I attended a meeting as a Paediatrics house officer
representative with other specialist coordinators for housemen from all
specialties and representative from the health ministry (KKM) to discuss about
the implementation of the flexi hour system (working in shift).
Before I start, let me just say that in my hospital, unlike
the KKM hospitals, there is no problem with excessive and overcrowding of house
officers. We have just the right amount of housemen that at any one time so no
one is idle. We have no complaint over the oncall system. We get to be attached
to a team or a ward, our MOs and specialists see us every morning, we know the
patient well and they can teach us something. Patient receives good care as the
same house officers in the team who look after them from admission till discharge
through to clinic follow up sometimes. We may be tired post call and might
whine slightly, but we are happy with the current system as we are getting good
training and patients are well looked after.
Then, in the meeting, this lady from KKM announced that the
flexi hour system has been decided and all hospitals in Malaysia HAVE to
implement it – there is no choice over this matter. It is an order from the
Director General of Health – with a full stop written in permanent marker. No
matter what we say now, the matter is closed.
Fine. In order to implement the flexi hour system, we will
need more housemen to join us – at least 25-30 in each department. So, this
hospital, which does not have a problem of overcrowding of housemen, will have
such problem in the future, as we will be forced to take in more housemen just
to fulfill this directive from the top. Rather than having the system to
resolve a problem, we are creating a problem just to serve the system.
Nevermind that training will be compromised (even though the position house officer is created primarily for training).
Nevermind that patient care will be compromised.
Nevermind that the house officers themselves and their consultants who are immediately affected by this directive are
all against it.
Nevermind that the mortality and morbidity rate will
increase.
Nevermind that in the future the nation will be looked after
by a generation of poor quality doctors .
As long as the flexi hour is implemented.
We argued at length. KKM wouldn’t budge. KKM said she
receives letters from parents of house officers regarding their children
working too long hours in the oncall system and those letters are often
conveniently forwarded to the top shots like the health minister and the prime
minister. On why these top shots think that they should entertain these parents, I am
at a lost. (Separate post coming soon regarding this issue)
I asked if I, and many other housemen who are against the
flexi hour system, can also write similar letters to the KKM to counter these
overprotective parents. The specialists and professors warned me not – fearing that
my action would annoy the DG and I might end up not getting my full
registration.
I became speechless at that point. Now I cannot even
exercise my right to freedom of speech.
I am now more acutely aware that I am back in Malaysia . Sigh.
Yes. Welcome back.
.
