For Future Doctors: The Changing World of Medicine ……. Part 2Three years ago, I wrote an article with the above title. I thought of revisiting the title again, as there are a lot of negative publicity with the medical profession over the last few weeks. It all started on 29/07/2018 when a front page article was published by the Star. The front page title […]
Three years ago, I wrote an article with the above title. I thought of revisiting the title again, as there are a lot of negative publicity with the medical profession over the last few weeks. It all started on 29/07/2018 when a front page article was published by the Star.
The front page title was followed by an article which supposedly exposed an HOD who has been sexually harassing junior doctors. Currently KKM is conducting an enquiry into this matter and the said HOD has been asked to go on leave. While I do not want to speculate on the truth of the matters raised, I am not totally surprised either. “With Great Power, comes Great Responsibility” but unfortunately, Great Power also comes with great corruption! It is not unusual for someone in great power to abuse their position. It happens in almost every field. Even in Hollywood and Bollywood, actresses have been sexually harassed. The recent expose of Harvey Weinstein sexual harassment scandals rocked Hollywood and subsequently many more exposures came to light. Whenever someone is in a vulnerable position, the superiors with ultimate power tend to take advantage. Have I seen it happening in medical field? If I say NO, I will be a liar. However, most of what I have heard are verbal in nature. Please be also informed that there is a difference between sexual harassment, sexual abuse and assault.
On 9th May 2018, for the first time since independence we saw a change of government. What happened after that? Expose after expose showing how the country’s and the people’s money were misused and abused. I have lost track of all the exposes since 9/05/2018. Why did it happen in the first place? The answer is the same: with great power comes great corruption! Anyone who stays in power for too long will bound to misuse their position. It is human nature. That’s why politicians will never try to give up their seat. The same thing happens in any organisation. When someone becomes the HOD and remains so till retirement, he becomes untouchable. He becomes so powerful that every single thing needs his approval. From approving leaves, giving SKT marks, approval to attend courses, signing for exams, approving claims, signing off housemen etc etc, almost everything needs his/her signature! What a powerful position! On the other hand, the HOD can go missing anytime, hardly does any clinical work, goes overseas conferences under pharma sponsorship etc etc and NO ONE will ever complain or take action against him/her! I have seen HOD’s who only came to work twice a month and was sitting on a JUSA C level! The rest of the days, he/she is contactable at home! I have seen HODs who hardly does any clinical rounds but will appear in the ward everyday when a VIP gets admitted. It really fits into the term ” Makan Gaji BUTA”. How many HODs even put in their leave application forms but yet they are on-leave?
When someone is that powerful, things like sexual harassment etc bound to happen. Many years ago, I wrote in the MMA magazine that HOD’s post should be rotated! When I was doing my attachment in Singapore in 2007, it is the policy of the hospital that HODs can only hold the post for a maximum of 2 terms. One term is 3 years. So, after 6 years, the baton must be passed to the next person. This next person may be a junior to the current HOD by years BUT the rotation will still need to be done. The whole purpose of this policy is to prevent abuse and at the same time, give the junior doctors an exposure to administrative work. Somewhere in the late 2000s, there was a circular from the then DG, Tan Sri Ismail Merican suggesting that the HODs to be rotated every 5 years among the JUSA salary scale. Unfortunately, there were huge objections from the HODs themselves and the suggested plan never materialised. Human nature: power! And absolute power corrupts absolutely!
IN 2014, I wrote an article about bullying. In fact, i had written several times on the issue of bullying and thus, I would not elaborate on that matter in detail again. There is a thin line which differentiates bullying from scolding. We cannot assume that every scolding is a form of bullying. Medicine is about life and death matter. A simple twist of the pen can cause death. Thus, seniors scolding juniors will happen no matter how hard you try to prevent it. However, it should not be done in front of the patients/relatives.Bullying on the other hand has nothing to do with scolding for making mistakes.Bullying includes actions such as making threats, spreading rumours, attacking someone physically or verbally, and excluding someone from a group on purpose. Unfortunately, it looks like now, every scolding is being considered bullying. Medical life is a stressful life, both physically and mentally. When you work in such a stressful situation, scolding bound to happen. However, with increasing number of doctors, shouldn’t it get better? Where did we go wrong? Why despite having increasing number of doctors ( I heard some hospitals have close to 4 MOs in a ward!!), there seem to be worsening situation of “bullying”? BTW, real bullying do occur and it occurs in every profession and in every country. This article talks about bullying in Australia and this in NZ. Nothing unusual but the type of bullying varies from one centre to another. We can never prevent it completely as we are working in a stressful job.
My answer is simple, which I had written since 2004! The quality of graduates had deteriorated! When quality deteriorates and graduates do not even know basic medicine, scolding aka “bullying” will become more rampant. From what I gather, the quality has deteriorated to the extend that sometimes, the consultants do not even bother to ask the HOs anything, as it is pointless! How did someone graduate when they do not even know how to take a history, examine and come to a diagnosis? It is the very basic of medicine that you go to a medical school for. How did someone even passed the final exam? Again, this is what you get when you commercialised medical education. Do you really think that the medical schools are interested in producing the best quality of graduates? All private universities are profit driven. Only profit matters. With such a low entry requirement to enrol into a medical school, we still have almost 100% passing rate! Can anyone beat that? Australia with such a stringent entry criteria, still have about 5-10% drop out rate! UK has almost similar figures. India went through the same phenomenon when they commercialised their medical education in late 1970s. Corruption, lowering entry requirement and high pass rate with dropping standards forced Medical Council of India to introduce a common entry exam! Now, every student who intend to do medicine must sit and achieve certain level of pass marks to be eligible for medical course. Only after that, you can apply to the universities: public and private.
I just hope MMC will seriously look into this matter and introduce some form of either a common entry or exit exam to maintain the standards of medical graduates. If not, we are be going backwards! Many still do not know how medicine has changed and still changing. I will continue these series of articles over the next few months. My next issue under this heading will be “doctor-patient relationship” and professional boundaries. With social media everywhere, do medical students or junior doctors know where their boundaries are?
Happy 61st Merdeka ……………
Source:
For Future Doctors: The Changing World of Medicine ……. Part 2
