"I believe in a country where hard work and merit, not privilege or background, determines success."
Tony Blair 2005

Friday, May 14, 2004

Waiting Time Debate

In the NST today,

Complaints of long wait for treatment at hospital
Nurjehan Mohamed and Tony Teoh
PETALING JAYA, May 13:
If being sick is not enough, some have to wait for hours before they get treatment at the Universiti Malaya Medical Centre, complained patients
interviewed today.Met at the Emergency Unit and General Clinic of the hospital, it was evident that some patients had to wait for three hours.

Retiree Chua Kui, 58, who took his 90-year-old father for treatment at General Clinic said that he often had to endure a long waiting period averaging three to four hours, excluding the time taken to register, just to see the doctor. "Getting the medication from the pharmacy is another hour's wait, thirty minutes if I'm lucky," he said.

Mastura Jamil, 33, who brought her five-month-old son, said it was her third visit to the hospital and from past experience, seeing the staff nurse was easy but trying to see the doctor would take up to an hour................................


This is an unfair report and extremely one sided. I am pretty sure there will not be any patients voicing satisfaction. It is a biased news report. Even Mastura Jamil was only waiting up to an hour. That is pretty good. Even popular private hospitals like SJMC have long waiting lines. Why are people not complaining then?

Perhaps the answer lies in this letter in the NST,

How to make doctors stay in government service
May 14:
I AM a doctor working in the Emergency Department of a government hospital. Much has been said about the condition of our health system, mainly the treatment of patients in hospitals, waiting time and the hardship faced by doctors. I believe the root cause of the problems mentioned is the shortage of doctors. We churn out many doctors from our universities — local and overseas, as well as from medical colleges each year. The problem is that we fail to keep them in government service.

The main reason why we fail to keep them is because of the low pay, long working hours and bad working conditions. Fewer doctors wish to remain in government service, thus causing an increased burden to those who do stay. Fewer doctors means longer waiting time for patients. Tired and overworked doctors may give substandard care due to lethargy and poor judgment. It is a vicious cycle.

How do we break the cycle? Increase the pay of doctors and improve their working conditions. More doctors will stay and then the workload will be lessened which will in turn attract even more to stay. To increase their pay, we need to find the extra money. How can we do this? Government hospitals are not profit-oriented. All medication is free despite being expensive.

Treatment at outpatient clinics and emergency costs only RM1. For example, a patient with fever and cough treated at the outpatient clinic will at least be given paracetamol and a cough mixture for his RM1. In contrast, the same medication bought at a pharmacy may cost RM1 to RM2 for 10 tablets of paracetamol and RM5 to RM15 for a cough mixture. There is so much difference in cost even for such a simple case as the flu. Another example is when a patient comes to the Emergency Department and is rehydrated intravenously with some blood tests and X-rays done. CT scans are done if warranted, and these may cost from RM300 to RM1,000 in private hospitals. All this for RM1. I believe increasing the charge from RM1 to RM5 is logical and necessary.

Currently, because it is so cheap to see a government doctor, patients abuse the system. I have seen patients in my Emergency Department with trivial complaints such as body odour, bad breath and dandruff! The prescription for medication by doctors in government hospitals should also be checked. A big chunk of our hospital budget goes into purchasing medication. It is not uncommon for patients to be on 10 different types of medication, some being expensive. The cheapest, most effective medication should be given priority over more expensive, newer medication.

Let us think of logical solutions which target the root cause and not solve a problem by creating another problem.

DR F.Z.
Kuala Lumpur


I agree that sometimes patients abuse the system. I have worked in the Emergency and have seen many cases which are non-urgent but they insist on going to the Emergency. These patients will voice their displeasure when told to wait or to go somewhere else. I still remember as the only emergency doctor on call on a weekend and with many emergency cases, there is little time and hardly any patience to see trivial cough and cold cases. Are we to be blamed then for long waiting lines? I hardly think so.

Patients have become increasingly demanding. The unrelentless and at times unreasonable pressure from the press does no favours as well. I suggest that patients and the press look in a broader perspective not just measure efficiency in terms of waiting times. We need the press to educate the public on the reasons for such a long waiting line. We cannot do magic and we need help to solve this matter.

Ultimately the above letter spells it out, we need more doctors in government service. We need to seal the leak of doctors going into private practice. There is only one way, make doctors feel more appreciated.

Perhaps we need to celebrate Doctors' Day too!! Why not?




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