Paga, yea thought about it but I doubt anybody is interested! Most are just interested in themself!

probably you should bring up this case to Jaya so that he can discuss this in the medical mortality meeting.

Paga, Surgery in Selayang is still going strong. And this is probably because the medical officers are expected to discuss with us any case which is different or difficult and if they don’t and we find a case as such they come under heavy fire!

Well the reason for the delay was nobody bothered to listen to the patient. Another reason is that, such difficult cases should by right be managed by a specialist but throughout the 9 months he was seen only by the medical officers. They may have ordered for chest Xrays but being a computer based system I doubt anybody has viewed it. It was only when the specialist saw the patient was he referred to us. I find that many medical specialist especially where I work tend to depend a lot on their medical officers who have just completed their internship.

And yes Paga, gone are the days of patient being the main importance. Subspecialisation, though important, have managed to divide a patient into compartments making it more difficult to see a patient as a whole, which is ultimately the most important thing. Personally I feel that the role of subspecialisation is to manage difficult cases and leave the rest to the primary team. Simple procedures and decisions should be made by the primary team. However, because of increasing fear of legal suits, lack of talking with the patient and relatives, and also fear of losing the income in a private setting either now or later(future), subspecialist tend to want to treat and manage the easier cases and still refrain or displace the difficult ones. This is the the trend I see.

Dr Bernard… yes, I was refering to you and you are most welcome. Have a good week up ahead.

M Joan… wowww.. i wouldn’t have known if i didn’t look at this post again. Thanks… … *ahem* .. am i too “perasan”? You are talking about me right? Kekekeke..

George… Primaeval eh? looks like you’re more up-to-date than I.. ok gotta work on it. Hehe.

Pagal… what attachment are you doing? I guess that subspecialisaton is the trend of the medical world. But then, when they come to private, they still go and do general medicine and general surgery.

It looks like you are even more bored after I left Selayang. Anyway you are doing a good job in your work. I just wonder about the case of ?suspected TB. Don’t tell me it took 9 months for them to realise that it was not TB? I am sure they would have done Xrays after Xrays before, right ?

Well, I have given up on Selayang Hospitals medical department and probably the entire hospital…………..

Well, it is going to be 2 weeks since i am in SGH. Here we have a different problem. Everything is subspecialised. Can you imagine that you need to call chest team for pleural tap, neurology team for LP and haematology team for BMA…………….?
Again what I can see is that clinical medicine is going down the drain even here. People here also look at the investigations first before going and looking at the patient……………..They conclude a diagnosis even before seeing the patient.

I am just keeping to myself as this is a different teritory and I do not want to interfere much as I am just doing an attachment. Just can’t wait to complete my training and become a full academician………….

Pagal

No.1 would keep me worried till I come back and No 2 well I would miss him so much!

Well Bernard, my last movie was Primeval which I decided to go to release the rising tension. I have 2 breaks coming up – Jakarta and Sipadan. Cannot wait! Hope that will work, M Joan and Judy, don’t you think?

What’s the latest movie you watched?

I can see why you feel ‘down’ and I pray that God gives you strength and continue to bless you with wisdom.

Whatever you do, please do not stop writing. Your blog is a blessing to many.