Second day was no less of surprises. I did my ward rounds with my colleague and was surprised that it was quiet over the week I was on leave. So quiet, that they, attributed it to my abscence because as of yesterday, the on call team was back on their heels with cases and OT going to wee hours in the morning. The on call team had a case of a young girl who was misdiagnosed in a private centre since May, if my source is correct, and was treated with antibiotics. She presented to us with intestinal obstruction with a soft distended abdomen which on radiological examination showed loculated areas of pus and fluid within the abdominal cavity. She presumably had a perforated appendix which was treated with loads of antibiotics from the few hospitals she was admitted to since May and the surgery took 6 hours to drain and release all the adhesions!!
Anyway, today was my scope day but I had only 4 patients for OGDS(upper endoscopy) compared to the usual 15 to 20. The strange thing was again, the first three cases had similar findings of severe gastritis with multiple ulcers and a suspicious lesion in the stomach. Weird but true!
A walk to my office finds me with a dozen of letters and much more emails in my official email. One was a letter for my subspeciality training in upper gastrointestinal surgery and another important letter was a letter for a course from the 4th to the 8th December in Shah Alam for “Peperiksaan Tahap Kecekapan” for promotional exercise under the absurd SSM scheme which makes being a specialist a joke! Yeah a joke, after 5 years of undergraduate studying and another 4 years of doing a speciality in surgery, I am still nobody in the eyes of the government — mainly the ministry of health and the public service department. Now this so called ” Peperiksaan Tahap Kecekapan” , a government administrative exam which has no medical bearing is needed to substantiate the need for my promotion rather than the medical training and speciality exams we go through! Why should we need this non-practical administrative exam when the administrative job is suppose to be done by the Public Services Department staff which are known as Administrative and Diplomatic Officers in the offices. These are the guys who sit in the office and are most of the time missing at work. This is their answer for their incapable officers who is of dire need of such exams rather than us! To make this worse, this particular promotional exercise are only for specialist gazatted by the year end 2006. So what happens to those after? They are forced to sit for two exams before reaching the supposed specialist pay! So tell me, is this a system that promotes and encourage doctors to be specialist and serve the public? Is this a system that will keep specialist in public service? Tell me, do you think that the government has no idea as to what is going on? They have the whole idea and we have told them the problems but the Public Service Department is the Almighty and they could not care less about the medical profession and neither our great top officials in Ministry of Health who have sold themselves to politics and the PSD! The public is often blinded by excellent phrasing of sentences to make it look like everything is settled. The public will soon realise that the government hospitals would be manned by unfit foreigners and exteremely junior doctors and a large gap of specialist. As the senior specialists in the public side retire happily, the public healthcare will then be affected as they will be forced to employ undertrained specialist. Well, I suppose only then will the public realise how important health is and start complaining, that is if they have not privatised health facility by then! If you have not realised our distinguished DG of Health has also tied his tongue about such issues! So what about me?
Well, I love the work as have my colleagues who left to greener pastures. I enjoy treating patients without needing to think much about the financial expense. I enjoy the satisfaction I get at the end of the day. But, all this is in the expense of compromising our own financial standing. No doubt the government canot match the private salary but it can increase and above it give due respect to our promotions and many will stay. The public must raise their concerns as health is the single most important topic in any community! Anyway, I have a strong feeling that the government will start its national health financing scheme soon after the next election thus its disinterest in our welfare.
