All this while, I have been talking about the healthcare system in this country, the issue of oversupply of doctors within the next 4 years, unethical practises in private sector, poor quality control and lack of proper training of junior doctors and clear-cut mistakes committed by junior doctors and front-liners. One issue that I never touched was the issues concerning patients!! As a country develops, medico-legal issues will increase as well. In some countries like US, there are more doctors resigning then being produced. That is one of the reason why you don’t see many being interested in becoming a doctor in developed countries and they depend on foreign doctors.
The comment below was posted to me in my blog few days ago. I did reply him but then I thought there is a need to explain this issue in more detail as a blog entry. If your intention is to help people, then are more than many ways to do it. I know many successful business man who spend money to set charity foundations, gives scholarship to the needy students etc etc. You may not necessarily need to become a doctor to help people. Many believe that by being a doctor, they can save many lives. This is the general misperception among the public. Yes, you may be right as we can treat many infections with antibiotics, do a cardiac bypass surgeries to save the heart etc etc. BUT, how many patients that you can actually cure from an illness? This is a question that needs to be asked. Many at times, we are just prolonging the survival by controlling a disease. Can you cure Diabetes? Can you cure Hypertension? How many tumours that is operable by the time it is detected? Almost 50% of heart attack patients die even before reaching the hospital. Even for those who reach the hospital, how many still survives despite being in the best cardiac centre? All the glorious lifesaving stunts only occur in TV programmes but not in reality. How many cancers that can be cured despite all the advance surgical techniques and chemotherapy? We see many well-known celebrities with a lot of money still succumb to cancers. When I was a student in UM, our motto was “ to cure sometimes, to relive often but to comfort always”.
I had a 3rd year medical student who went into depression when she found out that a 14 year old boy in the ward who had leukaemia died. She refused to go to the ward for quite some time and needed counselling. So, being a doctor does not mean you can save lives all the time. Be prepared to see deaths and suffering where you can’t do much.
Now, coming to the next question: do I enjoy my work? I replied that sometimes yes and sometimes NO. I did almost quit medicine at one point in time. When I was sitting for my MRCP exams, I had a credit card debt of RM10K with a pathetic salary of RM 2100 permonth. A car loan of RM 600 permonth is deducted leaving with an income of RM 1500 with 2 kids to support. I was staying in a rented house with no furniture but thank GOD, JKR was willing to loan some furniture. That was the time that I felt that I should have done some other course as I saw my friends who did engineering, accountancy, IT etc were already driving big cars and having a well-paid job and need not pay more for postgraduate studies like what I was doing.
Let’s talk about patients. Seriously, how many patients really thank you for the job that you do? When I was in government service, many patients just feel that the government is paying you to work and serve them. Many don’t appreciate what you do as they hardly pay anything. You are considered as a cheap doctor! Of course, many of the patient’s relatives are never in close contacts with the specialist in the ward. On the other hand, you can also scold the patients if they do not want to listen to you as they are not paying for your service. Then when the patients make a complaint to the pengarah, rules can be bent to entertain the patient. Many superiors just do not want the complaint to be blown up. Suddenly the patient do not need to wait for appointment and can be seen fast etc etc. VIPs get treated instantly when the general public need to wait in a “Q”. One good thing of being in a government hospital is the fact that patients rarely complains about a particular consultant.
In private sector, the situation is entirely different. Patients pay for your service and they expect no errors. Being human, there is no way a doctor can have no errors. Patients are becoming more demanding and dictate what they want. This is a scenario that you will see in any developed country. “ We pay and you do” is becoming the motto. Being in a private hospital over the last 2 years showed me how the younger generations got no respect to doctors etc. Do you really think that the younger generations are like the older generation who respects and accepts whatever you say? The older generations often forgive and forget but the younger generations don’t. I have been scolded by patients for treating a acute cardiac failure just because I am not a cardiologist. Complains have been made against me for refusing to admit a patient to the ward just because there is no one to take care of the patient at home!! Admission for family indications and not medical indications!! There are also patients or relatives of patients who just want to find fault at anything possible so that they can blackmail the hospital and specialist. All in the name of not wanting to pay the bill. Almost every month, my hospital gets at least 4-5 complains and dissatisfaction from patients. They even complain of you answering a phone call while examining a patient and refuse to pay the bill by claiming that the doctor is not paying full attention to their son!!
The world is changing. The generation Y that keep complaining in the papers of housemanship etc is the same generation who will face this kind of patients in the real world. The “forgive and forget” generation are gone. The same generation Y will complain against you. The litigation rate is going up on daily basis and almost every doctor will be sued in their lifetime. Complains to MMC is also increasing daily and they have 6 Preliminary Investigation Committee to look into all the complaints. For all the life’s that you might have saved, a single complain or legal action will leave you in depression. You will begin to wonder why this is happening to me when I have saved many life’s before! So, if you think working as a doctor is exhausting, wait till you have a patient who scold you, complains about you and even shouts at you.
This is the reason why you find many doctors order all sorts of investigations to satisfy the patient and relatives. It is also known as CBM: cover backside medicine. In most developed countries, this is what that happens. CT Scans, MRIs, battery of blood tests are being done just to save their backside. I saw this happening when I was in Singapore. The real medicine is gone and will eventually disappear. We will be taken over by machines and robots which will interpret the test and tell the patient what he/she is suffering from. Even treatment will be decided by computers. BUT the human touch will be missing………………..
Hi doctor, thanks for the eye-opening article.
I am a final year student studying Biomedical Sciences in UK, and I have an interest to pursue medicine since young. However, my parents do enot have sufficient money to fund my medical studies overseas, and my current option is : either PUGSOM / Monash, and I am intending to apply for Singapore’s medicine programme as well. Given that the future of medicine in Malaysia is rather bleak, I am having doubts about medicine at the moment, regarding the future prospects as a doctor. I don’t mind working long hours, it’s just that the inability to get the deserved career development (with so many restrictions imposed by the government) after putting in so much effort will make me miserable.
I did consider to switch into private corporate sectors, as I am partially attracted by the lucrative salary offered for oversea students (since I am from a considerably good university most of my friends managed to secure jobs with minimum 3.5k salary); but however I insisted on staying because I believed that no matter how much I am earning, it would not make my life happy because I genuinely enjoyed bringing happiness in people’s life.
But as I am approaching graduation, I am getting more uncertain about this decision. What I would enjoy as a career is one that gives me the flexibility to go from one area to another (i.e. corporate), with full potential for development (i.e. corporate), but on the other hand I would really wish to make a significant impact on other people’s life as well, and that is the reason why I am applying for medical schools.
I am sure that you will try your best to make sure that I stay away from medicine, as this has always been the mainstay of your comments to anyone who expressed any doubts in medicine, but I consider my case rather different, as what I am looking for is job satisfaction. My question to doctor : do you enjoy your job ? I am hoping to seek answers from you to enlighten me and give me an insight of what is going to happen to me in the next 10 years time. It is not an easy decision to make considering both sides are equally attractive, but I am sticking with the decision to become a doctor thus far. I am sincerely hoping that your views would guide me in my decision-making. thanks.
Pagalavan's Avatar 
it is the most overrated job in this world. there are other ways to help patients. doctoring is just one of them.
Overrated is a good description
How true, Dr Paga. I guess the only reason left to be a doctor is that you like the science of the human body and its diseases. Medicine is now just another job to put food on the table. What are your 2 cents on patients in the more “ulu” parts of our country?
Usualy these patients appreciate you more compared to city folks. They will remember your face
These group of patients tend to appreciate you more.
agree …. imagine my friends , tried to do venipuncture on those patients from ulu area , failed to take blood for few times(coz they are beginner) …. but these patients still greet them with ‘thank you’ with a smile ….
Dont forget if you do masters you get yourself into another pool of shit and screw up your life further by signing a non- existent scholarship where you pay 1st and claim later. Plus you have to fork out alot from your own pocket.
Hai Dr Pagal…
Waiting your comment with regards to the introduction of master program at KPJ hospitals as advertised on STAR y’day?
thanks
Coming soon
“I have been scolded by patients for treating a acute cardiac failure just because I am not a cardiologist. “.. i am sure you are doing your best for the patient.
But with the new medical act, can a rheumatologist treat cardiac conditions???????
FYI all physicians are gazetted as a Internal Medicine specialist before doing subspecialist. Thus we are eligible to treat all medical problems. Same like “can cardiologist treat pneumonia?”. Obviously can!
there’s a big misconception about subspecialists that needs correcting.
if the patients insist, would you get a respiratory physician’s opinion / consult to treat a pneumonia ? (cover backside medicine)
i know in some hospitals in australia, general physicians do that !
Yes, of course BUT in Malaysia most hospitals do not have all the subspecialist. Furthermore, all have to be gazetted as a general physician before doing sub. THus most common cases can be treated by general physicians unless you feel that the patient need further assessment by a subspecialist.
stupid pagalavan….do u think u hav the qualification to write all these? stupid indian…u think u noe a lot about medic?idiot
Haha, we all know who is bodoh here!! Since you call yourself a bodoh any way!
Dear xxx,
I believe it is a sin for talking and thinking like such as every religions teach us to become good.
If you manage to log in this page, i believe you are a medical personel. As a health care provider, again i believe profesional is the fundamental of medicine.
Everyone have to qualification to write their experience as they own their experience, thus he is qualified. His experience is his and no one in this world have neither the same experience like him, nor you and me.
Racist is one the reason why Malaysia is still lacking behind. If you love Malaysia change your mind or else, not you but your future generations will suffer.
He may not know “a lot” of things in medicine. Sometime, medical student may know a little bit more than consultant. All of us will not know everything in medicine, just someone may know more and someone may know less. Thus medicine requires life long learning.
If you think what he said is a fool, i think you should not start your sentence with all kind of scolding words instead you should write out your points why you disagree or dislike.
Dear Dr P.
Personally, i love this: ” If your intention is to help people, then are more than many ways to do it. I know many successful business man who spend money to set charity foundations, gives scholarship to the needy students etc etc. You may not necessarily need to become a doctor to help people.”
During interview, most of the interviewers will start with this question, “why you want to become a doctor?”. When i am a first year medical student, my answer will be saving life. When i graduated, the answer is different. Doctor cannot save life, instead doctor can only help and comfort patient. Saving is the job of God.
i have a friend who did a great job. He saves earth. He owns a recycle factory. Guess what, he is a PMR leaver. Currently owned a semi detached double storey house, a few lorries and vans. His income is 5 digits. He is doing greater job than doctor. Better quality of life.
Another friend of mine who is an accountant who own an ACCA, currently married and owned a happy family, blessing with 1 kid. Income, amost 5 digit. She is doing her job in helping people as well.
In fact, we are helping each other. If want to save the most people,then become government will be a better choice.
Lastly, I am very curious why all SPM leavers with top result will study medicine. Is it because of the name “dr”? If yes, that is ashamed.
Pray for evolution not revolution.
well said! This is what I have been saying. The entire public is totally misinformed about medicine. Many think it is a glorious, glamorous and money making life without looking at the real picture.
dear ‘bodoh’ … instead of bashing dr paga with words that might reflect yourself, why dont you just calm the f*** down and think for a second.He’s merely stating his OPINION in his blog,there is no right or wrong in opinion,thus the emphasis.Why dont you simply state your ‘rightful ‘ opinion here so all of us can decide and think like a rational human being.And stop being such a racist dumbass.Everyone hate racist.
Dear BODOH…
Please don’t enter into this blog n discussion…such a behaviour, racist and thought are not welcomed..
Dr Pagal, please ‘halau’ this person from this blog..
You see, I never censor anything in this blog. Anyone can comment but it just shows how some of them make a fool out of themselves.
Hi Dr Paga,
Can I share your article in my blog?
Thanks.
No problem
[…] of all, thanks to Dr. Pagalavan for allowing me to post his article in my blog. It’s for the benefit of the public […]
dr paga ..kudos !! ..and please ignore STUPID,bodoh,racist comments…
dr.praga..gud opinion..
Just finished my HOship…totally agree with ur article…this generation Y is not only in the community, but also in our health system as well..most of the new HO’s are so pampered..will complain a lot if they are given a lot of work..even there are lots of them..seems like they want to become doctors because of the title..which is true..OVERRATED..
On the other hand, patients nowadays tend to question back our management..when they come to see u..doctor i want to take blood’..’doctor i want this ubat’..’doctor i want this, i want that’..where most of the time they are unnecessary…so frustrated with our society’s attitude and lack of health knowledge..maybe our goverment should add health education as one of the subjects in schools
Exactly. Even in my clinic there are patients who just walk in and ask for CT scan before even telling me what is the problem!!
[…] my earlier 2 posts , https://pagalavan.com/2012/06/17/for-future-doctors-the-deppresing-side-of-being-a-doctor , https://pagalavan.com/2012/06/22/for-future-doctors-the-depressing-side-of-being-a-doctor-part-2/ […]
dear dr paga,
in deep of my heart is only dr as a main career.since rumour of overlimt dr,i hve switch my ambition to biomedicine eng, can u give your opinion about biomed eng?it is rumenarative career? did i can open a business wit tht?
Do what you are interested in and not think about money. Anyone who does what they are interested in can become successful later in life. Anyone can do business no matter what field that you are in. Even doctors in private clinics and hospitals are businessman. Is just that in medicine, your choices are limited unlike engineering etc where you can do many things with your degree , even becoming teachers, lecturers and direct selling agents.
I am not that well versed in Biomedical engineering. I got no idea about job prospect in Malaysia but I do know that Singapore, Australia etc is looking for engineers.
[…] I have written over here and here, the situation will only get tougher for doctors to survive. There is a saying now that […]
[…] demanding patients and patients who do not hesitate to take any action against you, over here and here . I had also written about doctor’s dilemma over here, here and here. I just had […]
Hello doctor. I am a 4th yr student frm Unpad, Indonesia. Ive gt my noc and my spm results were 10As then. I’ll be graduating in 2017.Yes, My seniors who graduated in May 2014 started their housemanship in gov hospitals in Msia this Sept. Is my future going to be bright in the nxt 3 years? Enlightment needed. I’ve got passion to be a doc but due to financial constraints and failure to get JPA scholarship and also failure to get into any kinda public unis, I ended up studying in Indonesia.
Definitely, in 3 years, the situation will be even more crowded. Waiting list will be longer.
Hey Dr. P, do you know how long the waiting list for housemans now?
6 months to 1 year
the Government ordered a freeze on all new employment in the public sector.
so the waiting period is INDEFINITE or UNTIL FURTHER NOTICE
Not new employment but NEW post. The existing post will be filled. Housemanship post are rolling post. Post will be vacated once someone finishes his/her housemanship
read this
http://www.thesundaily.my/news/1407513
it is a freeze on all new intake into civil services.
meaning no NEW EMPLOYMENT.
the waiting period is INDEFINITE!!!!
That is old news, and it does not apply to housemanship jobs. Based on the online application, some less popular hospitals will have almost immediate vacancies, but most major hospitals are now with a more than 6 months waitlist.
then show us the new NEWS
No matter is new employment or new posts…. please be patient and continue to wait and wait and wait….
Just walk into any hospital with housemans and look. In fact, housemans actually run a significant part of the public medical service, and it will be compromised without housemans.
The fact that you query this means you are not in the medical service.
housemanship in Malaysia takes 2 years.
that piece of NEWS came out 2 months ago.
those housemen you see in the hospitals were employed prior to that.
you have not been talking to the housemen.
6 months to 1 year