Misuse
I had this medical
certificate request placed on my desk 2 weeks ago. I reviewed the medical chart
grumbled a little while I figured how to write down the diagnosis.
There medical
certificate here is something different than the Bolehland. During my service
with the MOH, medical certificate a.k.a MC served as a permission for sick
leave. It was very crucial for those people especially the laborer group. There
were tons of reasons asking for one. It could allow them to take a day off
either for rest or run some errant. The issuance of such MC had truly test the
wisdom of the relevant MOs.
The medical
certificate however was something more like a medical summary with a column for
diagnosis and another column for comment. I had always been cautious to write
down the diagnosis as it is an official document with possibility of landing
into a medico-legal swamp.
The case of a
bed-ridden patient who was brought into ED by ambulance for generalized
weakness. I attended the patient 10 mins before the end of my shift. I reviewed
the chart and found that the patient was seen in our ED the day before for head
injury due to fall cause by weakness and poor intake.
The patient was
alert on arrival with no sign of cerebral injury. I did not repeat the CT scan
but order some blood test before I passed it to my colleague.
The patient was
later discharged after 10+ hours of retaining in ED by the day shift physician.
A diagnosis of R53.1 (Weakness ) was placed as diagnosis by the physician who
discharged him.
The blood test
came back normal and the reason of weakness was poor intake….
I was reluctant to
issue the MC upon request but had to do so as my named was put under the
attending physician column.
Few days later as
young lady came and asked for my explanation about the diagnosis and content of
the certificate. She identified herself as the daughter of the patient. Judging
from her outlook, she appeared to live in urban area.
She had queried
about the decision of discharging the patient. The conversation was not a
comfortable one as she had a misconception regarding patient discharge. From
her point of view which was based on common sense -> all patients discharge
should be able to walk out from the hospital without aid. She had questioned
our decision of letting a bed-ridden patient to leave the hospital.
She had expected a
very detailed medical summary on the MC and asked us why we didn’t write any
plan nor detailed instruction of discharge. She had barked on me claiming that
she as scolded by my colleague who had discharged her father on that day.
I had asked around
later and found out that an unpleasant conversation had occurred between the
lady and my colleague. The daughter had requested an admission and was turned
down; the reason of admission was that she was busy and she had wanted the
hospital to act as an interim care node for temporary settlement. She was
offended by the conversation and later she had come to us requesting medical
certificate. After obtaining the certificate, she had utilized the diagnosis
and the simple notation on the paper to query our decision; stupid but
effective one.
The beat up and no
retaliate strategy had worked out though and the daughter was in no ground to proceed
as I had avoided the provocation by the relative.
The feeling was a
strange one, I felt like a ghost being hit by a truck; no scratch over the
body. However part of my soul was engulfed by something which I cannot
describe.
It was difference
from emptiness resulting from a successful striking back. Frankly said, I don’t
like both of the feeling; but I need to make a choice…
Source:
Misuse
