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.