Shortage of housemen

Need to lead by example

It is really shocking to know that having gone through the system some 30 years ago, is still not changed for the better. It was acceptable then for us to work long hours non-stop as there were at times only a single houseman available in each department. At that time we had just one university producing less than a hundred doctors a year.

Today more than a thousand doctors are churned out of our 19 local medical colleges every year and they are all absorbed into the government hospitals for houseman and subsequent medical officer and specialist training. Despite this mass production, it is puzzling why we are still short of housemen, and they are still forced to work 36 hours at a stretch.

Despite all these years of development, we are told that we are not only short of housemen, but also medical officers, specialists, nurses, and all categories of paramedical personnel. In fact you name the discipline and we will be told we are short in that area. What is happening to all the doctors being produced by our own universities? When will this shortage be ever overcome?. It may not be the actual number that is in short supply but rather the manner in which they are deployed and administered.

I sympathize with housemen for being blamed for all the complications and death that may arise in the management of his patients despite his long hours of dedicated hard work. It is important to understand that a houseman is the lowest in the hierarchy of the doctors in the medical team. Although they have very important roles to play, they are the least experienced, needing great deal of guidance and supervision in carrying out the various treatments. They are to be practically “attached” to the specialists who are responsible not only for their clinical training but also ethical as well.

Unfortunately these days some housemen go through their entire clinical posting of several months without ever seeing their heads of department, who are too busy with everything else but training the junior doctors. The training of junior doctors has become the least of their priorities, leaving the junior and less experienced ones to the task, which can be described as “the blind leading the blind.”

It would be unfair to blame the junior doctors for all the flaws in our health delivery system when they are not properly guided. Unless the senior specialists and consultants lead by example; we will never improve the quality of care to our patients.

Most of us, who had been with the system, would agree that the quality of medical care on the whole has deteriorated despite the government’s efforts to build the latest sophisticated hospitals. The reason for this is obvious – lack of dedication. Our present system is breeding dedication to the “almighty ringgit”, not to the profession and patients.

There is a need to re-look at the reasons for the deteriorating standards of health care. Unless we bring back the magic called “dedication” into our work ethics, no amount of money spent will restore the excellence in our health care that our leaders are proudly promoting.

Dr.Chris Anthony