Working Hour For Doctors

9:46 PM

A good friend of mine recently shared his thoughts on the issue of working hours of housemen in hospitals. His points are worth pondering, especially for enthusiastic parents whom are keen to get their children to pursue medicine.
Here are his thoughts.
The OFFICIAL working hour for a government doctor is from 8am to 5pm. The TRUE working hour for a government doctor is UNKNOWN.
Honestly, I am actually tired reading the articles or letters of people complaining about the working hours of HO in Malaysia and how these young doctors are being bullied by the system or by their seniors. I am also annoyed every time I watch the faces of my HO reluctantly come to work, like they are being forced to do it.
As with other professions, to work means TO DO YOUR JOB. You can do it splendidly, half-heartedly or not doing it at all. Most of you will say that your morning routine at work i.e. your first thing to do is to be present at your desk by 8am. Now I’m telling you that the beginning of daily routine job of every doctor in government hospital is to KNOW YOUR PATIENTS and be ready for morning ward round.
I saw doctors doing early morning round when I was a kid and when I was hospitalized during school time. I was told about it when I was a medical student and prepared myself physically and mentally. I did it and suffer every single second of it when I was an HO and believe it or not, I’m still doing it now! You know why? Because IT IS MY JOB!
By hierarchy and for the purpose of training, HO must review patients in ward and present the cases to medical officers (MO), and later to the specialists/consultants. This is the job of a doctor, has been the same and will be the same, whenever and wherever you are!

Now imagine the old days of our specialists/consultants with only few HO to know 30-40 patients in a ward. Think about it, the size of the ward is still the same. So don’t blame them when they started shouting to 20 HO in wards for not knowing the patients.
Please understand their feeling when they heard words like "maaf doktor, semalam saya on-call, tak sempat review patients" when they previously did non-stop EOD calls every month. Or "semalam saya cuti/off day" when they didn't even have the luxury of holiday and only see their parents once a year. Or "semalam saya jaga wad/cubicle lain" when they didn't have the right to choose cubicle because they had to cover the entire ward alone!
The public demands hospital/clinic to function promptly at 8am, because that is what office hour means to them. So to fulfil that demand, what time do you think specialists/consultants do their morning ward round?
If they come at 7am, the MO will come earlier to KNOW THEIR PATIENTS because it is their job. So, if they come at 6am, what time do you think the HO should come to work?
To answer that question, it goes back to my earlier premise of how you want to do your job. How much time do you need to KNOW YOUR PATIENTS? If you tend to do your job half-heartedly, I guess 30 minutes are enough for you to review 4-6 patients in a cubicle.
I used to come to work at 5am as HO because my MO roughly comes at 7am at my previous hospital. I usually allocated 2 hours to review patients in my cubicle, to know patients in other cubicles, to cover for colleagues who accidentally or purposely come late, and to trace all pending lab results. By the time the MO appears, I was usually sitting down at counter waiting for them. Then I will start presenting the cases without opening the case notes. That is what KNOW MY PATIENTS means to me!
At times, I will fight with my MO to present cases to specialist/consultant. Not to impress them, but because I was sure I know more about those patients than my MO. Sometimes, I come at night even though I was not on-call, to prepare for the morning round the next day e.g. when I’m changing ward/cubicle or when the workload was heavy and I know I won’t be able to KNOW MY PATIENTS well by doing morning review alone.
Was I being forced to do all that? I could have come at 6am or later than that if I wanted to, like some of my colleagues did and like some of you are doing now. It was all because I know that IT IS MY JOB TO KNOW MY PATIENTS. I did all that not for me, not for my MO/specialist/consultant. All was done for my patients. Because I am responsible for my patients.
That is the job of a doctor. That is the life of your sons, daughters and spouses every morning as a house officer. If you think this is hard, wait until I tell you the job for the rest of the day.
So, to all parents and aspiring doctors, think hard before you embark on this journey. To my house officers, there is no running away from it because it is your job and your patients expect you to do your job well. Your patients. Not me, not your HOD, not the hospital director, not the Director General or Minister of Health.
If you think you can handle this morning job routine, I welcome you to this profession. If you think you can be responsible to all your patients, I want you to be my colleague. If you feel happy, contented and gratified by sacrificing yourself for your patients, this is the job for you!
If not, tell your parents that you prefer a job with an 8 to 5 working hours!

Dr Aimir Ma'rof

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  1. Assalam. May I ask what are the procedures or how to know your patients?

  2. silent reader here :)

    I myself work on healthcare field, so I do know what the doc go through

    love to read all your thought, sharing and other entries Dr :)

    keep on update

  3. I used to freaking come to the hospital at 4am and go back at 10pm every single freaking day exept when im oncall..I took care of 2 wards alone..and it would take me about 2 hours to take blood from 56 dengue pts...alone


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