Aida Zabidi
Recently making the rounds on chat was a screen shot of a new surgeon who was complaining about training medical officers from Klinik Kesihatan (KK), or district general practitioner clinics. It was an unfortunate situation where she decided to share her thoughts on social media, but put it in a very rude manner – comparing medical officers in KK to cows and the difficulty in training them. 

Coming from KK myself, when I initially read the screenshot that was circulating around I do understand her frustration. There are times when certain doctors enter KK with the expectation that life is going to be laidback and easygoing – and there are instances of senior doctors who have stayed too long within the system and have started abusing it. 

However, to generalize something is exactly that - a generalization and not a lot of people have an idea of what goes on in KK.

KKs are not just your cough and cold clinics, which is a misconception that many have. 

We follow up the stable patients for non-communicable diseases such as diabetes, hypertension and asthma, and try to optimize the patient performance within the shortcomings of time and resources. We monitor their target end organ damage through a yearly ECG and fundus examination and relevant blood investigations. 

The Mother and Child Care clinic looks at antenatal follow up and routine paediatric follow up up to 18 months. There were a lot of things I learnt once I started serving in KK and I consider myself lucky to have been placed in Muar, which has a fantastic, dedicated team of health staff. 

I see an average of 40-50 appointment patients a day, and a higher number of outpatients depending on the day and how many staff we have available. 

Blood tests take an average of a week or two prior to coming back, and having the luxury of (practically) instantaneous results from a hospital setting, this was very different. Follow up was on an appointment basis depending on how many medical officers and how many patients we had per clinic. Medical officers would have to juggle between administrative work and clinic duties, and if there was a meeting that clashed, sometimes it would be a race between trying to reschedule all our appointments or having the resident medical assistant look at them. 

On another perspective, I was stunned myself to realize my staff nurses knew every single mother who had given birth within our district and would go to their home for home visits up to 40 days post-partum. All the mother had to do was to inform their nearest district clinic that they had given birth, and you would get free home care. Coming from an urban area, I didn’t know a single friend who had used this service. 

And the returns! 

Returns were a new word to me, which basically encompasses data collection – a job usually done by the support staff, but as YMs (Yang Menjaga) or Medical Officers In Charge, we would have to keep an eye on these KPIs and make sure that we reach those yearly targets. We would have to answer to the state if we were lagging on these. Returns would include targets for our chronic patients, screening of the general population, school visits, mental health screens – and the list just keeps on going. 

This was just the tip of the iceberg of our Health Ministry, and it was a huge eye opener to see the machinations to keep the whole system running. 

I do miss the hospital setting sometimes. On occasion, I miss the rush of acute care and trying to puzzle out the mysteries of diagnosis. On the odd occasion where I get to practice my basic life support skills, I’m thankful for the training I had as a house officer in Hospital Sungai Buloh. 

However, being in Klinik Kesihatan has taught me more about the big picture. 

At the end of the day, whether working in an acute hospital setting or a district clinic, we all have our part to play and pointing fingers or making generalizations within our profession does not help anyone – much less the very patients we are supposed to treat. 

It is more important to be the best doctor you can, regardless of where you are – to be humble, and remember the principles of the Hippocratic Oath that we are meant to practice by. To be tolerant when needed and teach when you can. To remember what it was like to be fresh and new and ignorant, and to try and better ourselves. To treat our patients how we would like to be treated. 

The surgeon is question was reprimanded and I’d like to think that she’s learnt from her mistake and will continue on in a better capacity that previously. 

After all, we are all on a path of learning.
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