A new medical university, IIUM, has just been set up in Malaysia. I have lost count of the number of medical schools in this country. We have now too many medical schools. Yes, the demand is there , since everyone having 10 As wanted to do medicine, and Malaysia, been a boleh nation, has been producing ‘tons’ of 10 As students. ( now there is even 20 As…. ). Since the demand is there, medical education has turned out to be lucrative ‘business’ since medical schools can charge many times more than science or arts faculties.
Australia, with almost the same population but much bigger land area and much smaller doctor-population ratio, has only a handful medical schools, but all well known in the world..Yet, their healthcare is so much more advanced than us.
Well, firstly , I would like to tell parents and students out there, medicine is not suited to just anyone with straight As… Medicine is a field that requires a life-time commitment to the care of patients, not as a business to make money.
We call medicine a practice. Not as a business. When people ask me how is my business, I always tell them ‘ mine is a practice and not a business”.
In a business, you are out to make profits. In a practice , for the sake of livelihood, we do charge a fee for treating a patient. But if the patient cannot pay, we still have to give the treatment..
That is why it is wrong for hospitals to be public-listed companies. Public listed companies are out to make profits for its shareholders, not for the welfare of its patients. Well, it will claim that it provide the best treatment and have the best facilities, as a marketing gimmick to attract patients customers… Once a hospital is listed, it will lose its human edge… It becomes a commercial entity.
I have always held the views that provision of good health and clean water should not be commercialised.
Even ordinary clinics cannot turn patients away if they cannot afford the treatment.
That is the basic medical ethics.
I charge a fee but i always let my patients collect their medicine even if they have no money or not enough to pay. There are of course not many such patients as society becomes more affluent… We did service quite a number of these in the eighties, and on one occasion, I remember I went for a housecall and didnt collect a single cent after seeing the condition of the family…Please note that patients have dignity and they would not ask for waiver or reduction of charges if they are able to afford.. They ask because they cannot afford… And doctors must give the same treatment regardless they can afford or not.
For those who are going into medicine, ask yourself:
Is it for money you are entering the field of medicine , or is it really for the love of helping people and alleviate sufferings?
Can you be patient enough to sit there for 60 minutes listening to an old lady telling the woes of her family ? Can you be human enough to comfort her,holding her, even when she smells and stinks ?
Can you stand the chores of standing there for over 10 to 20 hours to do or assist in an operation without asking to be relieved, since chances are there would be no one to relieve you?
Can you stand working from 8am in the morning on a Saturday and finish work at 4.30pm the next Monday (that was the weekend call I personally went through)?
Are you prepared to be on call for 24/7/365 a year , if you are the only doctor in town in some of the rural areas?
Are you prepared to face SARs or Ebola patients coming to your clinic to consult you without you scooting off from the back door? (During the SARS scare, doctors carried on seeing patients like normal, even though anyone with fever could be a SARS patient and you would definitely be infected in the small confine of your consultation room if the patient that walked into your room was a SARS case)…
Are you prepared to handle excretions of patients such as stools, urine and vomitus, or physically handle a foul-smelling and maggot-infested wounds?Even if they cannot pay you?
Are you prepared to face a lifetime of learning since medical knowledge needs to be kept up to date ?
As a hypothetical question just to illustrate a point, are you prepared to treat someone who might have killed your loved ones? Medical ethics demand that you do..
If any of the answer is no, then medicine is not for you.
For the government, it would be pointless mass producing doctors even if we want to have a balance of professions among the different ethnic groups. We have to remember that doctors handle lives, and incompetent doctors can turned out to be licensed killers…A doctor ‘s ethnic group is off no importance, what is important is that he treats all his patients competently without a slight thought of race , colour or religions.
We cannot be producing doctors for the sake of producing them. We cannot shift the passing curve to the left in order to make sure that bad students, who would otherwise fail, pass exam and be doctors.
10 dedicated and competent doctors would be better than 500 doctors with ‘tidak apa’ attitude who never seem to have time for their patients. I have seen doctors not touching their patients, the famous case being mentioned by Dr M himself in the eighties, the doctor who touched her patient with a pencil and not a hand, for reasons that no one seemed to know…
With such a lot of medical schools being established within such a short span of time, where can we source quality teachers?How are we to ensure that acceptable standard is kept, not only medically but more importantly, ethically ? How are we to ensure that we are not producing licensed ‘quacks”?
I leave all these for you out there to ponder…