Blog revived after so long

Procrastination somehow led to the urge to start blogging again, like how I used to procrastinate from revision and ended up composing blog posts. I wonder if anyone even read blogs nowadays. Hahaha. Working life is so much different as compared to student days. Free time is a luxury no longer a right.

Work has been getting busier and busier. Gone were the days where I had time to give teaching to my staff and spend more time talking to patients. The number of patients has doubled if not tripled as compared to last year. Maybe this can serve as a very sensitive indicator to the economic situation - the more the number of patients, the worse the country's economy is performing. 

Points to support this include:
1. Lower spending power leads to switching from private GPs and hospitals to government as nothing beats RM1 per visit to the doctor plus supply of medication. This is true as so many patients bring medications that they've been getting from private and asking if they can get them from my clinic. Sadly, most of them are listed under specialist prescription only or not even available.
2. Economy slowing down means more jobs will be cut leading to higher stress levels and less care for health and subsequently falling ill to acute or chronic illnesses in the long run. More requests for medical certificates, application for welfare, SOCSO, insurance claims, younger patients with non-communicable diseases, etc. I'm not sure how the productivity of existing employees will be affected if suddenly there is a need to work harder to cover the jobs of employees who has been fired. One can argue that factories can increase automation but can they afford to upgrade that quickly?

Speaking about medical certificates, I feel that reward should be given for employees who has been able to take good care of their health and well being with less than 5 days of sick leave taken in a year. This will encourage more awareness of one's health and discourage people from seeking MC from the poor doctor. Why do I say poor doctor? No one empathises with the doctor if any patient hurls threats, verbal abuse and sometimes physical abuse when being denied of an MC. Sometimes I hoped that there will be a clear guideline issued by any authority be it the Malaysian Medical Council or the Ministry of Health on the issuance of MC so that we can protect ourselves. I've seen so many actors and actresses even as young as teenagers who deserves the Oscars for amount of effort put into getting and MC. Other who are not as talented revert to threats. Sometimes as the only female doctor in the consultation room, I fear for my own safety. I try to overcome this problem by requesting for an assistant but due to shortage of staff, it is a luxury to have an assistant/chaperone/safety measure at all times. Maybe it is my fault for not being more firm on this decision. Nowadays, due to the pressure of seeing so many patients in such little time, minimising the risk to oneself, giving up, whatever you call it, I've decided to just close one eye or even both eyes and just issue that MC. It doesn't help when patients' complaints are being held in so high regard nowadays and opinion of the attending doctor over-ridden easily.

Does anyone feel irritated by frequent news on excessive doctors? It is so different on the ground level. Patients visiting government health care are increasing rapidly and yet the number of posts for doctors remain the same and revision of these posts do not occur frequent enough. The visitors to my clinic a year back never had to worry about finding a seat to wait. Nowadays, the number of standing patients are quickly outnumbering the number of seats available. Short term measure - increase the number of seats. Mid term measure, increase floor area to fit more chairs. Long term measure - increase the number of doctors and health care support staff. Sorry for being so sarcastic.

I always tried my best to provide sufficient counselling so that my patient understand their disease and take appropriate measures to manage it properly. In the long term, this will reduce their number of visit and of course complications. However, I am reaching the point of giving up as patients come barging into the consultation room too frequent to complain that they've waited too long. I don't want to adopt the 'Touch n Go' approach but seems like there's not much of a choice. I look forward to the day when primary care can adopt the appointment based system.