The world of medicine is changing rapidly. For those who are aware what is happening around the world, we know how the perception of public towards medical profession has changed. Unfortunately, there are many out there who are living in cocoons, do not even know that sooner or later they can be charged for manslaughter!. The recent case in UK involving Dr Bawa Garba has sent shock waves around the world. A senior trainee paediatricians were given suspended jail sentence of 2 years for gross negligence amounting to manslaughter. GMC ( the guardian of medical profession) appealed to High Court to struck off her registration despite Medical tribunal giving only 12 months suspension. Two weeks ago, the court allowed GMC to struck off DR Bawa Garba from medical registry. A detail reading of her case will remind us that what has happened to her, happens on a daily basis everywhere in this world! Unfortunately , the world is changing.
Many still believe that medical indemnity will cover their butt if and when they make any mistake. Unfortunately, any negligence leading to death can now be charged under manslaughter and no more a civil negligence case. IN Malaysia, similar case is currently ongoing involving our very own DPM’s son in law’s death. The doctor who gave sedation is now being charged for manslaughter which can carry a prison sentence of up to 10 years. If he is convicted, it will set a precedence for any other such cases in the future. Similarly, another doctor was charged in December 2017 for circumcision gone wrong. He is being charged under Section 338 of Penal code for causing grievous hurt which can give you 2 years of imprisonment.
IN the US, just 2 months ago, an anaesthetist was charged for murder, “killing” a patient undergoing plastic surgery procedure by giving overdose of an anaesthetic agent. In fact, the first time a doctor was charged for second degree murder in US was in 2015.
Doctors around the world are rallying behind DR Bawa Garba. The fact is , the case just portrays how the healthcare system has failed. She was overworked, just came back from maternity leave and covering 2 person’s job without a supervising consultant. Sounds familiar? Unfortunately, the court do not take into consideration of all those shortfalls. It just concentrates on the negligence part and sentenced her accordingly. Any gross negligence leading to death is now considered a manslaughter! Is anyone still living in dreamland thinking that doctors are “gods” in the eyes of public? You are treated similar to anyone else when you cause a death due to negligence. Nothing special.
DR David Sellu’s case in 2013 is another good example. A well renowned colorectal surgeon of 66 years old was sentenced to 2 and a half years imprisonment for causing death of a bowel perforation case. A patient who developed bowel perforation following a knee surgery, deteriorated while waiting for surgery and subsequently succumb to sepsis. This happened in a private hospital with limited facility for emergency anaesthetist and OT. Thankfully, after 15 months spending in jail, the court of appeal reversed the decision when new evidences emerged regarding the lack of facility and why he could not do the surgery immediately. Unfortunately, damage is done and he had spent 15 months in jail together with other criminals convicted of rape, murder etc! After saving lives for 40 years, at the age of 66 he was treated as a criminal and even labelled as Dr Death! He was also subsequently subjected to GMC’s suspension. This is a good article to read as well : https://health.spectator.co.uk/david-sellu-a-surgeon-wrongly-jailed/
These cases have created a new term : ” Medical Manslaughter“! The list of such cases in UK till 2014 are listed in this article and attached below.
Looking at those cases above, we will wonder that these are nothing unusual in day-to-day medical practice. It happens on daily basis. Sometimes complications can never be predicted. Errors do occur and it is not entirely due to the doctor’s fault but the system as a whole. There are many factors that can cause such negligence to happen or how the complications are treated. Unfortunately, the court only considers the healthcare professional’s mistake. This applies to paramedics as well. Nurses have also been charged for manslaughter. This WEBSITE has some information of other health professionals who have been charged similarly.
The above video made last year is worth watching. Doctors are humans and do make mistakes. However, the society is not willing to accept these mistakes anymore. I had written much about civil litigation that is increasing day by day. Criminal charges are now increasing day by day as well. As long as you are proven to make gross negligence leading to death, you can be convicted for manslaughter. This can be as simple as giving a medication ! For example, if you give IV Pethidine for pain and the patient stopped breathing and dies, you can be charged for “murder”! And subsequently, the medical council will struck you off the register!
As I had always said, the world of medicine is changing. Modern medicine is infected by virus of mistrust as written over HERE. Commercialisation of medicine is one of the reason behind these issues. A profession which started during ancient times as a science to help people has been systematically and gradually converted into a multi billion dollar business. A business to suck people’s money in many developing countries. Generally, countries which have a universal healthcare system will have lesser number of negligence and complains, as patients do not pay much. Unfortunately, NHS in UK is dying day by day due to lack of funds and overcrowding.
If criminal charges against doctors left unchecked, we may be seeing many doctors behind bars despite saving many lives! I wonder whether AI will come to the rescue? Can AI be charged in court for making a mistake? These are the reasons why many doctors are feeling the overwhelming stress at work(burnt out) all over the world. After years of training and money spent, a simple mistake will land you in court. What use to be civil has now become criminal offence. I can only see more and more doctors retiring early and leaving medical practice. Many do not even encourage their offsprings to do medicine.
What I foresee is that the society will dig their own grave. More and more people would not do medicine. Many doctors would not take high risk cases. Consent forms will become as thick as “Harrison’s Book of Medicine”. Finally, mistakes will be hidden and notes will be fabricated! The art of medicine is already dying due to CBM (Cover backside medicine) but eventually medicine itself will undergo a silent death………..
Gong Xi Fa Chai everyone………
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Dr Paga, you’re right. I feel that nowadays its easy to blame doctors for everything.
No one bothers about the fact patients default follow ups, medication, appointments etc. They only see the fault of the doctor that cannot save the patient once the complications catch up with them.
How do we save someone who has triple vessel disease, end stage renal failure and diabetic foot ulcer compounded with peripheral vascular disease who has not stopped smoking, not controlled his diet, not take his prescribed medicine or exercise when he had the chance to.
The public only sees us failing and are quick to drop the sword of Damocles onto us. The above example is far too common in our setting where sedentary lifestyle meets poor eating habits.
It does not help that the new crop of doctors that come from questionable academic backgrounds make the backbone of the 1st liners in the primary care clinics and emergency departments. A large majority of them have poor clinical acumen and lack of critical thinking with poor attitudes.
In the government centres, most departments are more concerned with issues that look nice on paper i.e. SKT or KPIs that they lose the big picture about healthcare and that is to provide good quality care to peoples health!!. In my honest opinion KPIs are made by less intelligent people in power to make a name for themselves and to convince other less intelligent people that they are doing their jobs at the expense of patient care!!
Our support staff at the government setting aren’t helping much too. Most of them will not take the time to do their job properly. Like take vital signs or capillary blood sugar, height or weight at the counter before the patient sees us. They are more concerned about fulfilling their KPIs and SKTs. No one can measure good work ethic by means of KPIs or SKTs yet it does not require an analytical mind to see that good numbers look nice on paper. But what do they care? They still get paid the same amount regardless of how much work they do or lack thereof.
In all honesty, being a doctor in Malaysia is hard. If you do things properly and follow principles of management using references from guidelines or reliable references you’d be the odd one out because you’re the only one doing it.
Sigh. Our healthcare will fall one day. The day Malaysians cannot get free health care might be a good thing. Maybe then people will take their health seriously. I for one am for not giving free health care to all Malaysians, only a selective few. Then again, with everything else in our country, this will also be corrupted.
Yup, totally agree!
It is interesting to note from the following news article that there are 1548 Malaysian doctors working with the NHS, UK. Read:
http://www.dailymail.co.uk/health/article-5367011/The-202-nationalities-working-NHS.html
Yup. Stay there dont come back. No future here.
Yes, nothing new. Mostly are graduates within UK.
It happens in all professions and industries. So Drs, don’t expect to be treated differently.
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Medicine is not like other professions or industries.
I hate the term customer to be used for patients. They are not customers. A customer is a person coming to buy your wares whether they need it or not. A patient comes to you because they need it even if they do not realize it yet.
You can have a customer come to your clothing store and pick the ugliest looking shirt or dress that makes him or her look like an overstuffed porcine pinata and you’d compliment them so that they will buy your goods and feel happy about themselves. Then you’d key in your sales on your record so it enters your KPI of selling A number of ugly shirts/dresses a day. At the end of the month KPI tercapai!
When a patient comes to you, (I’m describing a typical Malaysian here), overweight, out of shape, smelling of cigarettes, has 2-3 co-morbids with complications, you don’t say “oh you look fantastic today, oh you don’t have to take your insulin or your antihypertensive medication if you don’t want to or if it makes you unhappy” or “cough for one day? here is a dose of meropenem the strongest, most effective antibiotics for your infection” or “here is a MC for the week for your bruise on your elbow you had a week ago”. We are not here to make patients feel good about themselves. We are here to make sure patients don’t get more ill or die from their diseases. We are here to improve their quality of life even if it means making them feel bad about their life choices.
We are not the same with the other industries. So do not try to implement KPIs, that make no sense unto us.
Errr your statement is laughable.
Just accept the fact that Drs who went to private practice are there just for money. They have “quotas” to achieve by the hospital’s management. Dr Paga had even mentioned it before in his blog. Pls la, don’t act noble.
After all, it’s just another job where profits are involved.
I am not in a private setting. I am in a government hospital. There are no profits on my side. Think before you shoot old man.
No one cares about where u practice or talking about you specifically, so don’t get butt hurt ya.
Btw, going private has not even crossed your mind? If that’s the case, happy rotting in Gov Hospital Chronic MO.
Your comment does not warrant a reply. Have a good day.
No one expect you to reply.
Lol. Chronic MO
I won’t be surprised that in near future , issuing DNR will be charged for manslaughter. These showed how system had failed to protect the medical doctors. Soon or later , the medical system will collapse (it’s collapsing anyway ) and the society will taste their own medicine . In the end , the one who suffering , and going to suffer , are patient themselves.
yes, of course
Hello Dr Pag, I’ve read articles of your opinion on the oversupply of doctors in Malaysia. I’ve also heard of many doctors who end up jobless after they graduate from their MBBS. My dream was always to become a doctor, I had made it a sole motivation of mine since my secondary school education to be one. I’ve always had straight As up to Cambridge A-Levels because of my drive and motivation to pursue medicine. However, with the current state of the country, my parents were worried about my future and forced me to go overseas to study Nursing to get a PR. Hence, I’ve been a nursing student for the past year and I confess that this has been the most depressing year in my life as I did not enjoy my degree and felt homesick overseas. The main reason I did not enjoy the degree was because I felt that everything I had worked for towards being a doctor had been wasted because Nursing revolved so much around the psychological aspects of caring instead of the biological aspects which I love.I told my parents how I felt about this and they might allow me to have a fresh start and pursue medicine in Malaysia. I am confident I can definitely go through medical degree and enjoy life as a doctor. I love to be pushed to my absolute limit and face challenges so I am not uncertain that I will enjoy the job.
However, I feel great uncertainty in my future if I pursue medicine because of the apparent oversupply and jobless doctors currently. In your honest opinion, how bad will it be in 5 years for medical fresh graduates in terms of job prospects?
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The future for young doctors are bleak. As we are under contract system for HO, only 50% or even lesser will get permanent post in gov after 2yho2ymo. If you are kicked out early, what are you going to do with your mbbs? You are almost goodbye to specialisation. More and more clinic are closing down, may be uber or grab driver?
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Eventually, many may end up doing other jobs.
Health Minister doubtful 1,548 doctors serving in UK. Read:
http://www.freemalaysiatoday.com/category/nation/2018/02/14/subra-doubtful-1548-doctors-serving-in-uk/
Hahaha, I don’t know where he got his facts from. Most Malaysians who graduate in UK will stay on till they finish their specialist training. Those who come back are either due to family reasons or did not get training post over there.
Doctors are money minded. I was duped into surgery. Spinal anaesthesia led to TB spine. That crook is happily practicing surgery. Incidentally I became doctor myself after surviving that criminal negligence , did MD in primary care , worked in med schools , after seeing the apathy & money mindedness of doctors, resigned from those jobs. Today I’m disappointed person after years of hard-work. More disappointed by medical fraternity than by anything else.
Time may come when people would stop trusting doctors anymore.
Would advise younger generation to think twice before choosing this profession.
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I call your bluff
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Education was meant to be agent of social change not to satisfy lust of money & carnal desires. Today education is being used to strategize money minting desires of people. That’s the reason why hate & discontent is spreading against so called highly educated people because they never acquired the education to serve people , their primary motive was minting money out of innocent gullible people. Education cannot compensate for crookedness of heart.If the character is flawed it will remain flawed in spite of any education person acquires. Even scribes & pharisees were educated but they opposed purity of heart advocated by Jesus. Even they plotted to have him killed.
Hello Dear Sir,
After finishing my IGCSE exams I decided to apply to uni for courses related software engineering and computer science as being a basic tech geek but later on certain incidents made me rethink and I took up medicine as my choice. I haven’t been exposed to much negativity about this profession so I was all driven with high passion. I set my targets as UK, USA , Canada, Australia and New Zealand. USA and Canada were the first one to get eliminated after hearing about the requirements. Australia become the first choice and a Doctor adviced me for Monash. After applying for foundation programme in 3 aus uni like Newcastle monash and adleaide. I got accepted in all of them but when I found out about drawbacks of Australias like its recognition degree of mbbs, high cost of mbbs and othere like what is the chance of staying back after my degree without bearing any tension about how will even get into a medicibe programme. I lost myself and started to find a easy route and found numed Malaysia. Their foundation programme looked lucrative and applied for it and I also started trying for uk but no luck as i was too late. i got accepted ans most probably will be joining InshaAllah in may if everything goes as scheduled. Now i wanted to ask your opinion on my wasteful 1 year gap after just basically my O level in pursuit of uni with changing and choosing careers as if its nothing. A friend of mine with the same intention opted for monash. i literally had have not much insight into all the complications i would be facing and i dont even have knowledge what my future after mbbs. I would really appreciate if you replied and i hope to gain some further insight by reading your blogs and be more aware.
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I would suggest you buy my books and read. I don’t think you understand how medicine works. IT is one of the most complicated profession out there.
You will be most successful if you do a course where your interest is. Never do medicine for wrong reasons!
[…] Not to forget doctors being assaulted in India and China! The video below shows how a doctor is being assaulted in India! It is becoming so rampant in India. It all started with commercialisation of medical education and medical business! The public now had lost trust on doctors. IN western countries, it is manslaughter charges as I had written in my last post. […]
Most of the conversations between medical professionals & patient’s relatives are not recorded by videography. If anyone records those conversations, you will be amazed how much is hidden from relatives. When the promised result does not happen the relatives get violent , understandably so because they feel cheated.
you can’t record such instances due to confidentiality issue. However, in medicine nothing is cast in stone. No one can promise anything. That’s why you sign a consent form.