Dengue: No room for complacency
The powers-that-be are crowing "
Dengue Epidemic Over"
KANGAR, April 29 (Bernama) -- The dengue epidemic that hit the country early this year is over.
Health Minister Datuk Dr Chua Soi Lek said Friday the number of cases reported each week for the past several weeks had dropped to between 300 and 400.
An epidemic was declared in February when the number of cases shot up, about 1,500 a week, he said during a visit to the Kangar Hospital. |
Techinically there was never an epidemic. The former Health Minister was actually correct. Dengue is
endemic in this country and what we witnessed was a period of hyperendemicity - many more cases than usual. It's still not a good thing to have "300 to 400" cases every week. We need to do more to eradicate this scurge.
Only last week I had to look after yet another dengue patient admitted to hospital - he lives in SS18 Subang Jaya and another neighbour of his was also down with dengue recently.
As they say, "It's not over till the fat lady sings". And the fat lady hasn't sung yet as far as Dengue is concerned!
Quackwatch : Foot soaked!
I sure you haven't been so gullible as to have your
Foot soak to remove toxinsIf you are one of those consumers who have paid for a miraculous foot soak treatment that claims to remove toxins from your body, you have been taken for a ride, the Sin Chew Daily reported.
The Negri Sembilan Domestic Trade and Consumer Affairs Department recently conducted a “spot check” on some stalls in Seremban which claimed to be able to help “patients” get rid of internal toxins, in addition to improving skin regeneration and giving them stronger immunity with the use of an electronic foot-soaking device.
According to the claim, “patients” need only soak both feet in a tub of “electronically treated” water infused with “herbal” ingredients to get rid of toxins.
The water is said to change colour after a while, indicating that toxins have been drawn out.
According to personnel from the ministry, the traders did not use any real herbs and they discovered that the water changed colour regardless of whether anyone put their feet in or not.
Their investigation revealed that the unscrupulous traders charged about RM50 for each soak. |
This is only the tip of the iceberg. There are lots of health fraud and false claims of miraculous cures going on in this country. In part it is due to consumer gullibility and ignorance. It is also due to poor enforcement.
Feedback: other interactive sites?
Fedaily wrote to ask if there are other sites similar to profizham.org which is now defunct.
Well, Fedaily, it is unfortunate that profizham.org is no longer in existence. I don't know of an equivalent one but may I suggest the following to keep abreast with CME:
-
Medscape-
Atmedica-
DobbsHTH. Anyone have any other suggestions please post a comment and I'll add on to the list
Anti-Smoking : New strategies needed
From The NST,
‘Tak Nak’ anti-smoking campaign in trouble
Farrah Naz Karim
PUTRAJAYA, Apr 26:
The RM100 million "Tak Nak" national anti-smoking campaign is in trouble.
Difficulties with the "clarity" of the message and complaints about the manner in which it is being implemented have led to a review of the five-year campaign. cont... |
The time for talk has ended. Campaigning without physical reinforcement is futile. It is time for radical actions.
No smoking zones must be strictly enforced. Heavy fines and humiliating community work should be implemented for violators of this law.
Cigarrettes must be taken off the shelves of regular shops and only sold in very selected places. The marketing efficiency of tobacco companies have penetrated even to the remotest of areas in Malaysia. Fighting them only through an advertisement war may be flawed.
Ultimately, forcing tobacco companies to bear responsibility through court actions may be prudent, perhaps charging them under homicide laws!
Campaigning and health education is important. However, the Government is not portraying itself as a reliable source of information. They are also not utilising the full armoury of celebrities and respectable public figures in their advertising assault. They also appear aloof when it comes to recent trends and fancies of the younger generation. They need to remould their image if they are to win the war against tobacco companies.
Banking on Biotech
On a similar note to the previous post, this article
MALAYSIA:Banking on Biotechnology - A Disaster in the Making? is worth a read.
Excerpt:
This national biotech policy comes after the disappointing Bio Valley project venture, which started in 2001 inside Malaysia's 3.7 billion U.S. dollar Multimedia Super Corridor. Malaysian officials were hoping to attract 10 million dollars in foreign and local investment in the biotechnology industry in 10 years - a tall order for a small domestic scientific community.
Four years later, the indications are that Bio Valley has been a dismal failure with only three companies signing up to establish plants.
Now, there is much speculation as to what the government has in mind.
''We understand it (the draft policy) was essentially farmed out to a private consultant and even among government ministries and agencies, the consultation has been unsatisfactory,'' said Chee Yoke Ling, the legal advisor for Third World Network - a coalition of NGOs in the developing world.
''From the public statements made by Malaysia's Minister of Science, Technology and Innovation, Dr. Jamaludin Jarjis, it is not clear exactly which part of the biotech world he is aspiring to,'' she told IPS.
In giving broad brush glimpses of the policy, Minister Jarjis said, ''We will discuss with the Ministry of Domestic Trade and Consumer Affairs for a complete review of IP (intellectual property) laws. Otherwise, the foreign biotechnology giants will not outsource their clinical trials in our country.''
It appears that Jamaludin may want to follow the footsteps of India where monitoring mechanisms and regulations for research are relaxed in order to encourage the setting up of contact research organisations (CROs) to take up the business of experimenting new drugs for pharmaceutical giants. |
Why is Biovalley not taking off? Is it because of red tape? Too much of bureaucratic delays and barriers may put off biotech companies. Malaysia should take a good hard look at what our neighbours south of the causeway are achieving.
Going Herbal
It's worrying to read of greedy developers and timber tyrants raping our environment and desecrating forest reserves and green lungs.
Now worry more as we read of
Malaysia Going After The Pearl Of Biotech IndustryChief Executive Officer of Tropical Botanics Malaysia Sdn Bhd, Dr Rajen M. is very philosophical in describing current state of Malaysia's biotechnology status.
He likens the scenario in the country to that of "a sea shell on the shore."
"We are excited by the sea shell with different colours. The real pearls are in the ocean. One pearl there could be worth more than all the sea shells -- that is herbal extraction," he said.
Tropical Botanics, a joint venture between Malaysian Herbal Corporation (MHC) -- the investment outfit of the Malaysian Industry Government Grouping for High Technology (MIGHT), is Malaysia's first multi-herb extraction firm.
MardiTech, the investment subsidiary of the Malaysian Agricultural Research and Development Institute (Mardi) and Mayban Ventures, the venture capital arm of Maybank, also have a stake in the company.
Dr Rajen said herbal extraction is the technology that Malaysia should undertake if it wanted to leapfrog into the world herbal industry worth US$50 billion.
He said there are many herbs that are unique to Malaysia which is the fourth largest producer after China, India and Indonesia.
Uniquely too, Malaysia is the only place in the world where herbs used by the Chinese, Indian and Malay, like "pegaga" (centella asiatica) and "kacip fatimah" (labisia pothoina) have been "cooked" for the last 500 years. |
Now worry that even more of our natural resources may be depleted - perhaps Gamat going extinct?
What is the flaw in this thinking?
Its putting the cart before the horse. Before one thinks of extracting and marketing herbal products, can these businessmen stop to think what scientific and clinical studies have been done to prove/disprove the efficacy of these herbal products? What about the long term safety and side effects (yes, herbs too have side effects)?
An analogy is a salesman comes to you and wants to sell you a "miracle" engine oil made of "all natural" products and "guaranteed" to prolong the life of your car engine. However there are no documented tests done on this "nautral" engine oil. Just the salesman's word. Would you dare put this oil into your car's engine?
If not, then how come the same people do not think twice about ingesting "herbal/natural" products on dubious claims of enhancing health?
More on foreign doctors
The MMR continues to receive requests for information from overseas doctors (especially from the Indian continent) on how to get or apply for jobs in Malaysia.
I have already put up a link on the RIGHT hand side of the web page but in case you missed it, here it is again:
Information for foreign doctors and medical studentsGoing to that link I realised that a Dr Viveg has added a comment and correction that it is the
Public Services Commission and not the Public Services Department (JPA) which is the recruting body.
In anycase, the MMR is not a recruiting body for foreign doctors so please check out the PSC website instead.
NHFS : The Dark Side
From The NST,
Free treatment at public hospitals to end next year
Annie Freeda Cruez
 KUALA LUMPUR, Apr 25:
There isn't going to be any more free treatment at government hospitals! From next year, some eight million Malaysians will have to pay for their medical treatment.
This is when the National Health Financing Scheme comes into force.
Those exempted will be the one million civil servants, some 200,000 disabled people, about 435,000 pensioners, around 250,000 hardcore poor and the unemployed. ...cont... |
The materialisation of the National Health Financing Scheme will definitely be a big relief for its advocates. It could possibly also lead to a boom in the insurance industry, which is already enjoying one of its best years. However, much of the details of this scheme is shrouded in secrecy with little information available for the general public to consume.
There are several points from this article that I wish to highlight. The definition of hardcore poor is vague so is the term unemployed. Should retirees be considered as unemployed. Are senior citizens accorded free treatment? How about housewives who are unemployed? How long should unemployment be in order to be eligible for this exemption?
How about disabled people? There are many disabled people earning very reasonable incomes. Should they not pay for their medical treatment?
Is it compulsory for the rest of the general public to contribute to this scheme? Can any of them opt out? What happens if the customer base of this NHFS is insufficient to meet the medical claims that arises?
What is the role of the Welfare Department in this?
With the liberation of billions of dollars in subsidies, how is the Government going to reallocate this sum?
The implementation of this scheme demands careful planning at all stages. The Government should display greater transparency even at this stage of planning. Open discussions should be formed to gather views from the different groups. It should be fair and not be seen to benefit a select few.
The implementation of NHFS is inevitable in this day and age. However, it is always susceptible to corruption and bias if proper planning is not done.
Typhoid Epidemic: MOH and Municipal Councils disjointed
The recent typhoid epidemic in Kelantan should be viewed as a lesson for other states. Unhygienic methods of food preparation is certainly not confined to the state of Kelantan. Examples of flouting basic rules of food preparation in commercial areas is abundant in areas even in the Klang Valley. As such, cases of acute gastroenteritis is commonly seen daily in Emergency Departments nationwide. Enforcement is lax due to flaws in the organisation between government agencies.
There are many flaws in our current system. There is lack of communication between the municipal councils, which on most occasions are responsible for granting food licenses, and the Ministry of Health(MOH) Public Health officers. Enforcement is usually done by the relevant Municipal Councils and not the MOH. Unfortunately when epidemics like the recent one in Kelantan occurs, blame is usually directed at the inefficiency of the MOH's Public Health division. I agree that there was indeed a failure of enforcement especially when typhoid vaccinations are supposedly mandatory for commercial food handlers. However the responsibility should be shared with the relevant Municipal Council.
I believe that there should be better co-ordination between relevant governmental bodies if we are to improve standards of public health in Malaysia.
Put them on an island
Mufti: Place AIDS patients on islandIPOH: Perak Mufti Datuk Seri Harussani Zakaria has suggested that people with AIDS and avian influenza be cast away on an island to ensure they do not infect others.
He said isolation or quarantine which was imposed at one time against lepers and those with other diseases such as tuberculosis would be the best way to stop any dangerous disease from threatening and spreading among the people. |
Yes put them on an island - and make sure there is no means of communication available . Not patients with AIDS but people who make misguided policies and stupid press statements. That way, their archaic ways and thinking will not infect the rest of us!
Do Pharma reps influence doctors?
These reps just wait and wait outside the clinic doors just to see the doctor, armed with pamphlets and little freebies like ballpoint pens and post-it notes.
I am usually too busy to see them and frankly view them as pests. But I do feel sorry for them as they have their "quota" of doctors to see in a day.
So do their visits influence doctors?
Unless the doctor is living under a coconut shell and does not read journals or keep up to date with CME, then perhaps about the only new information is going to come out from the pamphlet the rep passes to him/her - perhaps the visits wil be beneficial in such circumstances. Otherwise the visits are pretty much useless to the doctor and really only benefits "big Pharma" in being not-so-subtle reminders to doctors on their products.
So if you are a doctor, what do you think? Should clinic visits by drug reps be banned altogether?
Here's a bit of Dilbert humour which seems to think we are influenced by the reps after all ;)
Public Health Failure
In the wake of the large
Typhoid Outbreak in Kelantan where there are now 91 cases and at least two deaths, we should be alerted to the fact that these "old" diseases have not gone away and still pose a serious health threat if we become complacent.
The Mentri Besar of Kelantan has pointed fingers at the Kelantan public,
blaming their "dirty habits".
However I dare say that while hygiene is an important issue, it is also a Public Health failure. Food handlers should be vaccinated against typhoid and unfortunately the controls and regulations are poorly enforced in this country. Don't just blame the flies.
Med-IT Asia
Calling all those interested in telemedicine, telehealth and IT in health in general.
The theme of
Med-IT Asia is:
Improving the efficiency and quality of care by addressing the latest issues in e-health
Event Date: 26-27 May 2005
Location: The Ritz-Carlton, Kuala Lumpur, Malaysia
Thumbs Down to Alcohol
From Yahoo News,
CDC: American Alcohol, Health Ideas Wrong
Tue Apr 19, 1:24 AM ET
By DANIEL YEE, Associated Press Writer
ATLANTA - The government Tuesday warned that a few drinks a day may not protect against strokes and heart attacks after all. cont.... |
How many times have you heard patients arguing about the benefits of alcohol when you tell them otherwise? No doubt earlier studies have shown that alcohol beverages in particular wine, may be protective to the heart and prevent heart attacks. As such, many throw caution to the wind, and consume alcohol with such a false sense of security. Perhaps this article will shed some light on alcohol drinking. It counters previous claims of the benefits of alcohol and the biases of those studies. Eventually there is no shortcut to good health. The basics of a good diet and exercise is time tested and certainly well proven. Furthermore, unsound actions when intoxicated sometimes bear irreversible scars.
Inspirational speech
This is the time when final year medical students in Malaysia will be graduating or have graduated and finally become doctors.
While there have been many "negative" posts and letters on the hardships of becoming a doctor and doing housemanship, do step back for a while and reflect on why you became a doctor.
Many years ago, (1979 to be exact), one of my favourite actors, Alan Alda ("Hawkeye" Pierce of M*A*S*H the TV series) gave a speech to the P&S graduating class in the USA. I could not find a copy of this anywhere in the web but lo and behold,
dobbs located it in an old issue of Pacemaker (the UM medical schools magazine) and thanks to dobbs who scanned it in, we now have an e-copy.
It's an inspiring speech and I urge all new doctors and housemen to take some time and read this:
Shot in the arm
"Pontianak" in Malaysiakini calls the
New Health Ministry DG a shot in the armRead the report of Ismail’s appointment, I am impressed by his crusade to rid the ministry of excesses and red tape. His aim to produce a lean and efficient ministry, as well as for team members to stand up and be counted, though challenging, is timely.
Many times we meet lackadaisical Health Ministry officials like the ones he describes, eating cakes at meetings and going for even more meetings with no results or outcomes to show for them.
I'm glad their days will be numbered in his pending shake-up. The Malay acronym for the Health Ministry - KKM for Kementerian Kesihatan Malaysia - could also mean Kementerian Kursus Malaysia (Training Courses, Conferences and Meetings Ministry) |
Well I am not so sure. Perhaps it is too early for any report card on the new DG. Some press statements may already have
ruffled some doctors feathers.
I think the problems that lie in the system are so entrenched it would take a long time to see change. It also lies beyond the Health Ministry as the problems lie also with other departments like the Public Services Department who control the strings when it comes to salaries and promotions.
Shot in the arm? Won't do much good if both arms are already paralyzed with inaction.
Unscrupulous drug stores
One of the problems facing the issue of making drug dispensing solely a pharmacists' job is the lack of enforcement in Malaysia. Getting prescription only items like antibiotics and what-not is commonplace. Until this is properly regulated, I don't think it is a wise idea to prevent clinics from dispensing drugs as well (apart from inconveniencing patients and other issues).
Now we have further news from across the channel as
More Singaporeans buy prescriptive slimming pills in Johor .
Doctors say an increasing number of Singaporeans find over the counter slimming drugs just not effective enough.
So, they travel overseas or go online to buy large quantities of controlled obesity treatment drugs - but at what price?
Just across the Causeway, Johor Baru in Malaysia has a thriving pharmaceutical business servicing Singaporeans.
At Taman Sentosa, for example, pharmacists say more than 50 percent of their clients are Singaporeans.
Appetite suppressants like Reductil and Duromine, which also boosts the metabolism rate, are popular buys.
When asked, the pharmacists say they do not sell obesity treatment drugs without a doctor's prescription.
But there is no lack of Singaporeans who try to get them!
One Malaysian pharmacist agreed that Singaporeans do come up with all kinds of excuses to get the drugs.
But contrary to what the pharmacists say, it was not all that difficult to buy these drugs without a prescription.
When this reporter first tried to purchase Reductil from a pharmacy, the counter staff was at first reluctant and insisted on seeing her doctor's prescription.
But when she offered to pay RM$30 extra, the counter staff happily handed over the box of controlled drug.
The staff even asked her if she would like to purchase a few extra boxes.
This reporter asked another pharmacist if she could purchase five boxes of Reductil and another five boxes of Duromine?
He replied: "We have stock at the moment."
At another pharmacy, the reporter was told the prescription drugs could be delivered to her in Singapore for 20 ringgit! |
I say to the
MPS: get your own house in order first before making any more press statements about dispensing rights!
Stop the drain first!
I agree fully with Dr. Cheah in
Keep your house in order first. We have mentioned the Governments
Regaining brains program back in July 2004.
I can't believe how stupid the policy makers are. If the policies and conditions in place fail to keep doctors (and indeed other professionals in short supply) in place, how on earth will any "incentive programme" like the
Rules Relaxed for doctors benefit in the long run? I predict that like the "Brain gain" program which the Government now admits in the same article that it is a failure, the new "incentives" will also be a failure.
| For years, the Government had unsuccessfully tried to entice Malaysians working abroad to return home, with Human Resource Minister Datuk Dr Fong Chan Onn declaring the brain gain programme a failure. |
I would like to reiterate that the ones in dire need of regaining brains are the policy makers.
I'm just back from a medical conference in Sydney. Met up with a colleague doing a two year stint there. He can see the difference good staffing makes. One obvious way to help retain your staff is to pay your people decent wages. The on-call wages in Australia are very fair. The situation in Malaysia on the other hand is ridiculous where the
Health Minister has admitted the on-call rates are even lower than a fast food employee's wage. The attitude seems to be to take advantage of the doctors when there is compulsory service. The backlash is brain drain. If the Government thinks they can overcome this by "flooding the market" with medical graduate, they had better rethink this policy. With all sorts of medical schools mushrooming the question of quality of medical graduates arises. The brain drain really affects the senior staffing in the MOH and Universities - not only to provate practice but also abroad. Who is left to train the young doctors?
Playing to the Press
From The NST,
Helping doctors keep abreast of advancesAnnie Freeda Cruez
PUTRAJAYA, Apr 13:
Some doctors still believe there is no treatment available for Hepatitis B, while many doctors still prescribe medicines that have been eclipsed by more effective drugs.cont.... |
Proposing to implement the Continous Professional Development (CPD) programme is long overdue and certainly commendable. However for the Director-General of Health to degrade doctors for the sake of the press and popularity is absurd. In conjunction with his first MMC meeting, he has obviously decided to inform the press that doctors need more education as some are lagging behind. Despite being true, it only further reduces the confidence that the public has in the healthcare system. I feel that this programme could have been implemented without the need to inform the press and thus avoiding the need to degrade the doctors that have strived hard to serve the people.
The true purpose of the CPD programme is to make any learning more structured and help maintain a certain level of competency. I am sure all doctors are trying hard to keep abreast either through self reading, courses or even drug representatives. The CPD programme should aim to recognise them and allow many doctors especially in rural areas, the opportunity to attend more structured courses and perhaps to provide guidance.
There was ultimately little need to inform the press of such programmes when it hardly involves the public. Even worse, the DG painted a picture that some doctors do not have the patient's best interest at heart. This is the politicians job not that of a Director-General. Perhaps the DG should question the policy makers on the reasons for the declining standards involving doctors today!
Dengue: A barometer of complacency
From The NST,
Call to intensify fight against dengue fever
KUALA LUMPUR, Apr 10:
With more than 400 cases of dengue fever reported every week, the country cannot let down its vigilance against the disease.
Archive Since 1991 The Health Ministry's Communicable Disease Control Division director, Dr Ramlee Rahmat, is concerned over complacency in the fight against the disease. cont... |
Despite dengue being an endemic disease in Malaysia, our failure in controlling the current epidemic is evident. This disease is technically an easy one to control by eradicating the breeding grounds of the Aedes mosquito. In order to achieve this, there has to be co-operation between the public and health authorities. Relying solely on the health authorities to stem this disease is an error in judgement. Unfortunately, there is great public apathy when it come to cleaning one's backyard. A stroll through many parts of Petaling Jaya itself will reveal several spots of potential breeding grounds for Aedes mosquitoes. There is little civic conciousness among us Malaysians. Indeed we are reaping what we sow. Dengue can thus be viewed as a barometer of the Malaysian "tidak apa" attitude.
Keep your house in order first
In the NST,
Rules relaxed for doctors
Brendan Pereira in Canberra
Apr 10:
TO encourage more Malaysian-born doctors to return home, a move is under way to relax rules on compulsory service in the public sector.
Foreign-based doctors above the age of 45 will be exempted from the three-year service with the Ministry of Health while those under 45 will be exempted from compulsory service if they are returning to serve in a hospital or if they have qualifications and expertise needed by the country. cont.. |
It is understandable why the Government is trying hard to woo foreign based doctors back to Malaysian shores. Unfortunately, waiving the rule of compulsory government services and exemption from tax, may not be good enough when unfair practices still exist in this country. It is my firm belief that improving the working conditions of doctors currently in government service would be more advantageous than wooing those from overseas. Talents are lost on a daily basis to private ventures and other countries. What is the point of wooing doctors back to this country when others are lost? Perhaps the Government should strive harder to keep doctors in their services first. Ignoring this is virtually fatal to the current state of public Malaysian healthcare. Keep your house in order first before wasting precious finances in wooing doctors from faraway countries. Recognise local talents and support them appropriately.
Reasonable?
From a letter to Utusan,
Doktor main solitaire, pesakit menunggu lama
Saudara Pengarang,
BEBERAPA hari lalu, saya ke hospital Pusat Perubatan Universiti Malaya (PPUM) Bahagian PTJ Trauma dan Kecemasan kerana demam panas selama tiga hari berturut-turut.
Saya juga bimbang dijangkiti denggi kerana mengalami simptom yang hampir sama dengan demam denggi; iaitu demam panas, sakit sendi-sendi, kurang selera makan dan mual-mual.
Setelah mendaftar, saya dipanggil masuk ke bilik rawatan untuk mendapatkan bacaan suhu dan tekanan darah. Saya tidak kisah walaupun jururawat yang merawat saya kurang memberikan perhatian kerana nampaknya beliau seorang sahaja yang bertugas pada waktu itu.
Namun saya mula naik marah apabila dipanggil masuk berjumpa dengan doktor yang bertugas. Saya berasa amat terkejut apabila doktor itu merawat saya dengan cara yang kasar. Mungkin dia marah dan malu setelah menyedari saya ternampak dia bermain solitaire di komputer ketika saya masuk ke biliknya.
Tidak disangka doktor di situ masih sempat bermain di komputer, lebih-lebih lagi di Bahagian Trauma dan Kecemasan. Patutlah saya menunggu selama 30 minit sebelum dipanggil.
Saya amat sedih apabila doktor itu mula bercakap kasar dan kurang sabar dalam sesi soal jawab dengan saya. Beliau juga menyampuk penerangan saya tanpa sempat menceritakan apa yang saya alami. Lebih menyakitkan hati lagi apabila beliau berkata saya tidak demam!
Jika difikirkan secara logik, manalah ada di antara kita yang sanggup bangun pagi-pagi untuk ke hospital, melainkan kita benar-benar sakit. Nama jabatannya pun Trauma dan Kecemasan.
Sesi rawatan saya hanya berlangsung selama dua minit. Mungkin beliau hendak cepat menyambung permainan solitairenya. Lebih menyedihkan lagi, beliau langsung tidak menasihati apa yang perlu saya lakukan.
Jikalau saya tahu apa yang perlu dilakukan, tidak perlulah saya mendapatkan khidmat nasihat doktor.
Saya lebih hairan apabila pesakit yang disyaki denggi tidak dibuat ujian darah, berbeza dengan poliklinik kerajaan yang saya pergi tiga hari sebelumnya.
Adakah doktor itu ingin menunggu keadaan saya ini kritikal, barulah hendak membuat ujian?
Akhir sekali, saya berkata kepada beliau bahawa saya ke situ kerana ubat yang diberi oleh poliklinik tempoh hari tidak serasi dan kesakitan yang saya alami masih tidak reda. Namun apabila saya membaca preskripsi ubat yang diberikan, adalah sama dengan ubat poliklinik tempoh hari.
Jika saya tahu keadaannya begini, tidak perlulah saya bersusah-payah meminta bantuan orang lain menghantar saya ke hospital.
Saya telah membayar 20 kali ganda kepada PPUM berbanding sebelum ia diswastakan (dulu RM1 sekarang RM20 bagi yuran pendaftaran sahaja, tidak termasuk caj ubat-ubatan). Tentulah saya berhak mendapat layanan yang lebih baik. - YANG SAKIT BERTAMBAH SAKIT, Petaling Jaya, Selangor. |
This is a complaint letter lamenting on the undesirable attitude of a particular doctor on night duty at the Trauma and Emergency,PPUM. Reading this letter left me rather uneasy and has created a furore in this department resulting in the deletion of all solitaire games on computers at this department. First and foremost, any dissatisfaction should have been directed to the hospital authorities rather than the press. The press then should have clarified the facts first before publishing a letter that is obviously defamatory. Furthermore, when reading this letter carefully, several inconsistencies can be revealed.
The above dissatisfied patient came in the early hours of the morning for suspicion of dengue. He was triaged to the consultation rooms where stable cases are seen. His temperature was then taken and showed no evidence of a fever. The doctor then called him in after a wait of 30 minutes. He did not state if there were other patients before him. Even if he was alone, the doctor would have to pick up the file from an area away from computers and then requested the nurse to call for him. There was no way this doctor could have been caught playing solitaire when the patient walked in. He later mentioned that he was handled roughly but failed to provide details. He then made an assumption that his consultation time was rushed as the doctor obviously wanted to continue the game of solitaire. He was also not satisfied that the doctor found it unnecessary to do a blood test. Obviously the history and clinical condition did not arouse the suspicion of dengue fever. The doctor was obviously right as the patient is well enough to then write such a strong worded letter. The likely diagnosis of a viral fever is basically symptom control for which further displeases this patient.
It just does not make sense that this patient who visited a government clinic 3 days ago would wait for the early hours of the morning on the pretext that he is suspicious of dengue. I think there was an ulterior motive for this visit at an odd time. He was right, it was a TRAUMA and EMERGENCY center NOT a polyclinic. Many have certainly misused such centers just to avoid long waiting times at outpatient clinics.
In summary, this letter was obviously written in spite, for receiving the wrath of a doctor who probably thought that this patient had intentionally chosen an ungodly time to visit a Trauma and Emergency center for a trivial illness that could wait till morning, just to fulfill a hidden agenda that is seen all to commonly in medical practice.
Govt Doctors Unite!
Dr Lin has written to Malaysiakini :
Gov’t doctors need to unite for better termsWhile I agree with the points in general and the need for a collective voice, the mechanism already exists in Schomos under the auspices of the MMA. Schomos needs more support and participation.
I think personally there is too much griping but when it comes to action there is too little of it.
Administrative vs clinical work
From the Comments section of
The Star,
Shocking that some doctors won’t do clinical work
Comment
By V.K. CHIN
IT IS really amazing to learn that some doctors, who are performing administrative duties, are unwilling to spend a few hours a week to do clinical work.
Health Minister Datuk Dr Chua Soi Lek revealed this recently and it is a situation that must have come as a shock to the public. Some hospital directors are among those who refused such duties.
Dr Chua would like them to do 10 hours of such duties a week, which comes to just two hours a day, as part of his plan to ease the workload of their overworked colleagues.
It is difficult to explain their reluctance but it is strange that those who are trained in medicine should adopt this attitude unless they are no longer interested in the practice of their craft.
Those are the ones whom the Government is keen to keep out of the profession as they have lost interest in treating the sick or saving lives. Perhaps they are not prepared to sacrifice the time to treat patients or walk the wards any longer.
Hopefully they will respond positively to Dr Chua’s directive unless they are no longer keen to remain in government service and are just marking time until their retirement.
Even if their intention is to join the private sector on retirement, the clinical work will still come in useful as it is the best way of keeping in touch with the practice of medicine.
It is not good for any professional to stay away from practising what he has been trained to do for too long as he would lose out because he is no longer performing such duties.
By their behaviour, they have shown their selfish attitude and are not prepared to do more to help the people. Two hours per working day is really not much and all that they need to do is to organise their time properly.
Perhaps they have become so used to a nine-to-five job that they are not prepared to do any extra work. Or perhaps such additional duties will interfere with their golf or social life.
Well, Dr Chua will know whom to leave out in the Government’s offer to allow able-bodied doctors to serve up to age 65 years in order to keep them in the medical service.
The minister has said these doctors could not be considered as members of the profession. Their prospects of promotion will also be restricted.
Such a stance will certainly not endear them to their employers in the private sector, if it is their intention to start a second career on retirement.
Those running hospitals and medical centres, whether private or public, will frown on those who refuse to use the healing hands they had acquired after so many years of study and practice. |
I have to disagree with the current belief that all doctors should do clinical work. Similarly, not all lawyers go to court. Even our dear ex-PM left medicine for politics. Isn't the years of his training then wasted? Should he then have been forced to do clinical work while administering the country? Should Dr Chua then also perform clinical work at a government hospital? Alright, that is an exaggeration to prove a point.
Moreover, how is 10 hours a week or 2 hours a day going to relieve the shortages in manpower? By doing so, he will only leave equally important administrative work unattended.
The public should not stereotype doctors as persons who sit across the desk treating people. Doctors are a group with great diversity from administrators to researchers. Each has its own unique and important role to play.
I think that the above attack on doctors in administrative positions is unfair and highly biased. The inefficient handling of manpower has been unfairly blamed on such doctors. Although I do agree that in the event that the adminstrator has spare time, he should assist in every way possible.
Just as we cannot expect all lawyers to go to court, not all doctors will be across the desk treating patients. Unless in the event that Dr Chua himself volunteers to treat patients in government hospitals for at least 2 hours a day, I think he should concentrate on more important areas and ways to improve the current manpower shortages in government services.
Feedback: Ozone therapy revisited
Suhaimi writes:
| I did watch nona programme on tv3 last sunday. there was a segment about ozone therapy if i'm not mistaken where the blood is being 'clean'from toxin and fat. Can you explain the purpose of that treatment, cost and where one's can get the treatment |
Thank you for writing in Suhaimi. We have mentioned before and I'll state it again:
Ozone therapy is quack therapy. It has absolutely no therapeutic value.I am disappointed that local TV programmes continue to broadcast such medical misinformation. Sadly, in Malaysia, there are some medical practitioners who actually practise this form of quack therapy. Such practitioners should be reported to the Malaysian Medical Council for unethical medical practice.
Links:
Oxygenation Therapy: Unproven Treatments for Cancer and AIDSAnswers.com: Ozone therapyQuote:
| In the USA ozone therapy is illegal, as the FDA has not approved its use on humans. It is considered to be quackery by the mainstream medical and science communities. At least one death has been attributed to application of ozone through insufflation in the USA. Ozone has been found to convert cholesterol in the blood stream to plaque (which causes hardening and narrowing of arteries). Ozone has been studied extensively, and found to be carcinogenic to some animals (and not others), and a mutagen to some bacteria. |
Cancer quackery
Multi resistant bacterial Infections
From the NST,
Lifting the lid on hospital infections
Annie Freeda Cruez
KUALA LUMPUR, Apr 3:
Every year, Malaysians are dying from hospital infections, including the superbug MRSA. But just how many, no one knows.
The Health Ministry will soon begin a study to determine how many people in hospital for treatment die of infections contracted there.
Between 0.5 and 0.6 per cent of patients here come down with hospital infections every year. cont... |
Hospitals are indeed notorious for brewing multi-resistant bacteria. These organisms are mutating even as we speak and they are able to adapt at a rate faster than mankind. Since the discovery of Penicillin in 1928, we are no where near victory against these bugs. With the advent of new antibiotics dwindling and the number of resistant bugs increasing, there is a constant fear that we may relive the era before the discovery of antibiotics where simple infections can be disastrous.
In situations where multiresistant bacterial strains are discovered,
barrier precautions in hospitals are essential in preventing the dissemination of these bugs to other patients and into the community. Any compromise will only raise the number of infections by these superbugs.
In Malaysia, the standard practices of barrier precaution still leaves much to be desired. They are not strictly adhered to by healthcare staff and visitors alike. The infrastructure of current hospitals also do not promote a safer environment and only makes the implementation of barrier precaution sometimes laborious.
Indeed , there is much to be done if we are to achieve a lower incidence of multidrug resistant infections.
NHIS : A reality at last
From The NST,
Najib: New healthcare system inevitable
KUANTAN, Sat. - The introduction of the proposed National Health Insurance Scheme is inevitable due to the rising cost of health care, Deputy Prime Minister Datuk Seri Najib Razak said today. Cont... |
At last, the National Health Insurance Scheme is becoming a reality in Malaysia. With the escalation of healthcare costs, it is a wonder how any average earning individual could afford basic healthcare. Thus, government hospitals are overwhelmed due to the extensive government subsidies provided at these centres. But with spiraling costs, such subsidies are becoming a burden to the Government. There has to be an alternative scheme which benefits all Malaysians regardless of income. Could the NHIS fulfil this need?
Careful implementation of the scheme is important. Guidelines should be strictly adhered to as any abuse of the system will only result in a disaster. Education of doctors is also important to ensure responsible prescription practices. However, the NHIS is a step in the right direction and it certainly gives Malaysians better options in healthcare. It also removes the practise of tailoring one's medical treatment according to one's cloth.
Feedback: Medical PDA question
E wrote in with some PDA questions - well I thought they would be more appropriately answered in the
Palmdoc Chronicles - so head over there....
Rheumatologist in Demand
Highlighted in The NST,
Needed - 400 rheumatologists
Annie Freeda Cruez
KUALA LUMPUR, Apr 1:
Dr Chow Sook Khuan is a one in a million - literally.
She is one of 19 specialists trained to look after a growing number of Malaysians suffering from arthritis. There is just one rheumatologist to more than 1.2 million Malaysians.
The Health Ministry is aware of this grave shortage of rheumatologists.
Health Minister Datuk Dr Chua Soi Lek said to achieve a ratio of one rheumatologist to 85,000 population, a target for developing countries, Malaysia needed at least 400 of them by 2020.
cont... |
Rheumatology is indeed one of the less glamarous fields of Internal Medicine. Even UMMC is left without a rheumatology consultant for close to a year now. My guess is that other fields in medicine is also in short supply. Unlike undergraduate studies, there is a lack of post-graduate training facilities in Malaysia. I personally think that there are already enough medical schools in Malaysia. What we need now is to consolidate the position of these colleges and universities by offering quality postgraduate programmes. This should apply not only to medicine but other diciplines as well.
The other important task for the government is to ensure that specialists remain in their service. This should not be done by force with compulsory services and bonds but rather with better managerial skills and improved perks. Treat doctors like professional people and not like medical students. Reward them accordingly for their dedication and hard work. I fail to understand the reluctance of the government to improve the working conditions and the salary offered to doctors. There has been no explanation forthcoming except that the government can ill afford to raise salaries.
If the Health Ministry would like to achieve statistics similar to developed countries, then they must match this with the working conditions of doctors in these countries. We have often compared our statistics with developed countries and on many occasions fall short. Finger pointing then occurs and on most occasions, doctors and nurses end up boring the brunt of these attacks. LIttle did they realise that in order for us to achieve better health statistics, we need to ensure that our engine of growth, ie its human resource, is well oiled and taken care of.
Churning more specialist is of little use if they are continually lost to the private sectors and other countries and the root problem is not solved. Period.
