GE13..

The thought of going back for the voting still haunt my soul…. The GE12 was a stunning one for me… For sometimes, I had given up hope that the opposition would perform, especially those days of working with the MOH; I just can’t figure up people would like to settle with the situation. I had heard voice but still didn’t see any changes. I been to the Health officer introduction course conducted by the state health office – specially for Medical officer working in the health side(klinik kesihatan). The course was held in a very secluded resort – Kuala Gula, I drove a few hundred km to reach there. There was 2 non-Malay MO among the 10+ who joined the courses. During the course a senior medical officer had shared her opinion with us- > she actually talked about the privileges of the Malays and “advice” the Malays MO to stand up strong and not to satisfy with the right but to build a life of themselves with pride. She quoted that Chinese had to save up since young for their children education fund but most of the Malays don’t…..

But still BN swept during the GE11….

At the night of GE12, I went to a company dinner with my family. I came back at about 11:00pm and logon to the net. There was only a handful of result..and at 3am, I woke up and saw that Selangor and Penang were taken by the Pakatan. It was a stunning one.

I am still looking for a change, and I wanted to be there if that should occur. The election would mostly held during the school holidays at the end of the year… The reason is simple, it will be a close fight and a chaotic rally leading to curfew might just happen. It would be relative safe for the children if school is closed, no Monday shutting down of school is needed in the worst case scenario…

Most of the citizen (with whatever right or not) did not benefit from the current government, only some that share a piece of the pie…most are struggling with a moderate salary – trying to buy a house and car with a forever lasting installment….

I don’t mind our minister is being paid a million/year provided the country is progressing and every citizen is paid some dividend (just like our neighbor country) every year. But what I saw was a Minister who don’t have the guts to take out his own RM24200 for a car license plate – what he is afraid of ? a check from the MACC or he is too stingy?

Still 6 more months to go…. Lets see what kinda of joke they would perform…..

money not in my pocket.....

It had been 2 months since we joined the new insurance payment scheme….the 1^st batch of revision was supposed to be declared 2 weeks ago, the management had estimated a 30% reduction on the 1^st pass…. but we had not heard a word from the claim department….

I went to the nursing department for some errand and stopped by the claim department. I met the person in charge and asked her about the result….she told me the deduction rate was 12.8%...WTH, a very good result indeed, a 10% increase of amount of bed, 20% increase of bed occupancy rate and 15% increase of investigation rate….the is a boost of 30+%....well, maybe a good bonus increment next year for us…..

Negotiation....

Pt had become more, complaint from the ward had become more… admission become more, but our pay remain the same, unlike the other attending doctor in the hospital – when pt amounts increase ,their ppf(proportional physician fee) become more….the financial controller had not show up in the ED hinting us about empty bed in the ward for quit some time. The locals had made our hospital first choice after the use of new building….

Lem was called up by the dept supt of admin and he was told that he would have to give up his govt clinic visit. The notice had not only affected his pay but also affect 2 of us. K and me… During the Tuesday, Lem would spent his morning in the govt clinic and on alternate week, he would visit the local nursing home down south. I covered for the morning session(4hrs x 4 ) and K covered for the afternoon session(6hrs x 2). The admin had told Lem that he would remain in the ED and K and I would have to do weekend shift to cover for the lost of working hours. I had been working 140-150 hrs instead of 180 for the past few months and further down cut would definitely affect my pay…

Apparently the govt clinic and nursing home is passed over to the new family physician. The initial negotiation was not smooth as all of us resisted the change and there was once an agreement that it would remain the same for a short while. But yesterday, Lem was called up again and told him that it was a go and we would have to settle the issue ourselves.

I had given up the Tuesday morning 4hrs and a Sunday night shift and go for a 27 hrs call. (I am still -3…) but 1 long call for a change of 4 tiresome mornings ED shift…. Not good but acceptable

The act had irritated us but still the admin is alarmed by our reaction.

W(the weekend locumer) would be reconsidering his locum after August as the Respiratory ward he is covering in K City is phasing out him. He had planned to get a job in slightly up north. The hospital is considering to hire him as night shift duty physician covering for ward during weekdays and continuing his weekend call….

Another round of negotiation….I hope it would be smooth….

corporate's life....

The ED had become very busy lately….our pt amount had increased 30% since 1+ months ago… still able to coup with the situation but still, the calls from the ward is another stress.Not sure what would happen and calls would be worse than ever.

The doctor’soffice is situated in between the 1^st and 2^nd floor… adimension which not supposed to exist in the building plan. It looks just likean office in a company. There is a reception hall with sofa at the entrance. Adining area with ? coffee maker and some drinks. 2 call rooms with 2 beds each.
A large area which separated into 20+ cubicles, each cubicle has a desk 2 cupboards … Boss had told Lem to pick a spot and both of us had picked a seat beside the window…. Nice view with larger space.

Not sure if Iwould stay forever but it is the first time, I had an office seat….anothermilestone for me…

The hospital even issued a discount card…. bigger and bigger it grows and become more complicated on the job....

Mourn....Fatty....

The alarm of my hand phone rang at 5:00am, I woke up and did the routine before I woke up the kids…. Fatty past away last night….Fatty was Yun’s pet hamster… Fatty(a she) was passed over to us from a church member. The man of the house was severely ill (lung cancer with brain metastasis) and the family had to split up as the lady of the house had to look after the master in the hospital. The pet owner, a girl of Yun’s age had to stay in her granny house. Fatty had to be place at the  “kaki lima” besides a dog during that periods. The family had decided to “let” Fatty go later on and we thought it was a bad move and took over Fatty.

Fatty was about 2 yrs of age when we took her in. She was quite aggressive trying to attack every object that approached her initially. After months spending times with her, she became more friendly and tamer…

We had done some reading and knew that Fatty is at her last period of her life as most of the hamster live about 1 1/2 years…. At the age of 2, she is considered very old… I knew that day would come initially. It was another year since Yun started to look after her...

Fatty had become very thin when we came back from Malaysia, We had placed her again to her old master for a period of 2 weeks during the trips. Fatty was very weak and refuse to eat during that period. I had had a check on her and found that she might be emotional disturbed by the change of environment. In the mercy of LORD, she had regained her vitality 1+ weeks later and started to eat well, but she become less active and slept more than she does….a sign of aging....

Last night, when I was feeding the Titi and Dragon Cat (the 2 hares); I found that Fatty did not came out from her strawberry cave(we bought it for her during a trip up north)…. She usually come out and sniff for food and I would feed her some vegetable… I had bad feeling about it; I took a glance at the strawberry cave and she was not moving… I took her out and found that she is not breathing. I summoned Ving and the kids…. The kids were very sad and bursting in tears….Fatty was in her sleeping posture and food was noted in her paws….

It is time, I had expected it but still....

Today, I took everyone of the house to a ground in front of our church. Conducted my first funeral service and let Fatty rest in piece… I was tearing when I said the prayers….It is a loss for everyone in the family…it was a lesson for all of us regarding life, with pain and mercy from our LORD….

Fatty, may you rest in piece , we would remember you for ever…

Attitude ... it does matter...

We had an ex colleague rejoining us few weeks back…W is Burmish who graduated from top medical school here in Taiwan. He had failed to pass the board and later ended up working in some construction site down south. He was introduced to our boss many years ago, I had just returned from Malaysia then. He was posted to ICU and ward to freshen up his skill and knowledge. He had shown poor skill and knowledge and lack of working passion then. Posted to ICU and he had placed himself in the discussion/resting/office of ICU after the morning rounds instead of busying with order and charting. The skill parts were worst as he had no idea of sterile technique… Well, Boss had asked him to leave after few months of effort. Lem had given him some ref. material for the board examination on his leaving.

Few years later, boss had told us that he had passed the board and currently undergoing training in orthopedic. Good for him, a shame seeing a medical grad earning a living on hard labour.

Well, aprox. 1 + month ago, boss had introduced him to both of us while Lem and I was doing the morning Passover.

The introduction was a little bit weird,

Boss had told us that

1.W would be standing by for trauma case in the night
2.our senior orthopedic surgeon would be covering for him /going in with him for ops in OT.

3.We can call W for large/contaminated wd which need to be done in ED

W had told us that,

1.He is good at ankle – his mentor is an ankle expert

2.He can do trauma and nerve repair is not a problem

3.He is keen to learn everything – even medical management

Boss impression – he is under probation,

W impression – he is good….

Few days later, Lem told me that he had overheard a conversation between W and the management – it seems that W is still staying in a motel rather than a unit rented by the hospital. The management had never treated a doctor in such way - > rooms/house would be ready / almost ready on arrival…Lem told me that W might be still having attitude problem…

1.W is always playing with his Ipad – whenever he sits down, no matter where he is, no matter how busy is the environment

2.A case was send up to the OR and he had sit in the ED (With his Ipad of coz)  for 30-40 mins after the patient was sent up.

Another few days later, Lem had told me that Boss is going to let him go…. And Lem told me the incident that happen for the past few weeks..

1. 1.    OR (boss doesn’t know about this…)

He had done a few ops. He had done a Total hip replacement, which had taken him a long time to decide how to make the 1^st incision, and later the procedure was completed by the surgical aide and the prosthesis sales rep.

He had done a plating which later re-ops by the senior surgeon, the plating took him 4 hrs to complete…

1. 2.    Pharmacy

He had called up the pharmacy on his OPD session asking for drug info(mainly the use, QID or TID , AC or PC) for most of the drug (Except acetaminophene and some antacid). The pharmacists were irritated by his act…

1. 3.    Ward and OPD

The nurse had complaint about his attitude and prescription…

He was in a fuss when the management asked him to leave…. He had threatened to let the hospital suffered in the future after the meeting….

This was the 2^nd orthopedic surgeon I encountered who cannot operate properly… There was this urban legend about surgical training – the senior surgeon would bar those incompetence and attitude problem training resident from entering the OT. These residents would still pass their board but eventually ended up as one who cannot operate….I think I had seen one again….

Boss might had heard some rumor in prior to hire him and that was why he had no hostel to stay in…..

Well, it is not the knowledge nor skill, it is the attitude that matters… 

ACLSI - see u next year...

I did not make it to the list…..I did bad in one station, below average on another and the rest of the 2 was ok….well, I did not get the approval of 7 examiner and thus, again I was struck off the list…

 

Well, depress I was but still, those who passed include

- one who teaches no pulse than Chest compression for child pass(shoule be no pulse and <60/min c poor perfusion) : best candidate in our group....

- shock: volume ->rate>pump (wrong sequence)

- spent lot of time on intro than on hand skill

And much much more which violate the examiner introduction of what not to be done...

Well, the chief examiner had told us that it is an evaluation which based on "luck"...don't be depress if you fail....WTF.....

 

 I felt it was my destiny, time is not up yet and next year I would give it another try….

Well, nothing much to cried about and life goes on….