This was another response to the letter from Concerned Citizen. This was printed in The Star: 

 

Docs just want to be appreciated

I WISH to comment on “Stop whining, government docs,” by Concerned Citizen (The Star, Aug 12).

First of all, I would like to clarify that when we are on-call, we are doing “active call”, meaning that we have to be in the hospital for 24 hours.

This is unlike pharmacists who can stay and sleep at home when they are on-call as

they only need to come to the hospital should any problem arise.

Other healthcare personnel work according to shifts either in the morning, afternoon or at night. Therefore, they are not considered on-call and should not be paid on-call allowance.

When on-call, doctors are in the hospital 24 hours attending emergencies sometimes

even sacrificing meals and

sleep.

Most of the time the surgical doctors will be operating in the wee hours with only two to three hours of sleep if they are lucky and they have to continue the next day operating on the elective list for another 10 hours.

Mind you, we do not even have half a day off after being on-call the previous day.

The writer said that a fresh houseman commands a basic salary of RM2,458.39. I’m not sure where he got the figure but I've been in the government service for seven years and my basic salary still hasn't reached that figure.

Furthermore, the on-call allowances of RM150 on weekdays and RM170 on weekends are applicable for medical officers and not for housemen as stated by the writer.

We have accepted that on-call is part of our job scope.

We are not whining or complaining. We are used to working on public holidays. We are used to sleeping in the hospital while others are celebrating Hari Raya, Chinese New Year, Deepavali and Christmas with their love ones.

Our children are already used to staying at home during school holidays while their classmates enjoy family trips. Our children are also used to seeing their father or mother at home only 15 days a month because of on-call duties.

These are the sacrifices that we have made for the sake of our patients.

We are not complaining. We just wish that people appreciate us for what we do. It takes a doctor to understand another doctor’s plight.

A CARING DOCTOR,

Petaling Jaya.

In response to this remark, we replied with this:

 

 

We are replying to the letter from Concerned Citizen from Taiping entitled “Stop Whining, government doctors” issued on 12th August 2008. It seems that Concerned Citizen is very well versed with the fresh houseman (HO) basic salary and allowances. The fresh housemans nowadays get better pay than the senior medical officers 4-5 years ago. Currently the total sum of salary and allowances received by a senior medical officer (MO) and a fresh houseman is almost the same.

 

With regards to on call duty, in UK, doctors cannot work more than 16 hours non stop as it is impartial to the labour laws. A circular was formed by their Ministry of Health in UK to ensure that doctors do not exceed the legal working hours. They recommend doctors to rest after a 16 hour shift as judgement and managements of patients could be compromised due to lack of sleep/rest. However such labour laws do not apply here for Malaysian government doctors. It's bewildering that such a critically detailed occupation like medicine where lives of patients hang in the balance of precise medical decisions are given to the hands of doctors who have worked long 24 hour shifts. Its likely that mismanagement may occur as doctors are human and are prone to errors when physically and mentally exhausted.

 

In Malaysia, after being on call for 24 hours (I.E.: from 8 am to 8 am the next day), the doctors resume normal work in the wards immediately till 5pm. In short, the doctors work non stop for a span of 36 hours. There’s a shortage of doctors in the ward, thus the post call (after 24 hours on call) doctor is still needed in the hospital to continue on with his/her duties despite how busy it was the night before. These doctors attend a variety of cases during the call; emergency operations, CPR, intubation, child abuse case, premature babies, gun shot/stab wounds, drowning, head injuries, motor vehicle accidents, caesareans for fetal distress ..etc. Things that would keep anyone awake. This grueling on call duty would only earn us a measly RM150 a night (for MOs), which basically means RM10 an hour.

 

Concerned Citizen also mentioned that doctors (in his article Housemens) earn another RM 1000 – RM 2000 (totalling RM 5000 a month) a month for on calls. This would mean the poor chap has to do 10 to 20 calls per month as HOs earn RM 100 per on call. This poor doctor has to do on call every alternate day of his/her life (every other day) which basically means he/she has no life, as he/she would practically live, eat and sleep in the hospital. (We sleep after getting home from a call to recover. Most people do that. Its a natural body response.)

 

Basically, a senior MOs basic pay would comprise of RM 2600. Allowances would equate to another RM 1000, and on calls would provide another RM 1000 (if he/she were to do six on calls per month with RM 150 per day and weekend rounds), totalling to RM 4600. This is after 5 years of service in the government sector (MOH). Concerned Citizen should have checked his facts right before lashing out at government doctors.

 

On call pharmacists in the hospital usually do not need to stay in and do not need to attend to emergency cases in the wee hours of the night. If their services are required, the hospital will contact them via phone or page. Furthermore, if they were not paid for their overtime, they too are neglected in the sense of equal pay for equal service given. Pharmacists may be underpaid as well (which may explain why they too jump to the private sector).

 

Yes, fresh graduates of other discipline  may earn less than new doctors but our pay remains on a plateu for donkey number of years unless we specialize and progress through the ranks and by going through PTK in the government. If a doctor remains as an MO for years (chronic MO), then don't expect their pay to exceed RM 6000 in the government. As the example above, an MO of 5 years only earns a total of RM 4600 a month.

 

We are merely asking for a suitable on call payment for our efforts in view of the rising costs in Malaysia. If the government can afford to pay RM80 an hour for doctors in health clinics who attend the usual cough and cold cases, then they should consider increasing the on call allowances for MOs in the hospital settings, thus preventing doctors from leaving the government for greener pastures in the private sector. (MOs in private hospitals earn RM8000 basic salary).

 

I wonder if Concerned Citizen is aware of how taxing an on call could be. Imagine doing 8 – 10 calls per month for the past 4 to 5 years. A lot of doctors become exhausted with this lifestyle. 2 to 3 weekends in a month are spent doing on calls or doing morning rounds. It is considered as the main reason why doctors leave the government service/hospital settings to try and obtain a more comfortable lifestyle.

 

Please don't regard this as whining from the government doctors. Some of us have stayed on for years to serve the public and have furthered specialized to provide a better service. However, in view of Malaysia being a developed country by 2020, we were hoping that the working condition and salary of doctors would improve and that we would not be the minority of professionals who suffer in silence. Its a gruelling job, but somebody has to do it.