Wednesday, September 2, 2009

I Choose Ethics


Not too long ago, I was doing locum in a clinic in Kampung Air, Kota Kinabalu.

The deal was from 8 am till 5 pm, so RM 40 X 9 hours = RM 360.

It’s not much for a day’s work but it’s definitely more than the wage for a cashier in a KFC restaurant.

The day started like any other general practice.

Common things were common and in fact in abundance – upper respiratory tract infections, food poisoning, skin rashes, STDs and more STDs.

However, the situation became fishy when patients started turning up with medications that were not in their medical records.

A schoolgirl with recent food poisoning came back with severe bloating and constipation, her hands clutching some residual Lomotil and doxycyline.

Her clinic notes by another doctor showed that she was supposed to receive only oral rehydration salts and charcoal tablets.

A young man with common cold whom I had just discharged with symptomatic treatment came back into the room furious, asking why he was given the antibiotics.

He was dispensed Flagyl, an antibiotic usually reserved for anaerobic and protozoal infections.

An elderly Filipino lady with a fungal skin rash was outraged because she was charged an exorbitant sum for a treatment that didn’t work.

In her clinic notes one week earlier, the previous locum doctor had prescribed antifungal cream only.

However, she was sent home with the antiviral acyclovir five times daily and a potent steroid cream.

It wasn’t long before I discovered the culprit behind all this nonsense.

The clinic receptionist – she was not even a nurse proper, was dispensing poisons as she liked.

In her warped and twisted little mind, the locum doctors were less experienced as she was and the doctors’ treatment plans were not bringing sufficient profits to the clinic.

Much to my horror, I soon discovered she was handing out allopurinol for simple arthralgia and double antibiotics for a mother with possible dengue hemorrhagic fever.

Babies with mild cough were given the potent antitussives pholcodeine and dextromethorphan.

It’s not often I blow my top but on this occasion, my patience reached its limits.

I gave a stern warning that if she continued changing my medications and endangering patients at her whim and fancy, I will walk out and leave the clinic without a locum doctor.

She continued in her unrepentant ways and I walked out – less than two hours into the locum.

Between money and ethics, I choose ethics.

Better to live with less money than to suffer the knowing that one’s next meal was bought at the expense of patients’ health.

In Islamic terms, one’s earnings are haram.

The last I heard, the clinic is still continuing its wayward practices.

The clinic owner has since been charged for illegal possession and distribution of psychotropic medications but that did not discourage the doctor and his staff from a tradition of deception.

While the Ministry of Health is obsessed about the size of clinic doors and the measurements of its examination rooms, clinics like this continue to flourish from ripping off one’s hard-earned money, causing unmeasured harm and morbidity in the process.

P/S: This is not a tall tale of holier-than-thou self-righteousness. To all fellow locum doctors out there, let us all preserve whatever is left of the integrity in the medical profession. Let’s boycott damn clinics like the one I mentioned. It’s the least we could do for the society.

17 comments:

dakid said...

Oh my goodness, this is a nightmare! Sabah Tanah Air Ku, how sad. Besides walking out, cant you do something more? like making official complaints or make the news headline? This is not in the news. People deserved to know all these!

Product of the System said...

Dakid,

I've lodged complaints with the Malaysian Medical Council before, on one incident that involved my family member.

As usual - NO FURTHER ACTION.

dakid said...

I hate NO FURTHER ACTION. sigh. God bless Sabah.

pilocarpine said...

usually, it won't be no further action.

usual case is 'I will look into this'and they will keep looking till next next next General election.

worse case scenario would be half-baked 2nd poster house officer doing locum...

Kong said...

Here is a reason why, in the interest of the patient, it may be better to have some pharmacist doing the dispensing instead.

If the pharmacist dispense like that crazy receptionist, he will be taken to court and have his license canceled.

Likewise if the doctor made a mistake and gave double dose and the pharmacist did not spot the mistake, he is jointly (legally and professionally) liable for the mistake with the doctor.

Of course, doing so will increase cost to the patient. AFAIK, there are no free lunch in this world.

Nightfiller said...

Hi,
This really disgusting!!!
I know it is not possible for you to name the clinic, but could you tell us at least the name of the name of the building or landmark nearby.

Thanks

Anonymous said...

You chose ethics but the way you portray yourself in this blog is everything else but ethics. You criticize the government irresponsibly and you criticize other doctors like no one can (thats ethical?). Product of what system were you from? You're a typical Pakatan supporters. Propaganda is your weapon. If you really hate the government, why are you still a government servant?

Anonymous said...

I for one think we should kill more stupid people. East Malaysians consistently vote BN which shows you their limited mentality. Well done doctor. Prescribe more posion

Anonymous said...

How very noble and ethical...the key does not lye in the nurse...it actually lyes with an ethical doctor...and this has a lot to do with upbringing and what sought of medical schools they attend...and of course the system..

It's all about doing the right thing, monitoring and supervising.

Just as I guess....a cardiologist pumping in a little too much of propofol and not being able to handle the complications thereafter ...complications of which that can even snuff out famous singers....But in this case..the singer/patient asked for it...

It may perhaps be better to do away with the GP system and group them together in group practices with the facility being owned and run by the government...that way most of these practices with half baked dispensers or nurses may disappear....

As for the MMC, they are not interested. They are into selective persecution these days and if POTS or Palmdoc happen to be called for an enquiry, rest assured that they risk being reprimanded or suspended for the slightest of offences.

Both patients and doctors should just go to court. The MMC basically are a bunch appointed dummies from local Us and the public health sector who have little knowledge of GP or private practice with a definitely holier then thou attitude.

Anonymous said...

"If you really hate the government, why are you still a government servant?"

This is interesting. I always thought the government does not belong to any one party/person/institution. But rather, the people own the government. And if the people do own the government, then why can't the people work for the government.

Anonymous said...

I agree. People are the government & we, government servant serve the people..not just any political parties or individual with certain political interest..
Good job!

叶子 said...

Grrrhhh... feel like giving the receptionist a good lesson! Shit shit shit! Next decade no one will even respect doctors anymore if these kind of "pollution" keeps adding in!

Anonymous said...

"I for one think we should kill more stupid people. East Malaysians consistently vote BN which shows you their limited mentality. Well done doctor. Prescribe more posion"

Dude, if you think you know a lot about Sabah (or East Malaysia), or about EAST MALAYSIANS CONSISTENTLY VOTE BN, please think again. Unless you are born or spend at least 10 years in Sabah, then I think you are qualified to say this statement. Why blame the PEOPLE? Why killing each other? Look at the bigger picture dude! Stand outside the box and observe!

CK said...

u did the right thing.

drrita sandakan said...

POTS that is dangerous..
if anything happened to the patients you will be sued..
and the government led by UMNO won't support you as you did a locum outside the government.
Think again each time you want to do locum outside.
ya..think again.

sabah my home land said...

ya ...its true..
the UMNO-led government will never, never cover your ASS

Anonymous said...

Have u thought about to complain to Cawangan Kawalan Amalan Perubatan, Kementerian Kesihatan Malaysia rather than MMC? This is because this body is supposed to uphold the Private Health Care Facility Act 586. If they are caught,these culprit may end up in prison or at least a heavy fine by the court.