LETTER | I am a member of the medical fraternity in Malaysia.
I write this among the frenzy of letters and opinions regarding house officer (HO)/junior doctor training in Malaysia. A lot of expectations have been placed on HOs and they are expected to shape up and reach competence within two years.
There are countless examples of a bad attitude, laziness, etc, at work (which applies to all levels of the hierarchy, by the way), but how often have we stopped to think of whether we have really empowered them?
Certain policies in place in certain hospitals are not only time-consuming but also disempower the HOs. One very common ruling is that HOs are not allowed to check blood packets before transfusion.
Reasons such as "HOs are not fully registered and therefore cannot bear full responsibility" are cited as well as "previous errors made by HOs resulting in blood transfusion errors", etc.
To err is human! Having a medical officer or anyone else more senior up the hierarchic ladder does not guarantee fewer errors. In fact, it is more ideal to have more than one person to perform the checking to prevent errors. Removing this responsibility from the HOs does nothing good at all.
Another common policy is interdepartmental communication. Some centres have a policy that says all interdepartmental referrals cannot be made by HOs and must be done by doctors who are more senior. Well and fine, but this breeds arrogant doctors who refuse to even listen to a HO over the phone, even for trivial matters.
Many a time a HO has tried to call another doctor from a different department and cannot even get past saying "I am a HO..." without getting the phone line cut. We then expect them to produce tip-top referrals the day they become a medical officer.
This is very common among tertiary centres that service district hospitals, which often complain of the quality of referrals and information presented by the junior doctors at the district hospitals. What do you expect, if you don't allow them to communicate between departments as HOs?
Empower before having expectations. Times have changed and people might not be as resilient or capable as "the old times", but it is high time we scrapped ridiculous policies and pushed for true empowerment of junior doctors.
Junior doctors/HOs must also take this seriously and stop all forms of lackadaisical attitudes. If they are found to be not up to the mark, then necessary action must be taken, including termination of service and a recommendation to find another job option.
Being a doctor is not for the faint-hearted and there are many sacrifices to be made along this journey. There is no shame in choosing another path.
The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.
