Why So Like That?

4:18 AM

Despite common belief that I wear my mask to work all the time, I DON'T. I am just a simple doctor at a small clinic. I have facial hair like Hugh Jackman's Wolverine. Just imagine me as Wolverine with all the muscles but instead of six packs, I just have ONE big pack and a few spare tyres.

Yep, that's how I look like!

If I were to wear my mask to work, I would totally understand why patients refuse to trust my words as I would look like a joke. But why don't they believe me? Believe me and my colleagues? Why so like that one?!

I encountered TWO scenarios these past two weeks that left my mind boggling....just like a bad episode of SENARIOOOOOOO.





Scenario 1

A lady came in with chief complaint of "Mata kabur" and "Saya mau surat pigi hospital". Since my Cantonese is only limited to counting one to hundred, tim liu (diabetes), tam pu sun (high cholesterol), hit ah kau (hypertension) and kat (cough), I just proceeded with my examination.

Blood pressure..................hooooh leng (cantik!).
Fundoscope......................its one of the few times that I can actually see the fundus....normal fundus.
Modified Snellen chart.......looks like she has short shortsightedness.
No history of tim liu or hit au kau.

I proceeded to ask her whether she wears any glasses and whether she has seen an optometrist.

Saya tak tau Maalaaayuuuu. Mau itu surat pigi hospital.

Since it was a relatively relaxing day, I sought help from my Chinese colleague. After some lengthy conversation, she took out her glasses! She has glasses which she has refused to wear for the past FOUR years!

So my colleague and I counselled her that she most likely has short shortsightedness and requires some adjustments to the glasses. The patient insists that her FRIENDS (not medical trained) told her that she has cataract. She insists on getting a referral to the Ophthalmology Clinic. Keep on saying she has cataract. After a long explanation that she needs to see an OPTOMETRIST instead of an ophthalmologist. She stands up and say "Saya mau jumpa doktor tempat lain".

Since when does patient just order doctors to write a referral letter? Since when am I supposed to blindly write a referral without properly examining a patient?
Customer is always right?.....its my right to do job properly and not clog up the ophthalmology clinic with unnecessary referrals.



Scenario 2

Its noon in El Nino season. I was in the middle of barren land. There was barely a whiff of wind. Everyone was sweating. Some of my patients just wore shorts without a top. It was mobile clinic day. The van that I came with was a metallic junk called Ali-phard.

"I'm a PENSIONER and I am in a hurry. I have a meeting with Dato' XYZ. I know Dato' K, Dato' Lat, Dato' Trio.........and Mak Datok!" said a man in his late 50's.

MOfrust's Rule of Thumb:
   
      If a man boasts of WHO he knows rather than WHAT he knows, he's full of male cow excreta.

Mr. P:           I want the medication for gout. Not the one you take everyday (?allopurinol) but the one you                        take when you get an attack (?colchicine).

Me:               I'm sorry sir, but we don't have that medication here. We only provide some basic                                medicine. My van can't fit the whole pharmacy.

Mr. P:           Why la you don't have?! I'm a pensioner you know! I'm a committee in the village, party                                XXXX...blah,blah,blah...

Me:               I'm sorry sir. Please have a look at our van, it's not very well equipped. I can offer some                      analgesia if you are in pain.

Mr. P:           I just want too simpan stok in case I get an attack. I malas nak makan the (?allopurinol)                            everyday.

Me:               I don't think it's appropriate to keep stocks at home. It might be misused or someone                            can get an adverse reaction without proper guidance.

Mr. P:           Saya bukan BODOH doktor. I know how to take my medications....blah...blah...

Me:               I think you are in a hurry. You should leave. Take the pain killers or go.



It's hard to keep your patience after trying to talk politely. Heat, hunger and rude people doesn't make a good combination. What did this guy expect from a mobile clinic, the WHOLE PHARMACY? You didn't pay a single sen and expect to keep stock of medications at home?

The reason why we don't just dish out medications are:
1. To monitor efficacy of the medications.
2. To look out for any adverse effects and act appropriately.
3. Need to monitor compliance as a lot of times patient keeps stocks of anti hypertensives at home and don't take them accordingly but instead just take them when badan rasa macam ada darah tinggi (whatever that may be).
4. Medications have expiry dates and you may end up taking expired medicines if you stock up for too long.

If anything happens along the way, especially severe side effects the front page in Harian Mxxxxx the next day would be;

"DOKTOR BERI BAPA SAYA MAKAN RACUN"

Now, why can't people just trust me when I:

1. Explain that they might have a different disease than he or she expected?
2. Say I don't have all the medications because of NO BUDGET?
3. I can't dish out any medication sesuka hati?

Sigh, I guess that's just a life of normal Malaysian medical officer....maybe I should upgrade!

MOFrust

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4 comments

  1. Education. It's all connected back to education. I don't think we educate the public properly. You know how A&Es are abused.

    ReplyDelete
  2. people want to hear what they want to hear. not some patriarchal advise. They know there are king so push their power wherever they can.

    ReplyDelete
  3. I have patients coming in after having fever for one day and already on antibiotics. When asked " where did he get the antibiotics from?'' - he replied; "from a doctor dari A&E ini lah. He gave me antibiotics when I came last year with fever"

    *sigh*

    ReplyDelete
  4. I had patient in district came in saying she just wanted referral to eye clinic and rudely refusing vision test.that was my cut off point to leave that place.ironically, I'm pursuing master in opthal nowdays..hope I don't see her again :-p .. for public,Just try to respect & be nice to your doctor.a simple thanks really make my day

    ReplyDelete

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