Thursday, February 23, 2006

An Open Letter

Dear I.M. Sik:

First, let me say that I understand you are not feeling too well, & can empathise with your feelings of anxiety over your medical condition. I hope that you will be able to take the sentiments expressed in this letter with an open mind, and hopefully be able to appreciate that practising Medicine in the modern world is not as easy as you may think.

Doctors go to work everyday with the hope of making their patients feel better. I don't think anyone of us have intentions of killing/maiming/injuring their patients. In a perfect world, everything would come up rosy & everyone would live happily ever after. However, as you know, this is not a perfect world, & unfortunate things do happen, often beyond the control of us mere humans (yes, even doctors are human & not gods!). Whenever possible, safeguards & contigency plans are in place to try to minimise or rectify these unfortunate incidences, but not everyone can be saved due to factors like age, concurrent medical conditions & just sheer bad luck.

In this material world, the question of cost often comes up. Everyone expects excellent medical care with minimal cost. But surely you must understand that logically speaking, that is not possible. There will always be trainee doctors, who will eventually take over the role of their senior & more experienced consultants & professors. If they are not given the chance to learn (under the supervision of their teachers) how will they ever achieve the expertise needed in the future?

It is also not possible for everyone to be under the direct care of a consultant otherwise these poor doctors would not even have time to take a meal let alone do ward rounds, or surgery or spend time with their own families!

Ultimately, there needs to be a relatively fair way of distributing the healthcare needs without compromising on healthcare standards nor on the morale of the healthcare workers. And one way which the institutions have done so is to allow the subsidised patients to be seen by Medical Officers with supervision from their superiors. You have to admit that the amount of subsidy given by the government is not small, and the amount that each subsidised patient has to pay for consultation, drugs, investigations, surgery etc. is a small fraction of the actual cost! It is hard to fathom that many people don't blink an eye about spending hundreds & sometimes, thousands of dollars on slimming treatments, massages, facials etc at the spa & yet gripe about the cost of seeing a doctor when they have a health problem. I sometimes wonder if they have their priorities right.

I hope that you will also understand that doctors have personal lives outside the hospitals and clinics. They have spouses, children, and even hobbies to even out the balance of an otherwise stressful life. So please do not begrudge a doctor for closing his/her clinic on time if it's not a dire emergency or urgent condition. Do take note that locally, we are, indeed, extremely fortunate that there are clinics open 24 hours even on Saturdays & Sundays & public holidays. (Doctors often spend their evenings & weekends with their patients instead of with their own children.) Not so in some of the developed countries. They open from 9 to 5, Mondays to Fridays. If you catch a cold or a flu outside office hours, you can jolly well get your own medicine from the local supermarket. Urgent cases & emergencies would go to the ER. Locally, we are actually spoilt for choice; unfortunately, this is largely unappreciated.

Finally, a humble word of advice - take charge of your own health. Know your medical history & the drugs that you are taking or allergic to, so that when you next see a doctor, he doesn't have to guess or trace records which would take time away from the consultation. Don't be shy to ask questions about your management, your condition, and your treatment. If in doubt, get a second opinion. Most of us wouldn't mind (this is not a matter of losing face; it is your health we are talking about). Remember that risks are inherent in everything we do, including crossing the street! Same thing with medical procedures - do not take for granted that risks are non-existent. Risks vary depending on the treatment/procedure/surgery. Ask your doctor what they are & what are the chances of developing complications; know what the possible complications are. Success rates are also variable depending on the medical condition; and although we would like to be, we are in no way, miracle workers! Discuss all this with your doctor. In this way, you would be able to make an informed decision on how you want to be treated & managed.

Wishing you all the best,


Doc MD

No comments: