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For a long time I wanted to go for a cruise but never had the chance to do it.  Upon my return from my holiday in Orlando last June, I was planning for my next family vacation. I bumped into an advert showing an offer by Starcruise. I quickly decided to book 2 cabins on SuperStar Virgo from Singapore to Phuket, Langkawi and back to Singapore. This was my first cruise ever taken.

I must say that it was rather an exciting and fun-filled cruise. I never knew that a ship can have so many restaurants, games, theatres, swimming pools etc floating on the sea! We were served with 6 meals per day with lively entertainments. Other than that, you are also free and easy to try anything on board. Some may have minimal charges but mostly are free for you to use. They even have ping-pong tables, basketball court and mini golf course ! Another interesting fact is that you don’t need to go through immigration when you dock at Phuket or Langkawi. The immigration officers will come onboard and check the passports, which is kept by the ship upon embarkation in Singapore. You only collect your passport upon disembarkation. You can just walk into Phuket and Langkawi without your passport.  You just need to bring your access card.

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Since this was our first cruise experience, sometimes we did miss some programs and entertainment. Shore excursion to Phuket was well planned but rather short (at night) . Langkawi was rather free and easy for us since we did not take any tour package. Overall, it was a wonderful experience and we would love to go for another longer cruise in the future……

Lobby

Well, I am back to work again and the Dengue epidemic seem to be unsettling this year. An outbreak that started in April 2013 is yet to settle. The number of deaths, 84 in total is almost double compared to last year. I was told that JB GH is receiving 30 Dengue admission every shift with almost 100 patients in the ward at any one time.  WE really need a more structured well planned strategy to tackle this epidemic but unfortunately, our politicians are more interested in spending money on collapsing buildings!!

The public on the other hand is more interested in H1N1, giving birth at home and taking direct selling supplements!! They are least concerned about keeping their neighbourhood clean and tidy…………….

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Well, it was a post-election budget. Over the last 4 years preceding the election, we have been hearing all sorts of goodies being announced in the budgets. Now, it is time to get real!  It is very obvious that the government is running out of money and they need to find ways to get back the money.  The implementation of GST is to broaden the tax base. Only less than 10% of the workforce paying taxes at the moment. Personally, I feel GST is inevitable and it was first mentioned in 2007 budget for implementation in 2009. As usual, due to political situation after 2008 election, the GST was deferred and deferred again till after the 2013 election. However, for our PM to say that it is just a replacement for Sales and Service tax (SST) is only for idiots to believe! GST will be applied to everything that you buy except those that are exempted where as the current SST only applicable for certain items, especially restaurants. BTW, I thought BN promised a RM 1000 BRIM twice for 2014 in their manifesto but unfortunately, only RM 650 was announced! Another janji dicapatikan?

As for the health sector, I did not see anything interesting. For sure, 50 more 1Malaysia clinics will be built ( in addition of the already existing 231 clinics). More GPs will go bankrupt! No new hospital is being planned. Only those which are under construction were mentioned, such as Tanjung Karang, Shah Alam, Tampin and Rompin hospitals. To overcome the “unemployment” of nurses, 6 800 new posts will be created. This is pathetic to say the least. Each state will get about 500 post and if you further divide it to all the hospitals and health centres, how many additional nurses will each get? BY the year 2017, the same might be said about doctors, I guess.  Car parks for HKL seem to be so important that it has to be mentioned in National Budget! Are we being taken for a ride by this year’s budget? Everything looks like a joke! Of course, I do support the removal of sugar subsidy. We are the “sweetest” nation in the world.

The personal income tax will be reduced by 1-2 %and company tax will also be reduced. The highest personal income tax bracket will be increased to RM 400K compared to RM 100k currently. Somehow, I feel that it is only going to make the rich, richer. For those who do not understand why I say this, please read this book: ” Rich Dad Poor Dad”.  This is one book that should be thought in schools so that the students don’t get obsessed in doing medicine thinking they are going to make big money! Our schools never teach financial literacy………

Well, health sector will be exempted from GST. Nothing mentioned about the 1Care system. I was informed that it is deferred again due to political reasons and the fact that GST is more important to be implemented at the moment.

But then, the public should not be so worried. WE have Tune Hospitals on the way. You can book your consultation with a doctor 6 months ahead for Rm 10. Every additional 5 min consultation, you will be charged RM 50. Please do not “walk in” as you will have to pay full rate. Please bring your own bed sheath, soaps, fan and meals if you get admitted. You can get admitted with Rm 20/room. You need to book 6 months ahead and please decide when you will fall sick. Emergencies will need to pay full rate please! All medications will be locally made generics or from another third world country. If you want original, please pay extra. Consultants will be employed and not-self employed as per other hospitals. Quality of service will be better than the public hospitals. The more you talk/complain, the more you pay. The more investigations you request without doctors order, the more you pay………….. and the lists goes on…………….

Now , everyone can afford  a private healthcare………….

hasta la vista babe……………….

Fernandes’ healthcare dream – to set up Tune Hospital

Posted on 24 October 2013 – 05:41am

KUALA LUMPUR (Oct 24, 2013): Tan Sri Tony Fernandes, the founder of the Tune Group of Companies, is eyeing a new frontier – healthcare.

In his presentation to participants of the World Capital Markets Symposium on “Disruptive innovation: The Future of Business” here yesterday, Fernandes said it is a dream of his to set up Tune Hospital.

Indeed, he said plans for Tune Hospital are “a little bit further than the conceptualisation stage now”.

Fernandes, via Tune Group, is already involved in aviation, hotel, telecommunication, financial services and sports, among others.

“My last dream one day is to build Tune Hospital. (Today,) the difference in efficiency between state and private hospitals is huge. The state (hospitals) can’t serve everyone. Invariably, lots of people get caught out, getting poor service,” he said, adding that some hospitals are “a bit old fashioned” in the way things are done.

“Malaysia is a young nation and as it ages, healthcare will become a very big part of the nation’s budget.

“If we can find something that is slightly more expensive than state, but 80% cheaper than private health, you can take a lot of the burden off the state system,” Fernandes said.

Later, on Budget 2014 that will be tabled in Parliament tomorrow, Fernandes hopes that it would have an element to reward productive companies and industries.

“I hope the budget supports productive industries. It’s a reality that something has to be done (to address deficit), either raising taxes or cutting spending. The third one, which is a much more preferred option is to increase productivity and support entrepreneurs who can drive a lot in this economy and create a lot of jobs, and more taxes through better productivity.

“I hope there’s an element that rewards companies that can create jobs,” he told reporters after his presentation.

Fernandes cited the tourism sector which has been a “fantastic contributor” to the economy.

“One very simple thing is to break down monopolies, to create fair and well-regulated markets. The banking industry has done a good job at this – to inject more competition into the market and to make companies more productive. It’s lacking in some areas but the banking industry is very good at this,” he added.

He said Malaysians have to be aware of the need to cut the country’s budget deficit and the fairest way of doing so is to introduce the goods and services tax (GST) as he believes that with GST, those who spend more will pay.

Meanwhile, Fernandes said AirAsia Bhd plans to make Kota Baru an international stop, with its maiden flight to be to Medan. This will be followed by flights to Singapore and later Indochina.

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It has been 5 days since I landed back in Malaysia. Even though my tiredness has not disappeared, as per usual I have to return to work on 11/06/2013. No work, no money mah! That’s private doctor’s life. My family had a wonderful time in Orlando from 31/05/2013 till 7/06/2013. We visited 6 parks in 7 days in one of the biggest adventure I had ever taken since my journey to India when I was a 4th year medical student (for elective posting) !

Frankly speaking, this was my first overseas vacation as a family other than Singapore. Even though I had visited several countries for conferences etc, I never went with my family. The main reason was due to cost. Me and my wife are not from rich families and we do not have any inherited money/properties. My father was a teacher and mother housewife. My wife’s father was an ex-military officer and mother housewife with 6 more siblings. We learned to live together without any support from anyone else, all by ourself since the day we got married. After 16 years of service and 3 years in private sector, only now we could afford to do so.

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After the longest flight that we have ever taken from Singapore to Dubai(7.5hrs) to New York (13.5hrs) and finally to Orlando (2hrs), we finally reached Orlando around 4.45pm on 31/05/2013. Immediately after reaching Sheraton Vistana Resort (I got this via Timeshare Exchange), we bought our theme park tickets for the next 6 days. Walt Disney World was just 5 minutes away and the rest of the theme parks were just 15-20min away. Our real adventure began the next day when we made our first visit to Walt Disney World(WDW). WDW is a huge resort which belongs to Disney and has 6 theme parks within, including 2 water theme parks. I decided to visit only 3, which includes Disney Hollywood Studios, Magic Kingdom ( the original Disneyland) and Disney’s Animal Kingdom. It was a wonderful experience especially the grand finale of Magic Kingdom when they had the spectacular light show on the Cinderella castle and the fireworks.

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After 3 days of WDW visit, we turned to Universal Orlando resort which has 2 theme parks, the Universal Studio Florida and Islands of Adventure. These theme parks are for older children as well as for adults (with no heart disease, hypertension etc !!) and for the first time, I saw high and lengthy roller coasters which I have never seen before. It was fun with Marvel characters, indoor rides including 3D rides and many more of Movie characters/rides. The rollercoasters were huge and after riding all of them several times, I can consider myself immune to roller-coasters! The Wizarding World of Harry Porter was their latest attraction since last year and it was really worth it. You’re flying with Harry Porter on a broom (supposerdly) !

The final theme park was Seaworld Orlando. 2 more huge roller coasters, nicknamed Manta and Kraken! For Manta, you face downwards ! Seaworld had few good shows like Dolphin show and Whale shows which was so well done. They had a lot of rare animals including huge polar bears, sea lions etc.

Overall, it was an enjoying journey and the journey back was the most tiring and sad one.

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2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

About 55,000 tourists visit Liechtenstein every year. This blog was viewed about 520,000 times in 2012. If it were Liechtenstein, it would take about 9 years for that many people to see it. Your blog had more visits than a small country in Europe!

Click here to see the complete report.

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Welcome to Legoland Malaysia

Since it was a public holiday today, I decided to bring my family to Legoland, Johor Bahru which just opened on 15/09/2012. I bought the annual pass quite some time ago when they were having the promotion,much cheaper then. So, I thought of giving some review over here.

First and foremost, I could not last more than 4 hours in the park due to the weather. Even thou there was no hot sunlight but it was freaking hot. Most of the trees are newly planted and do not give you any shade or shelter. It will take at least another 2 years for the tress to grow enough height to give shade. I feel the management should provide more shelters and air conditioned environment. Most “Q” waiting areas got no fan, including the ticket as well as main entrance.

The park is mainly for children age 2-12 years old, thus can be called as a “family theme park”. Those with no children may not enjoy the park as much as a family. Most of the rides are catered for children except for the 3 rollercoasters which even adults can enjoy. I could not get into 2 of them as the Q was just too long ( at least 1 hour). Your children below 15 will enjoy Legoland.

The Miniland is one of its kind in this region. Almost all of the Asia’s landmark are built with legos and brilliantly crafted. The interesting part is when you see the miniature structures like LRT, KTM Komuter, bus, cars and even the airplanes moving! I must say it really catches your eyes.

 

 

 

 

 

 

 

 

I will go back there to complete all the rides with my family since I can enter unlimited number of times till December 2013. My personal opinion is that Legoland is more of a family theme park (family with young children) where else Universal Studio, Singapore is more for youngsters and adults. The water them park will be ready next year and for those outside Johor, the Lego Hotel should be ready by 2014, which is just in front of the ticket counter.

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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

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March 8, 2012

–>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.

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Finally, I manage to get a locum cover for Chinese New Year 2012. It was the best time to cross the causeway without any traffic. Thus, I decided to bring my family for a short entertainment across the causeway on the first day of CNY.

For those who can’t remember, Universal Studio was supposed to be in Nusajaya, Malaysia initially. Way back in the year 2000, Universal studio was already in talks with Malaysian authority to build a theme park in Nusajaya. I personally saw the MBJB master plan in the year 2000. However, some how it did not get throu’ and I am not sure why. We have a bigger and cheaper land than Singapore. I feel it must be the bureaucracy, rules and regulation that put them off. Finally we had to turn to Legoland which will open its door in June 2012 in Nusajaya.

Unfortunately, it was Singapore who benefitted. Surprisingly, Universal Studio Singapore belongs to Genting Berhad which is a Malaysian company!! How ironic!

The best ride was this:

I must say it lives up to its name as the world’s first Transformers ride. A virtual 3D action where you feel like you are in the movie! I would recommend this to anyone who visit Universal Studio Singapore.

The rest of the rides were awesome as well. The cyclone roller coaster was really scary. Lucky I do not have any cardiac disease yet. Felt like I was flying 14 storeys high

It was exhausting I must say. I spend almost the whole day from 10am to 7.30pm walking and taking rides with my kids/wife etc.

Despite that, I could not finish all the attractions in the park. The Mummy indoor roller coaster with visual effects was also excellent.

After all these tiring rides, the best part was when I could drive back to my house in JB in less than an hour !! NO JAM at all…………………………….

Looking forward for another visit in a year’s time.

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2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

London Olympic Stadium holds 80,000 people. This blog was viewed about 300,000 times in 2011. If it were competing at London Olympic Stadium, it would take about 4 sold-out events for that many people to see it.

Click here to see the complete report.

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Happy New year 2012

It has been almost 2 weeks since I last posted. It has been quite a busy 2 weeks with a lot of things to settle before the new year. Year 2011 has been a relatively good year for me, being my first full year in private practise. So far everything seem to be going on well.

Same can’t be said about the future of medical education and practise in Malaysia. The mushrooming of medical schools is a big screw-up. Unemployed  doctors are going to become a reality. The ministry has already started to give housemanship on contract basis indicating that the system is bursting. I can only say that the situation will get worst soon.

I had given enough advise to many budding doctors to decide on their fate. It is all up to them to analyse and decide on their future. Being a doctor is no more prestigious, money-making or easy life. The salary in government sector after the recent introduction of the new salary scheme (SBPA) is fairly good but getting a job in civil service is going to be the major problem in near future. On the other hand, the income of doctors in private sector is gradually dropping and unethical practises are increasing as a mode of survival. I will write more about this soon.

Well, whatever said, I hope 2012 will be a better year for everyone. I hope it will not turn out to be like the 2012 movie.

Happy New Year 2012 to everyone………………………

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2010 in review

The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

Healthy blog!

The Blog-Health-o-Meter™ reads Wow.

Crunchy numbers

Featured image

About 3 million people visit the Taj Mahal every year. This blog was viewed about 54,000 times in 2010. If it were the Taj Mahal, it would take about 7 days for that many people to see it.

In 2010, there were 110 new posts, not bad for the first year! There were 63 pictures uploaded, taking up a total of 46mb. That’s about 1 pictures per week.

The busiest day of the year was September 10th with 2218 views. The most popular post that day was For Future Doctors: General Misconception of being a doctor Part 1.

Where did they come from?

The top referring sites in 2010 were facebook.com, medicine.com.my, zorro-zorro-unmasked.blogspot.com, google.com.my, and mail.yahoo.com.

Some visitors came searching, mostly for pagalavan, mariam mokhtar, columbia asia hospital nusajaya, pagalavan blog, and columbia asia nusajaya.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

1

For Future Doctors: General Misconception of being a doctor Part 1 September 2010
18 comments

2

For Future Doctors: General Misconception of being a doctor Part 2 September 2010
33 comments

3

About Me January 2010

4

For Future Doctors: General Misconception of being a doctor PART 1 September 2010
7 comments

5

For Future Doctors: Housemanship, Medical Officer and Postgraduate Training (Part 3) November 2010
101 comments

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