One Ringgit

8:47 AM

Everyone feels the pinch of higher cost of living. Even I have to resort to finding other sources of income to support my family. As the saying goes “Kalau ayam mahal, jangan beli ayam” and so on. So, what can you get for 1 Ringgit today?

You can loads of fun! You can have a ball by irritating the hard working medical staff at the Emergency Departments of all the hospitals in Malaysia! Hoorray!
Hmmm, in case you don’t understand SARCASM. Please DON’T do this.

The serious part; Malaysians generally complain about EVERYTHING. Everything is other people’s fault and not theirs.

 Drive fast and gets into an accident “JKR la ni, buat jalan tak rata and straight”, get a ticket for speeding “Polis ni saja je cari duit nak masuk poket”. 
“Duit minyak mahal la, kerajaan songlap duit sebab tu tak mampu beli rumah” but smokes 3 packs of cigarette a day and drives a Kancil at 160km/h.

Politics aside, Malaysia has one of the most affordable healthcare systems in the world. Unfortunately it is commonly abused. Some will say Australia and Britain’s system is better but look at how much tax they are paying….have you checked how much you are paying per year? Please bear in mind, AFFORDABLE and PERFECT and EFFICIENT are two different things. Being an MOfrust has a lot to do with the system itself (I’ll explain in future posts).


NHS advertisement
This is wonderful ad from the British National Health Services. MOH needs something like this. Post all over the newspapers and in all hospitals. Everything is emergency in Malaysia.

Fever one day, "Doctor mahu tungu berapa lama?Saya demam sudah 2 jam, mahu tunggu saya mati ke?"
Small laceration wound at finger tip, despite seeing other doctors attending to an open fracture case  "Doctor, banyak darah keluar ni!!!Tak tahan sakit ni"
Just look at our highways when there is a traffic jam. Some idiot will pass through the emergency lane because of "I am more important mentality"...."Emergency ni, nak balik tengok Raja Lawak!"

Back to the ONE Ringgit. For ONE Ringgit, you can get a complete treatment at a government health facility (Getting just Paracetamol as analgesia IS adequate). Foreigners have to fork out RM 50. Once you get into the system, you can get your vital signs checked. Doctors will attend to you as soon as humanly possible. Get all the necessary investigations done such as blood test, X rays and CT scans. Once done, a treatment plan is provided and appointments are given if necessary.

When its ONE Ringgit, you can expect people to come and fill up the centers. Its a bargain! I once went outstation and had some minor cellulitis. Since I am a doctor, I decided to just treat it with some good old Cloxacillin. Why bother my colleagues and be a cry baby when I can treat it myself. I was surprised to find out that a 5 day course of C. Cloxacillin 500mg QID cost me RM 30. Just for antibiotics! 
All the while I've been dishing out medications like nobody's business. But still, Malysians will scold at doctors when we just give one or two type of medications.

"Doctor, I paid 1 Ringgit and I am a pensioner. I DESERVE better!"
Well, uncle you deserve some knock on the head to knock some sense into you!

Patients also come with ridiculous request:

Its 3 am and they come for ROUTINE BLOOD CHECKUP at emergency department.
Its not that we don't want to entertain you but its THREE IN THE MORNING!
A recent encounter I had:
" Pukul 2 pagi tadi bini saya kejut. Dia cakap badan abang panas la, pergi la hospital"
Pukul 2 was 2 TWO IN THE MORNING. Fair enough you have fever but you are better off continue sleeping and go to a clinic the next day.


Some patients can be plain rude.
"I know this VIP. I deserve to be seen quickly"
They boldly come up to our staff saying this although we are attending to a frail 80 years old lady or an MI patients. If you are a VIP too, just take your money and go to a private hospital. Staff at emergency department need to attend to 10 to 20 patients at any one time. Your rudeness will take up our precious time.


There are many more incidences that I will share. Again ED is for EMERGENCY ONLY. The more people abuse it you are taking away resources that can be used for other patients who need it most. Its not about the money. Its about saving lives. And please people, value the resources that has been provided to you. 

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28 comments

  1. I really think that any KKM fella..or the health minister..or DG..should be ur blog follower...so that they can really see how ED is being misused nowadays...and how Klinik 1 Malaysia does not help at all...sikit2 K1M..sikit2 K1M...such a waste of resources when hospitals need as many manpower n resources as possible to catch up with the increasing workload

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    Replies
    1. read the 3rd paragraph. its meant for ppl like u. maybe not..

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    2. Well.......I really am a MALAYSIAN though

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    3. In a way Suraya is right. I've been always 'not agree' with 1Msia Clinic. Why? Because
      1) the same resource should be used to upgrade all klinik kesihatan to a full-working KK, meaing fully functional X-ray, pharmacy, out-pt & [physio dept. Simply because !M clinic is only by MA.
      2) ED is only for emergency (as fully elaborated above). but is being misused for outpatient, follow-up, medical checkup etc.
      The point is to reduced hosp workload and distribute to KK. Building 1Msia clinic actually & indrectly burdens hospitals as we have to outsource.
      My opinion, from being in this field for past many years.

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  2. So true..i sometimes wonder,are they just plain IGNORANT didnt understand by the word EMERGENCY..!had a patient came to ED for having a NIGHTMARE!!feel like giving her a good wake-up slap!

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  3. Malaysians are just plain ignorant and dumb. Want the best for the cheapest possible. Most of em are.

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  4. Typical kampung mentality among 'civilized' malaysians..

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    Replies
    1. PPL,IN KAMPUNG ARE BETTER THAN SOME EDUCATED IDIOTS....

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    2. I agree with u bro..the word kampung is not suitable to mention the others thinking..even me are from kmpung..but i can see that villager can think wiser than 'city people'...

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  5. the whole lot of dem are ignorant and if they are not they abuse the system ... encourage the whole world to go rm1 for medical health !!

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  6. Been there before.
    Things will never change here.
    For the next 100 years we will have patients like these.

    Dont be suprised one of these days someone will come and see youat 4 AM with a stuffy nose and ask for MC

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    Replies
    1. Believe me, its already happening on a daily basis...

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  7. Hey. It feels great to read this.

    But Drs, most of us-stupid people who know nothing about medicine and health care, has no choice but to ask for your health. I mean yeah, sometimes we, especially those who live in kampung, not even pass their SRP/PMR, could never know how bad it was until they go to the doctors.

    Most of the campaigns asked us to take caution when it comes to the healthcare. Fever can lead to many kind of disorders. It could be dengue, or something else. I mean my relatives, who less educated than you guys still believe fever can cause mental disorder. Unfortunately, they don't know what kind of fever, and to what stage it would be worse. I think, the most practical reason to believe is they don't know. They're told that some kind of things can be fatal, and to those who don't know anything, would has no choice but to go to the hospital, asking the experts why, and yeah, hoping that you guys could help us.

    You know what, last week, I was admitted to the dental surgery. It was my first time (or maybe second for a very long time) to extract my tooth out. I was sedated twice and after the minor operation, I was about to collapse. I felt so cold and can't feel anything, my whole body. I don't know why but it made me feel like dying. Can you imagine how would my parents feel in that moment? It seemed like I was having stroke! I was so pale and couldn't even control my body.

    I wish no harm, or blame to any doctors. I love them very much since most of my friends are doctors. But the first thing I feel bad about is the dentist know nothing to handle the situation. She's a dentist since decades ago. She didn't even ask or say anything before the operations. Then after almost an hour of 'feels like dying', she managed to call a clinic for something to help me. But the doctor refused because he had a lot of patients waiting for his treatment. Not to mention she has no emergency numbers to call. After a while, of course, she has no choice but to call 999 and the finally called the nearest hospital. The ambulance, from the hospital which only 5-6km a way, came after almost 40min later. Well actually, when we called again for quite sometimes, the ambulance said that they had arrived but waiting outside the clinic. That's really helping!

    For your info, once arrived at the emergency unit, I was laid down for a few hours, got my blood pressure taken, and a bag of clear liquid into my bloodstream, I was discharged from the emergency bed by 2 am. The best part of it, the HA told my parents that I was fine, but it might be due to my shock or something. I think what he meant was, I was so afraid and collapsed! Dear God!

    So this is the thing. We people, don't know. We don't go to the medical school like you guys. We're pretty stupid when it comes to healthcare, but we reaaaallllly care about our health. We don't know, but we want to be educated. So yes, if someone could really help us what to do, and when to do, it would be very helpful. We don't really wanna spend time in the hospital for even a minute if you asked. We had mouth to feed, and we prefer to go to the work than resting on the bed and scolded by the nurses and doctors. At least this is me.

    I'm not trying to provoke. I know you guys are the best. We always respect you guys, but please bear in mind, that we're stupid. We don't know. So help us knowing what and how to do this.

    It's a good article, though.

    Lari tajuk ke?

    p.s: Sorry, my english is bad.

    ReplyDelete
    Replies
    1. just diffentiate between emergrncy and non emergency case........ur case was emergency eventhough it's just maybe parasympathetic shock.....but having swelling for years, without pain and present to the emergency department at 2 a.m or during hectic day at emergency but asked emergency people to see ASAP.... it's easy, doesn't need to study up to master or PHD to know waht is emergy and what is non emergency case....

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    2. Dear 'mic in your earphones',

      What doctors trying to point out is, if u have fever, do go to any nearest clinic during their operating time, i.e. 8am-5pm. However, many citizens love to come after 5pm, and even 2-3am just for fever, and hence there are too many ppl waiting and they complaint they wait too long.

      Yes, fever need to see doctor. But doctors trying to point out again, go to Kecemasan when u really in Kecemasan. Fever for 1 day, without sawan/ubah perangai, for your information, is not kecemasan. My advice is to standby some panadol at home if u have fever at night.

      So what is kecemassan? I give a few example: chest pain, loss of consciousness (pengsan), cannot breathe, seizure (sawan) etc. Kecemasan means, if dont go to hospital immediately for treatment, that person might have life-threatening condition soon.

      No hard feelings. Again, you do not need SPM, degree or whatever to understand this. Seriously many Malaysians need to be educated on this issues and use the facilities wisely :) Take care.

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    3. Hi mic in my earphones. I appreciate your comment. In your case, it may be Hyperventilation and can be considered as an emergency. Most of the time it will heal once you are calmer. However, it is difficult to comment on what actually transpired. There are a few issues I would like to point out:
      1. Any procedures require a consent from the patient. Maybe the dentist didn't explain properly especially regarding the sedation. If a sedation is indeed used, they should have the facilities to reverse it.
      2. The response time of the ambulance will depend on where you are located and the location of the nearest health facility. There are a lot of issues with abuse of ambulances and also the dire state of these ambulances as well.
      3. Some doctors do have problems with empathy, putting themselves in other's shoes. I have a soft spot for those less fortunate and help them as best I can. But most of the people causing trouble to this system are the educated ones; teachers, high ranking government officials and even doctors.

      No hard feelings alright? :)

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    4. Dear 'mic in my earphones', very nice comments. heard that, saw that, complained about that, but NOTHING goes. Doctors need to talk to their patients. Sometimes they do, between the 100 or so patients that they have to clear through their paractice, or between clinic consulttaions, ward rounds and surgery. If a doctor spends more time, that means more patients will be waiting longer, at the end of the day, a doctor feels so tired, he/she could only perform below par. Whose fault is it? We need to revamp the whole system.

      Cheers

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  8. I totally agree. Don't waste the health personnel time.

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  9. ah the dilemmas of government doctors. maybe the lecturers need to put an extra hours into patient care subject. after all, that is where all the so-called brilliant knowledge going to be used for innit?

    so my advice to suck it up and deal with it. and to the rests of Malaysian (who reads this), just be thankful that you can walk in at clinics asking for consultation. you will need to get an appointment in the uk just to see a gp (which by the time you are no longer sick).

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  10. Mental melayu. The same as Indonesian patients. Salam sejawat.

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  11. i just feel like responding to this and share my experience. Back in Sydney couple of years ago, I had to go to the emergency department. I had to wait for a good 2 hours to get a treatment padahal dah muntah melutut kat lubang jamban. and almost passed out in the hallway. I got super dehydrated, severe migrain and high fever. I was so shaky and sweaty.

    Few years ago when I was back in Malaysia, was rushed to HKL emergency department sebab stomach pain muntah2 sweaty rasa mcm nak mati dah. I was wheeled to the semi critical area (I puked in from of the emergency dept entrance and I couldnt walk and was wheeled in wheelchair). They dripped me and painkiller twice and complete xray etc. To me, the treatment and services was excellent. They took care of me just when I needed them to.

    both occasion, yang beza is the amount I had to pay. Nasib insurance cover for emergency cases. Follow up at Sydney's hospital, I had to spend 400dollar dulu then baru claim 80%. so total I had to pay was 80 dollar. hoii 80 x 3 is rm240 tau. my follow up kat hkl was rm1. and the services our doctor gave me, tak kurang pun compared to syd's hospital.

    cuma the ED kat sydney's hosp masa tu ada less than 10 people, and ED HKL i didnt manage to take a peek because I was wheeled directly to the bed and got treated immediately. but I've been there before for a family member emergency, it was swamped with people.

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    Replies
    1. Thanx for sharing your experience. Sad to say, Malaysia has (almost) 1st class facilities but 3rd class mentality

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  12. The irony when people say too many doctors!

    But I have to say, I am very thankful with our healthcare in Malaysia, though there is and will always be room and more room for improvement.

    I think we, the patients and doctors should all change and make each other's lives better. We should try to be more understanding and not go demand this and that, and understand that everyone is equal when in a hospital; all vulnerable and require attention.

    Docs, maybe you guys should offer more smiles if not wanting to talk more?

    Thanks for all your stories, and terima kasih kerana berbakti kepada negara dan bangsa.



    XX

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  13. I love their(Dr) profession...must have better understanding to one another..patient with good mentality and Dr be friendly as much as possible...smile at your patients, give them a bright smile atleast they will feel better and less stress to their complains... :D

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  14. Health inspectors and Malaysian Medical Officer should step in on this matter as it will become a problem in our country at a certain stage and will problems in the environment,adding to the problems we already have. Sharps Waste Disposal Gaithersburg

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  16. As a KKM staff as well, I agree that K1M is now more about the concept than the effect. However I disagree on killing it completely. As for a political point of view I can understand the move, however as a clinic staff I must say that their usage of K1M is flawed. It serves as an entirely separate unit of healthcare system for one. New cards, new appt, and non-linked to major healthcare systems efficiently for another. This would simply be understood as a naive political move than a political move with better campaign strategy. If it was me advising, I would link the card system of K1M to any nearest major hospital the first thing. Second, Major hospitals can rely on K1M as a smallcare redirective, which means Hospitals can pass patients to K1M therefore K1M must be strategically located if the cases can be treated with minor intervetion of health staff or is a simple case that does not take up doctors time which is still happening.

    The amount of money used to develop the whole 1 Malaysia campaign is enormous as stated in the 2014 Budget and the provisionary for K1M does not even include transport or efficient connection link between K1M with hospitals expecting normal civilians to know themselves which one to go to before hand. Therefore K1M is more of a conceptual political strategy than an actual systemic country development process. It serves more like a beacon of an isolated clinic rather than a connected healthcare facility that decreases efficiency in the long run rather than increases it because hospital still go through the same problems which did not improve after the incorporation of K1M... I would just advise any civilians to please promote either a different healthcare move or improve K1M to benefit actual already serving healthcare systems.

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