Two days ago, someone by the name of ThiruKCS wrote a letter to at least 3 medias, namely theStar http://thestar.com.my/news/story.asp?file=%2F2012%2F3%2F8%2Ffocus%2F10874444&sec=focus, Malaysiakini http://www.malaysiakini.com/letters/191405 and FreeMalaysiaToday http://www.freemalaysiatoday.com/2012/03/08/the-darker-shades-of-a-houseman%e2%80%99s-life/. I got no idea what he is trying to say and what is his intention but he sounds desperate!
I will say this again that if you want good, nonstressfull life, then go and find another job! Being a doctor needs a lot of commitment and stress management as life’s are at stake. If you can’t handle that, you can always quit and find another less stressful job. The last I can remember, housemen are doing shift duties now! so, if even shift duties are still stressful, then what does this guy wants? Does he really think that other jobs are less stressful and have better life? No doubt that the others may not be dealing with life but do you know how many hours an accountant spends doing accounts, a lawyer spends in preparing a case etc etc? Every job has it’s stress but medicine is different in the sense that it deals with life and since you chose this job voluntarily (hopefully by knowing all these before), you just have to go with it and learn how to cope.
There is no such thing as “office hour” job for a doctor. You need to make sure that every of your patient is well and properly managed before you leave the ward! That what makes you a good doctor. Of course, I am not saying that you should work 36 hours straight but working shift hours does not mean your responsibility is less! The stress of doctors only increases as you go higher in hierarchy as the responsibility increases. And don’t forget the litigation rate and lawyers ever waiting to sue you. BTW, where did he get the figure that 60% of housemen are having psychiatry disorder? That means 6 out of 10 housemen are mentally ill!! That’s scary. Are these the people who are going to treat us/public in the future?
BTW, this guy has just come up with a new theory for a cause of Cushing’s syndrome: Housemanship. So, medical students can now put this as a differential diagnosis. “Medical studies have determined that stress causes our bodies to produce more Cortisol. This “stress hormone” is normally only released into our bloodstreams in emergency situations. When we become scared or excited, Cortisol is flooded into our bodies to help us deal efficiently with the situation. Too much of this hormone in our bloodstreams can and does cause adverse health conditions. These conditions can include, but are not limited to, cardiac problems, strokes, obesity, a lower immunity system, and insomnia” WTH!!
So, for those who intend to do medicine and expect a good job, good life, good future and good money, please think again. It is people who have this perception who end up writing these sort of articles to newspaper and making a fool out of themselves. This was one of the purpose of this blog, to educate the youngsters about medicine and being a doctor.
THis was one of the comment that I just received in my blog yesterday, by a housemen: ”I realize that quality of doctor are dropping. Compare to senior 2-3 year older than me, i can see huge different between us. For example, during their HO time, maybe just 2 HO allocated in one 30- 40 patient ward,during my time it is 15 HO per ward. So, training is lacking.
Then, we also realize that our future was really unpredictable. After you complete your housemanship, where will you choice to go? I also find out that majority of the doctor will choose field which had relax life, they don’t mind to be a chronic MO, such as at KK, district hospital, or some posting with no active call like ENT, radiology, pathology, opthalmology, psychiatry. So, these posting become hot posting when it come to the time to apply as a medical officer there. When these posting are full of the chronic MO, then, it was a bit unfair for those who really had interest in the field and plan to be specialist there, because when a department is full, you will had to go to other department which you don’t really like.”
Asta Levista babe……………………………
The darker shades of a houseman’s life
–>March 8, 2012
FMT LETTER: From Thiru KCS, via e-mail
Lately, there has been a lot of discussion on the plight of medical house officers in our country who are compelled to work long hours uninterruptedly. The most important asset of a country is not its natural resources, but rather its human resources. This is especially true in a knowledge-based economy, which, of course, will be the trend in the future if not already the trend in most of the Western countries. When noble professions are ever discussed, the first that comes to mind is none other than medical doctors. The big unsolved question is that are we giving enough importance to this profession?
Stress and burnout are concepts that have sustained the interest of house officers and researchers for several decades. These concepts are highly relevant to the workforce in general and house officers in particular. Despite this interest and relevance, the effect of stress and burnout on patient outcomes, patient safety, and quality care is still at the tip of the iceberg when it comes to solutions and action plans.
The Employment Act 1955 (EA) mandates that overtime pay at double the normal wage-rate and triple the normal wage-rate must be paid when employees work on rest days and public holidays, respectively. I’m aware that civil servants do not come under the purview of the EA; and doctors, housemen and the medical fraternity in government service are specifically excluded due to “work, the performance of which is essential to the life of the community” [EA Section 60A (2)(b)]. It’s almost absurd when authorities are convinced that they have looked into the matter by comparing the improvements introduced from a decade back. The issue that crucially awaits justice is what could be done to further improve the lifestyles of these house officers.
The utmost important issue to be addressed over here, apart from the payments and incentives which has always been debated despite the rise in the cost of living is the quality of life that these house officers lead in their daily lives. As the flow of life force energy moves through the physical and emotional bodies, it can become imbalanced or blocked. Although the hazards associated with the prolonged hours worked by resident physicians and house officers have been documented in numerous studies, limited attention has been paid from the administrative point of view on how to curb this issue. It’s distressing looking at the rates of house officers that seeks for psychiatry consultation at an alarming 60% in total at year 2008. Is this the kind of situation that we anticipate being healthy for these group of professionals? I can safely call this a crisis that screams for immediate remedy!
The development of trust in the physician leads to a proper patient-doctor relationship and is part of the healing process. A major element necessary for patient trust is with an individual whom is able to respond to the patient with focus and diligently gather information from the slightest reactions exhibited by the patients; and this in no doubt is only possible when your mind and body is in synch. How would you even try to develop this professional relationship with your patients with these factors; red, puffy eyes and a haggard appearance, lack of mental clarity not mentioning your aching physical body!
Medical studies have determined that stress causes our bodies to produce more Cortisol. This “stress hormone” is normally only released into our bloodstreams in emergency situations. When we become scared or excited, Cortisol is flooded into our bodies to help us deal efficiently with the situation. Too much of this hormone in our bloodstreams can and does cause adverse health conditions. These conditions can include, but are not limited to, cardiac problems, strokes, obesity, a lower immunity system, and insomnia. An overworked house officer is prone to make unavoidable mistakes that would simply cause the lives of their patient not forgetting a huge blow to their career.
Based on current empirical evidence on stress and burnout in house officers, it is highly recommended that these issues are looked into precisely to enhance patient safety. May the relevant authority ensure that these public service doctors are happy and capable of providing the best service to the nation. So to the powers that be, wake up and smell the coffee.