by Insider
Aliran Monthly 2004:1

Moral foundation needed in healthcare

It is widely agreed that medical science, medical or healthcare services could have a moral and ethical foundation only to the extent they foster the well-being and welfare of the patient.

What do we see in Malaysia today? Is it largely a system where some consultants and general practitioners are getting rich, drug companies, private hospitals and pharmacies are getting richer - most of it at the expense of the poor unsuspecting patients.

Having worked in private healthcare for more than 10 years, I have now totally left the �industry� as it repulses me to my core. Yet more and more private hospitals are mushrooming; we are bombarded with consultants who specialisize in every part of our human anatomy. How many of us question these so-called specialists? Do we wonder when we are shoved with a list of endless investigations if the tests are actually necessary in the first place?

Why are we handing over control and autonomy of our body to these �specialists�?

Private hospital brochures stress the choice you have of a consultant, who can be either a resident or visiting consultant*; however, they don�t mention the fact that your consultant may appear for just five minutes, then disappear. For the other 23-plus hours, you are in the hands of a resident medical officer, who can be an inexperienced doctor having to cover every patient. Nurses, too, tend to be generalists.

Scenarios

Let me give you an interesting and not so delightful insight into the reality of a private hospital. My experience in the healthcare industry ranges from nursing, teaching, sales, marketing, customer service and administration. I am perplexed by the unending ongoing horrifying encounters that poor unsuspecting patients undergo almost everyday.

Have doctors turned bad? Have they become uncaring professionals, only interested in making money? Have they closed ranks and started covering up for each other? Forgotten their vocation and become hypocrites pretending to be true to the Hippocratic Oath?

Let me bring you to a real life scenario. A young pregnant mum was admitted for delivery. It was meant to be the happiest moment in her life - as she was joyously anticipating the arrival of her baby. During the delivery, however, her �specialist� came in half-drunk and pulled out her internal organs. She went through hell. Today, she is not even able to swallow fluid. She lives on a tube that delivers nutrients to her body.

Why was the hospital silent when there was talk about it in the hospital? The nurses who witnessed the incident remained silent as they are dominated by the doctors. There was a court case though - but the case was resolved with minimum settlement. The specialist, remains guilt-free, is still practising, and drives around in the latest Porsche.

Let�s move on to another real-life scenario. A patient who was under a �celebrity� doctor decided that he couldn�t afford his exorbitant fees anymore and wanted a follow-up at a public hospital. So he requested a referral letter from this specialist. His request was not granted; instead, he was brutally humiliated by the specialist who remarked, �Oh! (If) You have no money, you couldn�t have possibly seen me.�

Okay�a more general one now: patients who come into some private hospitals complaining of abdominal pain are more than often not diagnosed with appendicitis and will be asked to undergo an appendicectomy. Normal appendixes are removed all the time, exposing patients to unnecessary risks, pain, agony and money.

I have heard of certain doctors talking among themselves in the tea-room as follows:

Dr A: How is business these days huh?
Dr B : Oh not bad-lah
Dr A : How are your shares ?
Dr B : My shares went down-lah. Lost a couple of thousand�never mind I will make it back from my patients tomorrow.

How do you think he will �make it back�?

These incidents are just the tip of the iceberg. What exactly is going on? Has modern medicine - once hailed as bringing about the greatest benefits to humankind - become a dangerous activity? Have doctors turned bad? Have they become uncaring professionals, only interested in making money? Have they closed ranks and started covering up for each other? Forgotten their vocation and become hypocrites pretending to be true to the Hippocratic Oath?

Is it the doctors� fault and more importantly, what can doctors do to turn things around? What about the government�s role in protecting and educating the public? What about patients� rights? I leave you with such thoughts to ponder.

* Resident consultants are those who have a clinic in the hospital: their patients see them there and they do the investigations there. They pay for the rental of the clinics and a certain percentage of their fees. Visiting consultants are those who see their patients outside the hospital: they usually have their clinics outside. They can admit their patients into the hospital. They can also conduct their surgeries in the hospital. Insider is the pseudonym of a disillusioned former private healthcare worker with more than 10 years� first-hand insight into the daily operations of a private hospital.

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