Saturday, October 4, 2008

A Sincere Apology On " Wound Inspection Day Two"

My posting "Wound Inspection Day Two" was never done with the intention to portray a department in a negative light. If the article has resulted in such an erroneous and negative perception of the department concerned, I would like to apologise unreservedly to all my colleagues who have been hurt and affected by the article concerned.

As I have mentioned, I am not sure if the patient's death was avoidable or otherwise but was puzzled by the chain of events as related to me by a fellow colleague who was on call at that time.

I am sincerely sorry for the unintended consequences of my writings and seek no excuse behind any mitigating factors.

I have promptly removed the article concerned with full knowing that any damage inflicted cannot be undone.

Once again, I offer my most humble and heartfelt apologies.





18 comments:

Timothy said...

Everything that was written by me was written with love and concern for you , my fellow brother in Christ. Love,love,love,love and love the person before we even consider judging. Judging will leave our souls bitter. True we need correct many things that occur around us but it needs to be done with grace and finesse and above all with love.

Tim

p.s you do not have to post this

Jed Yoong said...

Malaysian Health Care is crap lah.
I rather treat myself after watching You Tube, since that's what some doctors do allegedly anyway, then risk going to a public hospital sometimes. Esp seeing what cancer care is like in the GH...So bad man...They are just so untrained...
Private? Gee, why dun they just test every thing possible from xrays to a ct scan when I go in for a minor infection... ;)
I like ur blog, it's eye-opening.
God Bless.

Product of the System said...

Dear Dr. Timothy,

Thank you for your edifying words in your earlier comment which i am unable to publish as the blog post has already been removed.

Your kind yet strongly-worded thoughts i'm sure was made out of concern and love.

Thank you.

Rest assured your words have not fallen on deaf ears, although i am not in agreement with everything you said.

Thank you and God bless.

Product of the System said...

Jed,
Malaysian healthcare is indeed in sore state. Yet it still the only accessible healthcare service available to say, 80% of the Malaysian population and probably 95% of Sabahans.

It is perhaps the only reason why working in public healthcare is rewarding.

Anonymous said...

pots, you don't have to apologize or retract your posts, anytime, period. timothy, as your friend, shouldn't interfere because it's your right to write whatever you want, and besides, you didn't mention names in your posts. if you apologize for that one post for the reason timothy preached, then you have to apologize for most of your posts.

CK said...

as long as what you say did happen, i don't see any wrong in telling it. of course, you have in your discretion the way you put it out.

Alan said...

I strongly think that your posting "Wound Inspection Day Two" should not have been removed just because some parties thought it has 'resulted in such an erroneous and negative perception of the department concerned'. Such an opinion is not representative of all your blog readers opinions, except for a few sensitive individuals.

What you wrote about was nothing near to judging someone. Most people do not understand the stark difference between judging and constructive criticism. For them, whatever sounds hurtful is inferred as passing judgment onto someone. Little did they know that the truth hurts most of the time. So, what's wrong with esposing the truth without fear or favor?

Correcting someone with love, as proposed by timothy, does not necessarily mean it has to be gentle. Love can be harsh as well.

So, POTS...may I urge you to reinstate the posting you've deleted.

pilocarpine said...

i am sure retraction is being made after a deep solemn consideration by POTS.

It is not the readers, but POTS himself who have to face his fellow colleague in medicine everyday in the line of work.

constructive critism would it still be constructive if it is creating a hostile working environment between POTS and the said department?

porcupine said...

People who are not in the medical profession will not understand the situation of our healthcare system. Granted there are deficiencies in the system, doctors and paramedical staff are humans too. Every doctor has their fair share of mistakes and they learn throughout their career. Let the person who has not sinned cast the first stone. They may be a few black sheeps who are recalcitrant but your posting will encourage mistrust in the whole profession at large by the public. This will encourage the public into fault finding and you as a doctor will bear the brunt of it later on whether it is your fault or not. Your posting about alleged negligence will not achieve anything but will only degrade your profession into comtempt by the public at large. The healthcare system has already turn into a system of defensive medicine. At the end of the day doctors facing the mistrust of patients will be defensive the cost of healthcare will go up. Many doctors will be forced to take expensive insurance and perhaps will only treat "low risk" patients. Who wants to treat a "high risk" patient like the lady depicted in your post? Not me if I'm faced with a mistrusting patient and a potential lawsuit. Who will be at the losing end? In addition, poorer patients will be at the losing end. Today, it cannot be denied that although mistakes and some negligence occur, many many patients have benefited in the deficient public hospitals. For every patient who had an "alleged negligence", 9 patients have benefitted. Where else can you get thousands of expensive treatment or surgery for just RM1? This is not to justify negligence but to put it into perspective. Encouraging public mistrust will drive the medical profession into oblivion and more TCM sprouting up. Do you want this to happen? Is this better for the public at the end of the day ? The public only sees I, me and myself and you have the opportunity to see the bigger picture. There is a place and forum to address the grouses you brought up. Putting this into a blog judging a fellow colleague is truly unethical IMHO.

No system is perfect. Take a look at the Medicare healthcare system in the US. Granted your post may be intended to be like the TV3 Karam Singh Walia, please do not politicize healthcare. Some things are best left unsaid for the best of all concerned. Everybody in the medical profession knows. And it has happened before you were even born and will continue to happen in the future. I appeal to you to think carefully before coming up with such alleged negligence. If you think you are doing the public a service by highlighting alleged negligence, please think 3 times.

And personally I think you shouldn't be judge and jury. A by person not in direct care of the patient cannot claim to know the circumstances, some of which may be left unsaid and unwritten in the case notes. If I challenge you that "the patient and their relatives had opted for no further intervention even if she bleeds to death" and this was unwritten as a trust between the doctor and patient, how would you know? You have no privy to this doctor-pt relationship how can you so readily judged that some negligence had occurred?

I concur with Timothy and I pray that you will see from a different perspective as well. No system is perfect and there is a proper channel to bring up your grouses.

p.s. You do not have to post this as well.

Alan said...

To pilocarpine who asked this question: "constructive critism would it still be constructive if it is creating a hostile working environment between POTS and the said department?"

I don't see what's not constructive if that were to happen. Question to ask is: "whose interest comes first, the patient's or the doctor's?"

Would you rather have POTS maintain a non-hostile working environment with the said department and put other patients' life in jeopardy or would you rather have POTS prevent such an incident from happening again even if it means creating a hostile working environment with the said department?

BTW, being critical of somebody who is blatantly wrong does not necessarily have to end up in a hostile relationship. I believe a fellow doctor should be humble enough to acknowledge his shortcomings and thank the person who points it out to him.

Such should be a healthy working environment but unfortunately humility is hard to come by especially amongst doctors today. Taking care of one another's face/dignity is more important that the patients wellbeing.

porcupine said...

Is this the health
care system we want to promote?

Not surprising patients come to hospitals only when they are just a foot away from their death bed.

http://www.nst.com.my/Current_News/NST/Wednesday/National/2369037/Article/index_html

http://www.nst.com.my/Current_News/NST/Wednesday/National/2369027/Article/index_html

Now, instead of one patient dying from "alleged" negligence and 9 got better, all 10 will die rather than to seek modern care. Because of distrust.

Responding to Jed Yoong :Defensive medicine is exactly the reason why they will test everything from x-ray to CT scan. Especially to distrusting patients with potential lawsuits.

Without trust, the medical care cease to exist.

pilocarpine said...

thanks alan for pointing out whose interest comes first.

this is where i am very delighted to work in my current department who constantly stress that all doctors should come to work with their egos well-kept and zipped up in the pocket.

in my department, patient care precedes everything.

but patient care most of the times, is multidisciplinary, and therefore, good ties with other departments is vital for the absolute benefits for the patients.

risk of creating hostility should be the last resort.

as for porcupine, trust is not about hiding "alleged negligence" but it is about reducing this "negligence" or as 'negligence'-free as possible.

if you applied the similar trust to BN, do you see where we are heading to?

btw, sorry, I don't buy your "1 in 10 die or 10 all die" stats, based on single news item

However, I buy your "Without trust, the medical care cease to exist." statement, provided that you understand, a negligent medical care does not deserve trust.

P.S. Sorry, POTS, for spamming ur site

Anonymous said...

Hmm, your withdrawal of Wound Inspection Day Two and the ensuing apology leaves me in two minds. Firstly it does seem a shame that you appear to have bowed to 'censorship'. A blog entry is one's own personal opinion, and readers should discern for themselves the amount that they can or cannot believe.
However it's true also that many lay people will not be able to understand and appreciate the context of your remarks, and may have a rather negative view of our medical services as a result, being not in a position themselves to weigh the issues for themselves.

Perhaps a lesson to learn from this is that words can hurt, and do great harm. So while free speech is to be defended, unbridled comments without consideration of consequences isn't in the same category. We live in community, and have to take some responsibility for the good, and bad, that wour words can bring.

And with age you'll realise that nothing is in stark black and white; people are not all good, nor all bad.

Even the bright sun has dark spots, and the darkest ink reflects some light.

Product of the System said...

Your comments are all very welcomed and appreciated. I'm not sure if there is an absolute right or wrong with regards to the article.

There are times when we do certain things with the right intentions but in the wrong manner, or more often than not, to be perceived as such. Sometimes our motives are misinterpreted wrongly either because we failed to clarify or because some parties are intentionally instigating animosity.

The article Wound Inspection Day Two would have fulfilled its purpose if only as a wake-up call.

As true as it was, any other resulting effect is not desirable and especially not when it would create a false overall impression as a result of one person's actions.

This blog has always been about whistle-blowing and not judging.

The times i ever judge harshly were the time i readily blame myself for a patient's death.

The articles are all there as evidence.

I don't believe making enemies will edify anyone.

At the same time, i see much wisdom in the adage that a friend to all is a friend to none.

porcupine said...

Perhaps I've not made my statement clearly. This is not about hiding negligence nor condoning it. There is a proper place and forum to address negligence. One can go and speak to the relevant HOD/specialist concerned for example. Or bring the matter up during an interdepartmental meeting.

I feel trust includes acknowledging some degree of risks involved in human care (This is not the same as condoning negligence). Unless we are all robots with no defects. At the end of the day it is our own conscience which which will lead the way. When trust flies away, defensive medicine arise - which is what we are seeing today.

Creating an atmosphere of distrust/hostiltity is not helping the cause. Distrust/hostility between doctors or between doctors and patients. Such an atmosphere is not in the best interest of the patient. Nor the caregiver.


"Patient care precedes everything"

How I wish this were indeed true in the real world. Can any doctor sincerely vouch that they have practised this every single time, every single day, without fail, without any other consideration? For example, leaving an inexperienced HO struggling to take blood for 30 patients while going for lunch isn't putting patient care above everything else. Aren't we all guilty of this to some extent? Or at least once upon a time we might have poke a patient once too often because we were apprehensive in calling for help for whatever reason.

The 1 "negligence" in 10 analogy is not to be taken literally. It is just to exemplify how one can cripple public confidence to proven evidence based medicine (as opposed to TCM) to the detriment of many other potential patients who could have otherwise benefited.

Medical care and politics should be kept apart. The players are still the same. Only in different parties at a different time.

Product of the System said...

Porcupine,

I really don't want to pursue (or to be pursued by) the article anymore.

However, I am truly struck by your employment of the term "proper forum".

It just might be the crux of my next article.

Anonymous said...

THE DEVIL CAN CITE SCRIPTURE FOR HIS OWN PURPOSE

Well I’ll be damned! Speak the truth and one is damned.

I know damn all about medicine. What I do know, is there’ll be devil to pay for any kind of constructive criticism and there is none so blind as those who would not see. There’s a lesson to be learned from this incident. Damn sight better to stick one’s head in the sand and pretend all’s well (cue mental image of an ostrich sticking its head in the sand)when faced with damning evidence of negligence or incompetence. Truth and deontology be damned. Far better to adopt a devil-may-care attitude and live in fools’ paradise never mind if things spiral out of control.

The “see no evil, hear no evil, speak no evil” maxim holds true. This code of conduct must be observed at all times. Breach it and one is regarded a rebarbative turncoat who has to be put in one’s place. Breaching this code of conduct is unacceptable. It’s just not the done thing. Comprende?

One should never, never, never upset this status quo. We must all pretend that all’s well and humming along nicely. Squeal on us and we’ll wail, yowl and howl that it’s a hatchet job. Speak out of turn and one will surely be censured, lambasted and roundly criticised.

Truth hurts so one must be ever watchful of one’s opinion. Rule of thumb in such an unforgiving corporate culture is to wilfully turn a blind eye.

Finally as an act of expiation one must eat the humble pie, apologise and practise self censorship. One is lucky one is not required to perform seppuku (せっぷく)to atone for one's sin. In breaking one's silence one has broken the honour code thus bringing shame to the profession.


Q8-)

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