Saturday, December 29, 2012


I am one of the thousands of JPA sponsored doctors who came home to serve after spending 5 years learning the trade in overseas.

The change is sizeable I must admit, from the patients' disease spectrum, expectations, understanding and social background to my colleagues and seniors' working attitudes, clinical competence, career progression, team support and ethics.

I see little benefits in discussing about the quality of houseman, insufficient training resources for post-graduates doctors, or even the national healthcare system when we are not doing much in addressing the core component of the problem - Politicking policy-making.

The major difficulty in delivering good healthcare is the lack of the will to address the flaws in our system rather than not having a good system.

It is not unknown to us that our policy makers are mostly not feedback-friendly and taking negative comments on the system and policies in placed as mischievous and uncalled for.

Nothing saddens me more than hearing a senior personnel brushing off a complaint of our inadequacy with: "that is how the system works", or "please work within the system", and then paradoxically advise us to "express our discontentment in the suitable in-system's channels in placed"

We are in Malaysia whereby five out of ten decisions are flip-floppy mainly due to the over politicking policy making. I am being very nice to give that figure of 5 in 10.

Inconsistency is the most consistent feature in our system. You will never know what the system would be like, in the next 2 years.

Two years ago, the ministry came out with the system that all Peninsular doctors who agreed to serve the East Malaysia where doctors are most needed, would be granted priority in transferring back to Peninsular hometown after their two years service and new doctors from Peninsular would be sent there to take over and then cycles continues on.

A very well intended system to address the issue of getting healthcare to places that needs the most. Well done.

But what happens in reality? The transfer is happening to a certain extent, but it is not all according to plan.

Again the sadness of our Malaysia system, like in all other sectors, those who refuse to transfer and have powerful connections or knows how and who to complain will be able defy the system.

When there is no replacement coming through, there is little choice for the local administrative but to give sweet promises to the current batch to work a little longer.

There is a saying among the rural doctors: Don't make your life more difficult in exchange of making those who sits in office's life easier

I opines that policies involving healthcare should not succumb to unfair treatment. 

We doctors pledged to give equal treatment to all, not to selected few who has education or who has money and it is only fair that we should be treated the same by the system.

We must strive to have a system in placed whereby everyone will have to, and happily to respect the system, and there is no cutting corners, jumping queues or different queues for different people. 

That should be our aim.

For my esteemable policy makers; your job does not end with the issuance of a Pekeliling of your carefully crafted well intended system: you must make sure it is adhered to: fully and not only to those who are willing to follow.

Will patient be any more happy in having a sad, angry and unmotivated doctor in comparison to having no doctor?

Of course in politics of policy making, numbers is more important.

There are a lot of us who is willing to serve in wherever we are needed. 

But it saddens me when some are here and stuck due to a Janji tidak Ditepati.

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