Recently someone wrote in Malaysiakini, asking us to stop bullying junior doctors.
Wait a minute. Bullying? What bullying?
A quick look at dictionary.com tells us that a bully is a blustering, quarrelsome, overbearing person who habitually badgers and intimidates smaller or weaker people.
I’m going to ask house officers, their parents, partners or big shots who claim to be their relatives/ family friends: which part of a junior doctor’s job could be defined as “being bullied”?
Reality check here, people.
(1) ALL of us came from that place called being a junior. A beginner. ALL the top consultants were once house officers, who barely know how to clerk a patient, assess how ill the patient is, put in an IV line (which can be quite a challenge and delay your other work), let alone make a diagnosis and properly lay out a plan of treatment. Don’t even talk about prognosticating, which means predicting the outcome for each patient, days, weeks, months or years down the line.
All this needs practice. A LOT of practice. Seeing patients upon patients day in and out. Talking to them, looking at them with your eyes, brains and heart.
You can’t achieve higher levels of competency and knowledge by just seeing two patients per day, spending hours on that particular patient only while your friends (or seniors) do all the work for you.
Trust me, all those top consultants in top private hospitals, earning millions per year, had it much worse than the generation joining the medical fraternity now. Trust me, they have gone through all that and more, and they still work hard. Because they understand its importance.
(2) One may ask, did these doctors not come from five to six years of training in medical school? Surely they were taught something?
As with everything with life, learning and applying are two different things altogether. Simple example, you can read a chocolate cake recipe, but trying it out will give different results with different people, or at different times. How many tries does one need to bake a consistently delicious perfect chocolate cake?
(3) If the junior doctors complain that they come home late everyday, and need to come earlier than the rest of the team in the morning, and they think it’s unfair, well, think about it again.
When the whole team does rounds, the senior ones would want to assess the condition of the patient to be able to decide on the treatment plans. As with point number one, a junior doctor will need to learn themselves on how to make this assessment, and report their findings to the seniors, so that the seniors may correct them and guide them if they are wrong.
If the house officer does not make this effort to assess the patients before his seniors come for ward rounds, then he would miss the chance to recognise his shortcomings, to discover the many things that he does not know, hence poorer performance, ending up being an incompetent and negligent doctor.
That is why they need to come early.
(4) Dear parents and the society, what kind of doctor would you want to have treating you? One who works hard to be a better doctor? One who has experience seeing more patients? Or the one who whine about the workload they had to face without doing anything to handle the situation?
Would you rather be treated by someone who was poorly trained just because he thinks all sorts of training equal to bullying?
Would you want to be treated by someone who does not run to save your life, because hard work is too much to handle?
Would you want a doctor who has so many “big shot” contacts that he reports any attempts to properly train him as “bullying”?
Would you want a doctor who has been too arrogant to admit his mistakes, and learn from it?
The training is gruelling and the workload is huge. But it’s for one sole purpose, for them to be competent doctors who are responsible, who can be released to the society without much supervision, who know what they don’t know and when to seek help.
(5) So nowadays the news reported that there are too many doctors around, and they work shift system so they wouldn’t be so busy. But have they told you how much our healthcare burden is, and how people are getting sicker earlier?
When the glut of house officers started, they were so jobless that they only take care of three to four patients each. Just imagine, how are they going to be adequately trained if this is the case?
So the shift system was supposed to give them a better quality of life on top of making them see more patients per day.
(6) Ask junior chefs or junior accountants all over the world. How do they work? As busy, or maybe even more. Much much more.
(7) I have to say, there ARE true bullies out there. There are bullies among senior house officers, medical officers, registrars, specialists and consultants. They bully their juniors, and they bully each other. Yes, EVEN among the consultants!!
It’s not right. Personally, bullying in medicine simply means asking a junior to do what is not within the scope of their duty, example buying drinks (when they could have bought it themselves), making coffee for department meetings (on top of the thousands of things the house officer needs to do), filling up on call claim forms, or other personal things that’s supposed to be done on their own. Some call people rude names, which is uncalled for in any situation.
There are those who are gender biased, racists, or simply angry all the time, scolding everyone without reason, being totally unreasonable with their treatment plans.
These people exist in ANY profession.
(8) To tell you the truth, none of us in our right minds will scold a houseman eager to learn, competent ( or increasing their competency by the day), humble and caring. Bearing in mind, “the right mind” may mean differently according to their upbringing, as doctors are all human beings.
But having said that, don’t brand all your seniors who scolded you as being “not in their right minds” because a lot of time they were correct, or maybe they are scared because the mistakes you have made could have killed the patient, or worse, already killed him.
You really have to look into yourselves, why are you treated this way? Is there anything to make things better? Were the patients lives affected by your actions, or lack of it? Did you cause more pain to the patient? Or simply delay their discharge for another day which in turn exposes the patient to hospital acquired infection that is much much more difficult to treat?
(9) Reality check, EVERYTHING in life needs hardwork.
(10) To those house officers who drive daddies’ expensive cars and expect to be treated like a queen, who expect to have less work compared to Kancil-driving colleagues, who expect to cry and run to daddy saying “my specialist scolded me” and daddy will scold the specialist back, let me tell you something:
MONEY CAN’T BUY LIVES.
Money can’t even buy experience and competence.
Money can’t bring that poor man’s wife back to life when she’s dead because of your negligence.
Money can’t do all that.
(11) Dear parents, don’t force your children to be doctors if they are not interested. Anyone interested with something will work hard with all his heart and passion, does not mind spending days and nights to learn and perfect their skills. Those who are truly interested in what they are doing will continue to greatly contribute to that field.
If they do well in their exams, they don’t need to do medicine or engineering. They can do fine arts if that’s what they love.