and housemen. The specialists were on call daily, seven days a week. There was no such thing as public holidays or weekends for them. Moreover no overtime or call allowance of any sort was paid at all. Despite these shortcomings and frustrations, work went on reasonably well. The driving force behind was the commitment of doctors to their patients. All patients admitted were seen by the respective specialists daily without fail, sometimes more frequently as the needs dictate. Work went on irrespective of whether it was a weekend or public holiday. Today the scenario is very much different. These clinical units are now staffed with 5 to 10 times more specialists and medical officers. There are also the super-specialists in the various subspecialties. I am made to understand a specialist these days just goes on call 3 or 4 times a month. Furthermore they are given time off on the day after the call (post-call).They are also paid handsome overtime allowance (call allowance). Despite having more doctors in the public hospitals we still frequently get complains that specialists do not see their patients, even the critically ill ones, for days at a stretch. The patients, especially after office hours and on weekends and public holidays, are left to be managed by junior doctors with minimal clinical experience. Why are our doctors and specialists adopting such uncaring attitude towards the welfare of their patients? Why are they indifferent to the plight of the sick and dying? The Health Ministry should seriously look into the reasons behind this lack of dedication among our doctors and specialists. The underlying cause of this malaise is the commercialization of the medical profession in general. Medical training and treatment have become lucrative industries that are quickly tapped by big business corporations. Like in all industries, there is no place for medical ethics and compassion for the patients. It is strictly “you pay, I treat” relationship. This has indirectly been reflected onto potential doctors early in their training days. It has become necessary for doctors to quickly obtain the necessary paper qualifications and leave the public sector to join one of these corporate institutions.There is no place for dedication to their profession as that will not take them far in today’s materialistic and consumerist society. If this commercialization of the medical profession is allowed to continue, the care of patients will continue to deteriorate. Patients may continue to receive treatment but for the wrong reasons. The final loser in this “you pay, I treat” medical business will be the poor penniless rakyat. The government, instead of promoting this commercialization of medicine, should take steps to bring back the nobility of this age old profession. Dr.Chris Anthony