Friday, December 02, 2005

Gimme a Break!

Ever since I started my self-imposed sabbatical away from the world of medicine (both clinical & non-clinical) 6 months ago, people I meet, be they family members, friends or even newly acquainted persons, ask me why I stopped working & when I will be going back to work.

My much repeated answer to the first question is, to summarise it: disillusionment, dissatisfaction, re-prioritization of my life.

Why disillusionment? I must admit that this started way back in the first years of my residency, when I was posted through the then-compulsory outpatient rotation (in my case, a polyclinic posting). The workload back then was just as bad (if not worse) than it is now. I remember my personal record of seeing 100 elderly patients with chronic illnesses on a Saturday morning from 8.30 am to 12.30 p.m.!!! It was literally come in, sit down, measure blood pressure/pulse, listen to heart/lungs, repeat prescription & out they went. Not quite the ideal situation for consults, as you can imagine.

Another eye-opener for me was the lack of scruples in our fellow man. My inherent (& perhaps naive) idealism in the goodness of human nature took a battering when I came across numerous malingerers (especially those NS guys -sorry, but this was based on my personal observations) hoping for MCs.

And in more recent times, I have grown increasingly disillusioned with this so-called "noble profession" as I see the dog-eat-dog world of corporate medicine, fighting to get contracts with companies, with undercutting and fancy packages (with sometimes dubious value) geared to attract HR managers. Doctors have become assembly-line workers, churning out patients from their consultation rooms. The higher the number of patients they see, the better it is for the practice since more consults = more $$$. I know that this is not reflective of all doctors, & that my skepticism & jadedness is a result of my personal experiences, but I am sure there are many fellow physicians out there who feel the same way.

And then there are the patients. Period. I am sure angrydoc's blog will give you many examples of doctor's dealings with patients which can be rather, ahem, challenging :). I have also recounted some of these experiences in some of my previous entries.

As for the 2nd question, the answer is simply: I don't know. I have yet to feel the urge or the calling to resume clinical practice. Whether or not I will ever feel it again, I don't know...I may still go back to practising part-time or as a locum, just to keep the neurons firing, but not just yet...let me take a break first.


angry doc said...

I will not go gentle into that good night.

There are patients who abuse the system, there are those who will not or cannot be helped. But each one that you help, is one more who is helped.

Even when you just churn the numbers, the number of adverse events you prevent doing your repetitive task is enormous given the sheer volume (number needed to treat and all that jazz).

I believe that we each make a difference. We are the human interface between the science, the economy, the profession, and the patient. We are a vital link and we must all strive to make our role in our own vision. They need us, and when we all speak in the same voice, they'd better listen.

We were once great because we believed in our cause and our powers. They try to take that away from us, but I at least will rage against the dying of the light.

Time to be great again.

Dr Oz bloke said...

Yes we are important. We are needed.

But does the health industry recognize that? Do the customers recognize that? Do the paymasters recognize that?

No they don't. They don't give a damn about doctors frankly. Neither do the politicians nor the people.

What they want are slaves.

The greatness of doctors has long passed. Unless we can bite back, there will be more beatings of us dogs.

Anonymous said...

Fact of life: It's the SAME in every profession, and workplace... there is always the crappy environment

Good to hear that amidst all the gripes, u folkz are still optimistic that u do make a difference in your own way to your patients :)

aliendoc said...

Hats off to angrydoc, & all like him, for carrying on valiantly despite the obstacles faced. I did so too, till one day I realised that half my life is over, & there are still things out there I want to do. When you start waking up daily & dreading the rest of the workday, maybe it's time to relook your life's priorities. :)

angry doc said...

But I ALWAYS hate waking up and I ALWAYS hate having to go to work.

That's why they have to pay me to get me to get my butt down there.

So you see, Anonymous is right! :)

I actually keep my work-life pretty separate from my personal life. I don't expect my work to define who I am as a person, but professionally I do have some strong views about how our profession should progress.

Anonymous said...


It's the experienced Drs that we need to help guide/mentor the younger Drs... else, we're juz going in circles playing musical chairs... and we still end up with more "disillusioned" Drs ev. yr...

It's always sad to see these burnout Drs calling it quits.. *sighz*

I always read about successful healthcare organizations with excellent mentoring schemes for their Drs on continuous learning and sharing of knowledge... without those hierarchical status or political stuff... i think Mayo clinic's one of them (HBR did a study on this b4)
Any chance of us duplicating suh an environment for our Drs in SG?

Anonymous said...

eh? the doc profession so bad meh?? i was actually thinking of medicine as a career....

aliendoc said...

anonymous said: "I always read about successful healthcare organizations with excellent mentoring schemes for their Drs on continuous learning and sharing of knowledge... without those hierarchical status or political stuff...Any chance of us duplicating suh an environment for our Drs in SG?"
Hahahahahahaha....sorry, ahem {composing myself} hierarchy & political stuff??? Here in SG??? I wish I had your idealism (still).

aliendoc said...

to the 2nd anonymous: If you TRULY TRULY feel that medicine is your calling, then by all means go for it...don't let us old jaded fellows put you off.