Tuesday, June 9, 2009
What a surprise!
Recently I found out that the area I stay got few stalls selling green bean soup (Chinese dessert) which is my favourite in Penang. Didn't ever think about finding some here as this is not that popular 'tong sui' compare to others. I tried out some, nothing great but good to know that I can have some in the future. Happiness is simple. Haha.
Friday, May 1, 2009
Busy, Busy, Busy x3
Still struggling with my subspecialty rotation. Time is not enough, too many patients (20-30 patients daily by me alone, the only medical officer)to cover and many paper work to do (Discharge summary of every patient, procedure note, referral letter, memo, etc.) Life is even worse when I'm on call that day and post call later. No post call off in my deparment as there is always not enough doctors in service. (Except Anesthetist MO can have a FULL DAY OFF after on call, SO ENVY! :( ) Seriously considering to go back hospital to settle my paper workk during weekend. But, how is my life? Where is the quality of life? Sigh.... Basically now working from 6.30am till 6.30pm now every day (12 hours x 5= 60 hours per week + 1-2 On call Per week ). I just realized that I become easily agitated and irritable. Sigh again. Lucky that my parents are still very healthy and can take care of themselves. Otherwise it would be very sad that I spend most of my time looking after others parents but neglect my own. Seriously don't think that this type of life is reasonable. Anyway, the good thing is, I really learn alot from this rotation, both theory and practical procedure and it does help me to become a better doctor.
Well, another 6 weeks to go.......
Sunday, March 8, 2009
Busy life.....
Recently I just join a new sub specialty rotation in my hospital, the life is hectic. Everyday I need to reach hospital to start my round at 6.30am-7am then continue my clinic up to 2pm, then continue with seeing new patients and doing procedure. If I were lucky the work end at 5pm, otherwise I've been going back only at 6.30pm-7pm after my overnight active call (worked for 36 hours in 2 days). So, this is the life of a doctor in government hospital. Yet our Deputy Health Minister claimed that "Too bad those doctors who work so hard are in wrong profession with unreasonaly low salary" ? Well, it's too much and too heart breaking. Our politicians really don't care about our healthcare system, do they? Big doubt!
p/s: I really don't mind hectic life like this as the rotation only last for 3 months and it's part of the learning process. Besides, I'm serving the public who need our service. However, it doesn't mean that the politicians can ignore/neglect our contribution/sacrifices!
Tuesday, November 25, 2008
Unfair To Blame Doctor
Recently, I noticed that our media and public possess bad impression abou doctors, which may not be true. Here are few example and my thought (may not reflect the real condition, but just my opinion)
- A child was brought to A&E and noted severely ill and was resuscitated at a district hospital.(In fact, the parent did bring the child seek treatment from a GP and was adviced to seek treatment at major general hospital a day before, however parents didn't do so due to unknown reason) After resuscitation, patient was intubated (ventilated by machine) and awaiting for transfer. Sadly all major general hospital nearby all running out of ventilator, thus patient was kept in the district hospital while the district doctors trying their best to call all over Malaysia to look for ventilator. Unfortunately, patient didn't make it and passed away after 4 hours in district hospital. Family can't understand why patient was not referred to major general hospital at the very first place. But the truth is, the doctors in general hospital refuse to accept this poor child in view of no ventilator available. So, whose fault and who to blame? (I myself had experience of calling whole country looking for ventilator, i've called Hospital Kangar -->Penang-->Ipoh-->KL-->Melaka-->Seremban-->Johor Baru and end up no ventilator available and patient passed away in my A&E. I was upset, but what can i do if our government not willing to invest more money in health care to provide more ventilator for public?)
- A child was brought in death (no sign of life on arrival) into a private hospital and the doctors there tried to resuscitate but fail to revive the patient. As cause of death can't be determined, a post mortem is mandatory for cause of death. Parents were told to bring the body to government general hospial for post mortem (as private hospital does not offer post mortem service when medicolegal is an issue), the parents misunderstood that the private doctors ask them to bring the "Living" child to government hospital by their own and died on the way to government hospital, which in fact, the child already died long time ago.
- A newspaper editor claimed that a wellknown doctor set a high charges for consultation and causing poor patients losing the chance to seek advice. Well, does he mean that doctor should not charge patient by giving professional advice? So how about other profession like lawyer? If he think the poor deserve the same opportunity for consultation, i would rather say that it should be depend on the doctor own judgement, case by case basis. If the doctor offering a FOC consultation session, it should be alright. If he didn't offer that, too bad but I don't think that the doctor should take the blame as "greedy".
Wednesday, September 3, 2008
Doctor! My Medication Is Not Enough!
As a Dr in government hospital, I always face patients complain to me that they can't get complete supply from the government hospital which make them upset. Though i tried to explain to my patients, sometimes I do blame our pharmacy making things messy. However, I just read this comment from MMR blog who is a government hospital pharmacy and I agree that his point is valid.
http://medicine.com.my/wp/?p=4295#comments
Quote:
I am only a base-level pharmacist in a small government hospital and these are some of the issues regarding stocking and supply that we face:
We’re unable to give a full supply of medicines (e.g. 3 months) out to patients all at once because:
a) There isn’t enough money to ensure that at any one time, there will be enough medications to provide full supply for every patient that comes to the pharmacy.
b) For most hospitals, there isn’t enough storage space to keep that mega amount of medicines equivalent to every patient’s full supply. With doctors frequently overprescribing and with polypharmacy being practiced, the amount of medicines that need to be stored is staggering. Incidentally, there is also difficulty in securing the necessary budget to increase storage space.
c) As it has been frequently mentioned, the supply of pharmaceuticals to the govt is monopolized by one particular company resulting in us being unable to procure drugs at a (possibly!) cheaper rate from different companies, thus completely cutting out the middleman in many instances. Additionally, woe betide if there is any disruption in that company’s manufacturing process or logistic operations…the whole of Malaysia automatically faces a shortage. This naturally has happened many times.
d) Overprescribing of medicines by doctors. Many patients nowadays are on an average of 6-10 drugs. The prescribing pattern has been described as ‘one symptom, one pill’. Pharmacists have often tried their best to reduce this problem but frankly speaking, after the 10th time of being shouted at by a doctor who’s indignant that a pharmacist should tell him what drugs may be unnecessary, we find it hard to summon the effort to do so anymore.
e) Patient wastage. Many a time I’ve felt like strangling a patient who has ‘lost’ three whole months of medicines worth around RM2k because he/she left it in the car in the hot sun or misplaced the entire supply of medicines or perhaps their pet cat/dog ate it. So much for my goodwill.
f) For certain patients however, making them come back every month for their medicines results in them being more compliant to the medication therapy as we have the opportunity to ‘nag’ them every month when they come to collect the meds.
These are the current issues that are being faced by us pharmacists in the government. However, I have often taken on requests for full supply on a case-to-case basis, especially for those that are going overseas for a holiday or to perform the Haj.
Personally, I hope that no one takes out their frustration regarding this issue on us poor pharmacists as we are only performing to the best of our abilities within the constraints of ‘policy’. Especially doctors who feel that they are doing so on behalf of their beloved patients.
Really, if I could just give them all the medicines and reduce the number of patients I see every month, I would.
Cheers
from, Mark
http://medicine.com.my/wp/?p=4295#comments
Quote:
I am only a base-level pharmacist in a small government hospital and these are some of the issues regarding stocking and supply that we face:
We’re unable to give a full supply of medicines (e.g. 3 months) out to patients all at once because:
a) There isn’t enough money to ensure that at any one time, there will be enough medications to provide full supply for every patient that comes to the pharmacy.
b) For most hospitals, there isn’t enough storage space to keep that mega amount of medicines equivalent to every patient’s full supply. With doctors frequently overprescribing and with polypharmacy being practiced, the amount of medicines that need to be stored is staggering. Incidentally, there is also difficulty in securing the necessary budget to increase storage space.
c) As it has been frequently mentioned, the supply of pharmaceuticals to the govt is monopolized by one particular company resulting in us being unable to procure drugs at a (possibly!) cheaper rate from different companies, thus completely cutting out the middleman in many instances. Additionally, woe betide if there is any disruption in that company’s manufacturing process or logistic operations…the whole of Malaysia automatically faces a shortage. This naturally has happened many times.
d) Overprescribing of medicines by doctors. Many patients nowadays are on an average of 6-10 drugs. The prescribing pattern has been described as ‘one symptom, one pill’. Pharmacists have often tried their best to reduce this problem but frankly speaking, after the 10th time of being shouted at by a doctor who’s indignant that a pharmacist should tell him what drugs may be unnecessary, we find it hard to summon the effort to do so anymore.
e) Patient wastage. Many a time I’ve felt like strangling a patient who has ‘lost’ three whole months of medicines worth around RM2k because he/she left it in the car in the hot sun or misplaced the entire supply of medicines or perhaps their pet cat/dog ate it. So much for my goodwill.
f) For certain patients however, making them come back every month for their medicines results in them being more compliant to the medication therapy as we have the opportunity to ‘nag’ them every month when they come to collect the meds.
These are the current issues that are being faced by us pharmacists in the government. However, I have often taken on requests for full supply on a case-to-case basis, especially for those that are going overseas for a holiday or to perform the Haj.
Personally, I hope that no one takes out their frustration regarding this issue on us poor pharmacists as we are only performing to the best of our abilities within the constraints of ‘policy’. Especially doctors who feel that they are doing so on behalf of their beloved patients.
Really, if I could just give them all the medicines and reduce the number of patients I see every month, I would.
Cheers
from, Mark
Sunday, August 31, 2008
Funny Yet Irritating
Sometimes I think that Malaysia goverment hospital should change the "Hospital" to "Hotel" instead. As the charge is merely $10 per day including 4 meals+ bed, a lot of people started to abuse this welfare. I would like to share some of my experience:
#1. While doing round in ward, I was satisfied about patient's progress and planning to discharge patient, but he refused as he claimed that nobody around at home to look after him as his children planning to go holidays this weekend and request me to keep him in hospital. My response???? It's like this #@+#*$#
#1. While doing round in ward, I was satisfied about patient's progress and planning to discharge patient, but he refused as he claimed that nobody around at home to look after him as his children planning to go holidays this weekend and request me to keep him in hospital. My response???? It's like this #@+#*$#
#2. My friend told me that in HKL infectious disease ward always full with HIV patients. However there is certain day of the week (can't remember, may be wednesday) when the admission suddenly increase as the next day the ward will serve special dish (?Chicken Rendang) which is the Best of The Week and every drug abuse will come with some funny complaint and admitted 1 day prior to that. After enjoying the special meal then everyone request for discharge. Funny right? LOL......
Thursday, July 24, 2008
Poor Doctors: It happens all over the world
I thought that Malaysia Gov's doctors suffering for underpay problem, then i realize that this even happen in England, so this is the fate for new doctors all over the world===> POOR DOCTORS.
Here is the link and the article.
http://nhsblogdoc.blogspot.com/
"The cynical betrayal of junior hospital doctors continues
posted by Dr John Crippen at 3:12 PM
Doctors' Mess
After five or six years at medical school, most newly qualified doctors have educational loans far higher than other students. And when they start work, most of them have no alternative but to live for at least part of the week in hospital accommodation. The hours may not be as long as they were but the shift system still means unsociable start and finishing times and that makes commuting difficult. Rotating jobs means it is impossible to settle in one area. Buy a house in Birmingham and then your next job is in Manchester. It was hard enough for a newly qualified doctor to buy a house in the first place. Now (s)he is forced to pay huge sums of money for tatty hospital accommodation, it is impossible.
The use of university halls-style rooms in their first year after graduating has been used as an excuse to keep the starting salary of junior doctors low, just £21,000 this year, compared to the average graduate's first salary of £24,000. But the provision of free accommodation has been removed without any compensatory pay rise. (source)
Remember also that newly qualified doctors are not “average” students. They are la crème de la crème. How do other high-flying graduates fare?
As a trainee solicitor in London you will earn £37,500 in year 1, and £41,500 in Year 2. Once you're qualified, this rises to £66,000 plus a bonus scheme. (CMS Cameron McKenna)
Graduate Starting Salaries
STARTING SALARIES for graduate Lawyers have shot through the £60,000 mark for the first time – more than twice the level they were a decade ago. But some graduates can expect to earn less than £15,000 per year in their first graduate role. Newly employed solicitors from London’s top firms have seen salaries rise by sixteen percent in the last twelve months to £64,000. Many trainee solicitors can expect to earn ‘only’ £35,000 – the same amount as trainee accountants. High-earning graduates often see their pay packet swell with a £10,000 Golden Hello on top of their annual earnings.
Investment banker £33,000
Management consultant £24,000 – £35,000
Junior doctor £20,741
Police constable £20,397
Teacher £20,133
Nursery manager £20,000
Nurse £19,683
Civil service administrator £19,387
Paramedic £19,195
Electrical engineer £17,000 – £27,000
Soldier £15,700
Library assistant £15,000
Full-time shop assistant £13,000 – £16,000
Teaching assistant £11,000 – £14,000
Fashion model £10,000 – £15,000
Regional newspaper reporter £10,000
Part-time nursery nurse £7,500 – £10,400 (Student Direct)
So a newly qualified doctor thus earns little more than a nurse or a paramedic. Why bother to train as a doctor?"
I love the end of this article as well, "Why bother to train as a doctor?" In my case, it's just because of passion. However, I'm sure most of us become exhausted very soon when we start service at government hospital. Is there anything that we can do? Our politic leader? Our MMA leader? Silence...........
Here is the link and the article.
http://nhsblogdoc.blogspot.com/
"The cynical betrayal of junior hospital doctors continues
posted by Dr John Crippen at 3:12 PM
Doctors' Mess
After five or six years at medical school, most newly qualified doctors have educational loans far higher than other students. And when they start work, most of them have no alternative but to live for at least part of the week in hospital accommodation. The hours may not be as long as they were but the shift system still means unsociable start and finishing times and that makes commuting difficult. Rotating jobs means it is impossible to settle in one area. Buy a house in Birmingham and then your next job is in Manchester. It was hard enough for a newly qualified doctor to buy a house in the first place. Now (s)he is forced to pay huge sums of money for tatty hospital accommodation, it is impossible.
The use of university halls-style rooms in their first year after graduating has been used as an excuse to keep the starting salary of junior doctors low, just £21,000 this year, compared to the average graduate's first salary of £24,000. But the provision of free accommodation has been removed without any compensatory pay rise. (source)
Remember also that newly qualified doctors are not “average” students. They are la crème de la crème. How do other high-flying graduates fare?
As a trainee solicitor in London you will earn £37,500 in year 1, and £41,500 in Year 2. Once you're qualified, this rises to £66,000 plus a bonus scheme. (CMS Cameron McKenna)
Graduate Starting Salaries
STARTING SALARIES for graduate Lawyers have shot through the £60,000 mark for the first time – more than twice the level they were a decade ago. But some graduates can expect to earn less than £15,000 per year in their first graduate role. Newly employed solicitors from London’s top firms have seen salaries rise by sixteen percent in the last twelve months to £64,000. Many trainee solicitors can expect to earn ‘only’ £35,000 – the same amount as trainee accountants. High-earning graduates often see their pay packet swell with a £10,000 Golden Hello on top of their annual earnings.
Investment banker £33,000
Management consultant £24,000 – £35,000
Junior doctor £20,741
Police constable £20,397
Teacher £20,133
Nursery manager £20,000
Nurse £19,683
Civil service administrator £19,387
Paramedic £19,195
Electrical engineer £17,000 – £27,000
Soldier £15,700
Library assistant £15,000
Full-time shop assistant £13,000 – £16,000
Teaching assistant £11,000 – £14,000
Fashion model £10,000 – £15,000
Regional newspaper reporter £10,000
Part-time nursery nurse £7,500 – £10,400 (Student Direct)
So a newly qualified doctor thus earns little more than a nurse or a paramedic. Why bother to train as a doctor?"
I love the end of this article as well, "Why bother to train as a doctor?" In my case, it's just because of passion. However, I'm sure most of us become exhausted very soon when we start service at government hospital. Is there anything that we can do? Our politic leader? Our MMA leader? Silence...........
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