Wednesday, March 4, 2009

Workers Victims of Doctor’s Ignorance/ 医生缺乏职场卫生意识

Recently, there has been a lot of publicity about doctor’s ignorance on occupational diseases. Hence, the employer goes scout-free while workers loses out on compensation, treatment and disability benefit.

Occupational health is a highly specialized course. There are a lot of diseases related to your working environment, what we call work related diseases.

This may include heavy metal poisoning, skin disease, cancer, bronchitis, asthma, and babies with abnormalities. These are some of the common diseases associated with the employment. Many of these diseases may have originated from their work place.

Malaysia employees take on average of 4.2 days of medical leave per year. This is higher than most other countries. However, the number of cases related to occupational diseases is about 500 cases annually. This is extremely small number of occupational diseases reported yearly.

Based on projection, Malaysia should have about 60000 workers afflicted with occupation related illness every year.

This should be of great concern to the workers and the authorities. Who should take the blame? I would say the employers and doctors should shoulder the blame.

Employers in order to reduce cost often cut corners on safety measures and often if there are any occupational diseases linked to their work place, rarely workers report to the authorities. The employees of course for fear of discrimination and dismissal normally do not report on their employers.

Doctors should take the major portion of the blame for the underreporting of occupational diseases in the country.

Most general practitioners are ignorant about occupational health and hence are unable to link diseases and health problems to work place.

Often doctors treat patients based on symptoms and because of ignorance, doctors find it difficult to link diseases to work.

Doctors should undergo training on occupational health so that they get better acquainted with the potential danger posed by working environment.

It is often said that doctors don’t think about a disease, they often miss the diagnosis.

A very casual history taking and examination will in no way detect occupational diseases. Often it needs detail understanding of illness and work place.

So, the call to have specialist in the Socso panel clinics is justifiable. Most of the time, when the most common occupational disease reported to Socso, it is grossly underreported. Employees should demand their rights according to the Socso Act.

There is a need for emphasis on health and safety of workers in their work place. An employer should be directed to provide safe and healthy working environment for their staffs.

Doctors obviously need better training on occupational health, otherwise this severe underreporting of occupational related disease will continue.













呉 和豪 said...

Dato Seri Dr chua,

your's comment on this issue is very much welcomed , I will make use of this as a teaching material in next semester. We have to take care of money , mateial as well as man.不能单单只要马儿好而不给马儿吃草,同样的员工也必须得到适当的医药治疗机检查

Anonymous said...

Dear Dr. Chua,

I hope you could publish this in your Blog if it is not offensive to you.

An Open Letter from CSK:

Why as a doctor I want this government to go away??

I am a local graduate and have been in practice for 31 years. I am
basically a physician by training and received my qualifications from
the Royal Colleges in 1985. I see mainly kidney ailments and their
predisposing illnesses which usually are high blood pressure, diabetes and heart ailments.
I was in government service for twenty years and the remainder now in private practice. I run a clinic in Penang and have visitation rights to private hospitals.
When I was in government service, yes, there was much bureaucracy. But nothing of the sort we see today. There was a greater deal of
camaraderie. And although there were differences with private
hospitals or clinics, generally everyone learned to work together.
When I first opened my clinic, it was fairly a straightforward affair.
Apart from my APC (Annual Practicing Certificate), it wasjust
ensuring the clinic was adequately equipped to treat the type of patients which I knew I would be treating, and making certain I had
the type of medication I wanted to prescribe to my patients generally.
My first brush with the law, if you can call it that, came when a
group of government medical assistants and health inspectors walked into my clinic without notice and brusquely gave me a warning regarding a new rule regarding toxic waste and how we should dispose them in yellow containers recommended by the ministry. I complied.
About two years later, there were problems regarding my X-ray machine, when third parties who appeared not so knowledgeable but
apparently approved by the Ministry of Health, started walking in and out of my clinic for purposes of calibration and licence renewals. I could not quite understand why the supplier or manufacturer himself was not
allowed to service or calibrate these machines. The cost ran into
thousands of ringgit which I had to pay.
To add insult to injury, I was forced to attend Continuing Medical
Education (CME) programs run by what looked like staff who didn't know much about the programs they were conducting despite myself having a qualified radiographer to do the X-Rays. The cost of the CME programs again had to be borne by me.
And then came the PHFSA (Private Health Care, Facilities and Services Act). No one understood the need for this Act. In this
respect I must praise ex-Health Minister, Chua Jui Meng, for putting this nonsensical Act into cold storage. However Chua Soi Lek and a couple of not so clever ministry staff, typically without the approval of the very people it was going to affect in the private sector, got together and convinced the government to pass this Act in parliament.
They say that an idiot is a stupid person with a mental age below
three years, while a moron is a stupid person with a mental age of
between seven to twelve years. I am uncertain which category the
Ministry staff who conjured these laws belonged to. Even the opposition didn't or could not make much noise.
Doctors were forced to register clinics, made to pay hefty registration fees, comply by doing expensive renovations and buy
unnecessary equipment unrelated to the type of practice they had. And
despite this, the authorities can still choose to provide or not
provide a license as and when they please. Many unnecessary trips had
to be made to the Ministry which these days seemed to be staffed by
Indonesian and Manipal graduates or by doctors who have not worked a
single day as an independent doctor in a clinic of their own.
Politics was certainly not standing at the door of my clinic anymore. It had come right in and engulfed my practice with a red tape which I could not keep up with any certainty.
Despite all the noise regarding a Dr. Basmullah who pparently was
jailed pertaining to this Act, the Pakatan Rakyat has not made any clear statements if they would repeal this law and the many other
restrictions placed on medical practices by qualified, fully
registered Malaysian doctors if they came to power.
It is uncertain if Malaysian doctors would be squeezed out first by our own government or by AFTA (ASEAN Free Trade Area) when
full implementation with regard to the liberalization of medical services takes place soon.
As for now, at least, I think I have heard and seen enough. Despite
the scandalous mortality and morbidity the country faces due to the largely ignored dengue scourge and possibly many other illnesses, and despite knowing from past and current experiences regarding the tacky standards in government hospitals, they appear to be above
the law without accountability nor transparency.
For now, I have decided to take more time off from my medical practice and spend sometime now instead to focus on helping remove
this government. As a doctor in private practice, I just want
this government with all its Little Napoleons and conniving,
corrupted, incompetent, and unproductive civil servants gone.
I believe now that this government is incorrigible and beyond
redemption. The time to work as friends within the system has long
since passed. If we are to save this once beautiful and free country, it is apparent at least to me now that this government must first be removed.


Unknown said...

From what hotburger said and if that is all true, the government is very sick and need a doctor more than the people.

Why isn't send the same article (by hotburger) to current health minister ?

good to see the internet serve it purpose again.

Mike said...







NEIL said...

There are many registered who are so poorly trained that they even don't know how to take blood pressure or read simple english.I have personally come across these nurses and I personally ask them some simply questions which they only shake their heads.I don't look down on these nurses but I do pity some patients who are left at the mercy of this not well trained nurses.Some patients who have life threatening disease are been care by this nurses and a slight mistake will cost them their lives.Many death,I bet are not reported and just passed as 'natural death'.So many mistakes are being make during the course of being treated by this nurses.
It's high time that these nurses needed to be retrained before our hospital are been called a hospital of death.

Unknown said...

"...Through the last week, Malaysians have borne witness to a shameless display of belligerence and arrogance.

Violence has been done; to the Federal and State constitutions, to the Rule of Law and to all that these fundamentals represent.

War has been waged on Democracy itself. I can think of no other way to characterise events.

The Executive laid siege on the Legislature.There is no law that allows police officers to deny members of a legislative chamber access to that chamber for the business of Legislature.

An inability to resolve the imbroglio to advantage, the Barisan Nasional at the State and Federal level collectively took the law into its own hands.

That all affairs will be conducted to the exclusive convenience and the advantage of the Barisan Nasional and its leaders is more suited to a Dictatorship, in which the Rule of Law means nothing.

And if it could do this in one state (Perak), what is to stop it from acting in the same way in other states or at the federal level. Judging by the way in which it has responded to criticism over its actions these past few weeks, it would seem nothing much.

It is manifest that the Barisan Nasional considers itself a law unto itself.That is the painful truth that lies at the heart of Tengku Razaleigh’s declaration that the Constitution is dead.
-Malik Imtiaz Sarwar

Anonymous said...

Dear Dr. Chua,
Occupational health is part and puzzle of the general health of an individual. Diseases caused by occupations can also be caused by other factors. Patients whether they are on SOCSO or not should receive the best of care, if Malaysia wishes to be a first world health deliverer. Sometimes the patient receives the due care but his or her SOCSO claim is not given quickly or not given at all. Imagine how sad it is if a worker were to go for an amputation and can never work again because of occupational hazard and he or she is not eligible to receive SOCSO, even though he or she has that coverage when he or she was working before the accident. In Malaysia, government doctors are overworked. Government wards all over filled with patients. The refusal to open up an empty ward is because of financial constraint. In that case, how can a particular hospital be accreditated ? There are not enough proper equipments to go around. There is a need to improvise. Sometimes medicine are not in stock. Sometimes there are interunit quarrels between doctors because one unit may be using a particular medicine and the other unit is refused an order for the same medicine. Some doctors are really good in head knowledge. No problem if the patient is seen by him. But he does not have good communication skill with his patients. The MOH is right about this. The doctor will be playing around with his handphone while the patient is sitting there waiting for him to ask the first question. This is not a dumb doctor. This is one of the cleverest doctors but no communication skill. Then there are doctors or medical students who look like beauty queens and entertainers. That is why there are so many complaints from the public. Or there is no linkage between one hospital and another regarding the care and follow up of the patients, even though there is teleprimary conferencing or internet. The doctor is more concerned about keying in information into the computer rather than really looking at the face and really examining him. As for the poor quality, well if Maths and Science is going to be taught not in English, then what sort of medical professionals will you get ? In fact, it is ridiculous if a university graduate cannot talk in another universal language, English that is, because he or she can never be competitive. Try telling their scientific research findings in Bahasa Melayu to the international delegates or do they expect an interpretor ? Is Malaysia progressing or is she digressing ?

呉 和豪 said...

YB Dato Seri Dr.Chua Soi Lek
"This may include heavy metal poisoning, skin disease, cancer, bronchitis, asthma, and babies with abnormalities. These are some of the common diseases associated with the employment. Many of these diseases may have originated from their work place."
I think you had missed out the mental related illness which might be caused by working environment, perhaps you should make comment on that also.

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